• INDEPENDENT MEDICAL OPINIONS FOR VA DISABILITY CLAIMS | NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS
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Our Services

Medical Opinions for VA Disability Claims

Eight core services. Flat rate, no consultation fees. Every opinion personally reviewed and signed by David Protaziuk, MSN, APRN, FNP-C, an experienced VA C&P examiner

VA Nexus
Letter

VA Nexus Letter

$549

Links your condition to military service

VA
DBQ

VA DBQ

$249

Documents condition severity
Best Value

Nexus + DBQ Bundle

$699

Both, one condition. Save $99

Aggravation
Opinion

Aggravation Opinion

$599

One condition worsening another

TDIU Medical
Opinion

TDIU Medical Opinion

$649

Supports unemployability claims

Aid &
Attendance

Aid & Attendance

$649

VA Form 21-2680 for SMC-L / A&A

DIC Cause of
Death Opinion

DIC Cause of Death Opinion

$649

DIC Cause of Death Opinion

Rebuttal
Letter

Rebuttal Letter

$199

Answers a VA denial point by point

NEXUS (MOST REQUESTED)

VA Nexus Letter

$549

When You Need a Nexus Letter

  • You have a diagnosis but need a medical link to service
  • Your claim was denied for “no nexus”
  • Secondary condition caused by a service-connected one
  • Toxic exposure / PACT Act presumptive claim

What's Included

  • Full record review of STRs, C&P exams, and civilian records
  • “At least as likely as not” opinion with rationale
  • Peer-reviewed citations supporting the mechanism
  • Secondary opinions use the Spicer but-for standard (38 CFR 3.310)
  • Personally signed under my license and credentials
Start Nexus Letter, $549

SEVERITY DOCUMENTATION

VA DBQ

$249

When You Need This

  • You have a diagnosis and need severity documented for a rating
  • Your rating is lower than your symptoms warrant

What's Included

  • The official DBQ form for your specific condition
  • Severity, frequency, and functional impact documented
  • Completed and signed by a board-certified provider
  • Joint, back and neck DBQs: live video exam with me from your home
  • Pairs with a Nexus Letter, see the Bundle
Order DBQ, $249

BEST VALUE

Nexus + DBQ Bundle

$699

SAVE $99

When You Need This

  • You need both a nexus opinion and severity documentation
  • One condition that needs the link AND the rating evidence
  • You want the strongest single-condition package

What's Included

  • A full Nexus Letter for your condition
  • A completed DBQ for the same condition
  • Both prepared and signed together
  • Live video exam with me for joint, back and neck conditions
  • Saves $99 versus ordering separately
Order Nexus + DBQ Bundle

AGGRAVATION

Aggravation Opinion

$599

When You Need This

  • A service-connected condition made a non-service condition worse
  • A non-service condition is aggravating a service-connected one
  • You need a baseline-versus-current worsening analysis

What's Included

  • Baseline severity established from the records
  • Medical analysis of the degree of aggravation
  • Opinion framed to the 38 CFR 3.310(b) standard
  • Peer-reviewed citations and personal signature
Order Aggravation Opinion, $599

UNEMPLOYABILITY

TDIU Medical Opinion

$649

When You Need This

  • You cannot maintain substantially gainful employment
  • Your combined rating is below 100% but you cannot work
  • You need functional impact tied to service-connected conditions

What's Included

  • Functional limitation analysis across your conditions
  • Opinion on ability to sustain competitive employment
  • Tied specifically to service-connected disabilities
  • Personally signed medical source statement
Order TDIU, $649

SMC-L SUPPORT

Aid & Attendance

$649

When You Need This

  • You need help with activities of daily living
  • You are housebound or substantially confined
  • You are claiming SMC-L or Aid & Attendance

What's Included

  • Completed VA Form 21-2680
  • Documentation of ADL assistance needs
  • Clinical support for Aid & Attendance / housebound status
  • Personally signed by a board-certified provider
Order A&A, $649
Full Aid & Attendance details

Independent Medical Opinion: Cause of Death

DIC Cause of Death Opinion

$649

When You Need This

  • You are applying for Dependency and Indemnity Compensation (DIC) benefits.
  • You need a medical opinion linking a veteran’s death to a service-connected condition.
  • Your DIC claim was denied and you need additional medical evidence for an appeal.
  • You need an independent review of medical records to support the cause-of-death claim.

What's Included

  • Independent medical opinion addressing the cause of death.
  • Review of relevant medical records and death certificate.
  • Supporting medical literature and clinical evidence, when applicable.
  • A signed opinion from a qualified medical provider.
Full DIC Cause of Death Opinion details

AFTER A DENIAL

Rebuttal Letter

$199

When You Need This

  • The VA denied a claim after I prepared an opinion for you
  • The denial rests on a negative C&P exam or a rationale that does not hold up
  • The decision misread your records, your diagnosis, or your service history
  • You are filing a supplemental claim and need the VA's reasoning answered directly

What's Included

  • A point by point response to every reason the VA gave for the denial
  • Direct challenge to inadequate, inconsistent, or unsupported examiner reasoning
  • Additional peer-reviewed citations where the denial turned on the medical literature
  • Written to stand alongside the original opinion rather than repeat it
  • Personally signed under my license and credentials

A rebuttal answers a denial of an opinion I already wrote. If I have not prepared anything for you before, a Nexus Letter is the right place to start.

Order Rebuttal Letter, $199

TRANSPARENT PRICING

Priced Fairly, No Middlemen

Independent medical opinions for VA disability claims, priced fairly. Most providers charge $1,000 to $2,000 per nexus letter. I keep prices low because this is my solo practice, no sales team, no call center, no markup for middlemen.
Service
Price
What It Covers

VA Nexus Letter

$549

Medical opinion linking condition to military service

VA DBQ

$249
Disability Benefits Questionnaire — severity documentation

Nexus + DBQ Bundle

$699
Both above for the same condition. Save $99.

Aggravation Opinion

$599
Service-connected condition aggravated by (or aggravating) another

TDIU Medical Opinion

$649
Supports Total Disability Individual Unemployability claim

Aid & Attendance

$649
VA Form 21-2680 for SMC-L and A&A claims

DIC Cause of Death Opinion

$649
Independent Medical Opinion: Cause of Death

Rebuttal Letter

$199
Answers the VA's stated reasons for denying an opinion I wrote for you
LEGAL & CLINICAL AUTHORITY

Nurse Practitioner Opinions Carry the Same Evidentiary Weight as a Physician’s

Under 38 CFR 3.159(a)(1), an NP’s medical opinion carries the same weight as a physician’s in VA disability claims. The VA routinely uses NPs to conduct official C&P exams.

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David Protaziuk, MSN, APRN, FNP-C is ready to review your file and provide the high-quality medical evidence your VA disability claim needs.
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