Independent medical opinions for mental health claims.
We prepare the evidence before physician review, match the condition to the right specialty, and return $849 if we recommend that your file should not advance. If you choose to advance against our recommendation to wait, the unsupported-opinion refund does not apply.
Start My ReviewWhat an independent opinion can address
Mental health claims turn on a medical question: is the documented diagnosis at least as likely as not connected to service, or to a condition the VA has already service-connected? A structured, physician-authored opinion addresses that question from the records.
Claims the review can speak to
- PTSD connected to a documented in-service stressor
- Depression or anxiety with onset or aggravation in service
- Depression or anxiety secondary to chronic pain or orthopedic injury
- Mental health conditions linked to sleep apnea, tinnitus or other service-connected conditions
- Aggravation of a preexisting mental health condition
- Functional impact documented in work, home and social life
The VA applies the "at least as likely as not" standard, meaning a 50 percent or greater probability. The opinion states its conclusion to that standard and explains the clinical reasoning behind it, including the records reviewed and why the evidence does or does not support the link. Where the evidence does not support the requested opinion, the physician says so.
The evidence a reviewer looks for
A diagnosis alone rarely settles a mental health claim. Reviewers look for a coherent record in which the diagnosis, the service history or service-connected condition, and the treatment timeline line up.
What strengthens the file
- A current diagnosis documented in the record
- Service records or documentation of the in-service stressor or event
- The rating decision for the service-connected condition in a secondary claim
- Treatment history showing symptoms and their timeline
- Lay statements from the veteran, family or fellow service members
- Prior C&P exam reports and VA decision letters, if any
Lay statements matter more in mental health claims than in most others, because a stressor or a change in behavior may never have been written into an official record. You do not need every document before you begin. A case specialist requests records through a separate secure intake after payment and helps identify what is missing.
Understand the medical question before you begin
These articles explain how reviewers approach the most common mental health claim theories.
The evidence veterans overlook
Why a diagnosis alone rarely proves service connection, and how lay statements, occupational impact and medical rationale fill the gap.
Read about PTSD evidenceWhen physical injuries lead to mental health conditions
How depression, anxiety and sleep conditions can be connected secondary to chronic pain, and the evidence the VA looks for.
Read about secondary claimsSleep apnea and mental health
How obstructive sleep apnea interacts with PTSD, depression and anxiety, and when a secondary connection may apply.
Read about the connectionMatched to relevant mental health expertise
Mental health cases are matched to a reviewer with relevant clinical background, including psychiatry and psychology. A Registered Nurse and Medical Coder organize the file first and confirm whether it should advance. See all services and specialties.
How it works
Secure Intake & Payment
Complete the short $899 intake for one claimed condition. Records are not required to start. A case specialist then sends a separate secure intake for records and clarification.
- Encrypted record submission
- Guidance on relevant service, VA and private records
- Stripe receipt sent separately from the welcome email
Clinical Readiness Review
A Registered Nurse and Medical Coder organize the file, identify missing evidence and confirm whether the case should advance to physician review.
- Diagnosis, stressor and treatment timeline checked
- Missing documentation identified
- Clear recommendation to advance or wait
Specialty Match & Physician Review
When we recommend advancing, a specialty-matched physician independently reviews the records, service history and lay evidence.
- Chronological record analysis
- Diagnostic criteria applied
- Evidence-based clinical reasoning
Structured Opinion
The physician authors a focused, evidence-based opinion stated to the "at least as likely as not" standard, with clear rationale.
- Nexus language the VA recognizes
- Defensible clinical rationale
- Records reviewed identified
Secure Delivery
You receive the completed written opinion securely within 14 days after Valor confirms your final required information and records are complete and ready for physician review. Many standard cases are delivered sooner.
- Secure delivery to authorized parties
- Ready for your claim or appeal
Pricing and Turnaround
The standard independent medical opinion engagement is $899 for one claimed condition. Flat pricing, never a percentage of backpay. Standard cases are completed within 14 days after Valor confirms your final required information and records are complete and ready for physician review, and many are delivered sooner.
Payment: The $899 service fee is paid at intake, not a deposit toward a second standard physician-review charge. If you follow our recommendation to wait, or the physician cannot support the opinion after we recommend advancing, $849 is returned. We retain $50 for processing. Proceeding against our recommendation to wait is not covered. Readiness review comes first; a supportive opinion or VA outcome is not guaranteed. Read our conditional refund protection for the two safety gates and their requirements.
A documentation-based review, not care
Valor does not provide mental health treatment, does not establish a diagnosis and does not create a physician-patient relationship. The physician reviews existing records and states a medical opinion. Continue to work with your treating clinicians for care, and use the VA's own resources for anything urgent.
Mental health claims & medical opinions
Still have a question? Contact us and we will help.
Can a nexus letter address PTSD, depression or anxiety?
Yes. An independent medical opinion can address whether a documented mental health diagnosis is at least as likely as not connected to military service, or to an already service-connected condition. The reviewer works from the records; the opinion cannot guarantee a VA decision.
What is a secondary mental health condition?
A secondary mental health condition is depression, anxiety or another diagnosed condition that developed because of, or was aggravated by, a service-connected physical condition such as chronic pain, sleep apnea or tinnitus. The medical question is whether the documented physical condition caused or materially worsened the mental health condition.
What evidence does the reviewer look for in a mental health claim?
A current diagnosis in the record, documentation of the in-service stressor or event or of the service-connected condition the claim is linked to, the treatment history and its timeline, and lay statements from the veteran, family or fellow service members. Lay statements can corroborate a stressor that official records never captured.
Does Valor provide mental health treatment or a diagnosis?
No. Valor coordinates a documentation-based review of existing records. The physician does not treat you, does not establish a new diagnosis and does not create a physician-patient relationship. Continue to work with your treating clinicians for care.
How much does a mental health nexus letter cost and how long does it take?
The fee is $899 per claimed condition. Standard cases are completed within 14 days after Valor confirms your final required information and records are complete and ready for physician review, and many are delivered sooner. The clock does not begin at payment.
Start with one condition.
Complete the short intake and secure payment. A case specialist follows up for records, and a specialty-matched physician reviews the evidence when we recommend advancing.
Opens in a new tab, so this page stays open. Our intake is a secure, HIPAA-compliant system that keeps your medical records encrypted and protected.
No physician-patient relationship is established. We do not guarantee outcomes or provide medical treatment.