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How much is a nexus letter?

Not everyone has a treating doctor that can write a nexus letter; if you need to pay for a forensic specialist you have options.

Paying a Bill with Dr. Finnerty:

All medical records reviews and examinations must be paid for in advance. Dr. Finnerty would be happy to email you an invoice via Square or PayPal if desired. When you pay a bill with Dr. Finnerty you are agreeing to his policies including those noted on this PDF. Paying a bill from Dr. Finnerty means that you agree to his policies related to the records review or examination.

You can learn more about fees and pay for a nexus letter or exam with Dr. Finnerty via an online checkout by going to

How much is a Nexus Letter or Exam with DBQ from Dr. Finnerty? Dr. Finnerty’s prices are very competitive. The price is a one-time, flat rate fee. Dr. Finnerty requires payment in advance, however you can apply for a payment plan through the PayPal checkout by using the “pay later” option from PayPal that may let you make interest free installment plan payments.

Nexus Letter Based on a Records Review- secondary conditions ($600)

Many times a review of your medical records is enough to write a nexus letter based on a secondary condition (and you can be located anywhere in the world to have a records review performed). Dr. Finnerty will review your records and cite relevant scientific research related to your nexus opinion for the nexus letter. This is the fee for things such as connecting sleep apnea to an already service connected PTSD (or other conditions to an already service connected psychological condition). This is also the fee for connecting psychological conditions to already service connected issues (ex: tinnitus, chronic pain, etc.). If Dr. Finnerty agrees to take your case but is then unable to write a letter he will either refund the entire $600 or you can discuss the possibility of scheduling an exam for an additional $300.

Nexus Letter Based on a Records Review- primary psychological conditions ($740)

This is for a records review (without an examination) directly connecting psychological conditions that originated during the military including due to a trauma or stressor associated with the military. It includes a non-refundable $140 fee for the time Dr. Finnerty spends even if it turns out he is unable to write a letter. If Dr. Finnerty reviews your records and determines he is unable to write a letter based on a records review alone you can upgrade to the $900 DBQ/exam fee by paying the difference in price (an additional $160) or you can receive a refund of $600 ($740-$140=$600). If Dr. Finnerty previously quoted you a different price for this service (ex: $600), Dr. Finnerty will still honor that quote through the Fall of 2021. You may also prefer to schedule a DBQ exam with him directly as it is only $160 more and includes a DBQ with the nexus statement.

DBQ (with nexus opinion if needed) Based on an In-person Examination in Columbus, Ohio or via Zoom telehealth ($900)

Advisory: Dr. Finnerty’s wait time for exams is currently long and he can likely get a nexus letter based on a records review back to you sooner if that is an option for you. Please also note that effective January 1, 2022 this fee will be increasing to $1,500 (though the fees for nexus letters based on records reviews will not be increasing). There is limited availability for exams in Dr. Finnerty’s schedule prior to 2022. Dr. Finnerty is not currently scheduling additional exams for DBQ’s and Dr. Finnerty has not decided if or when he will resume scheduling exams for DBQ’s.

In relation to when he does offer exams: Dr. Finnerty offers in-person exams in Columbus, Ohio. He does offer telehealth exams via Zoom for VA disability claims in Ohio and to a double-digit number of other states. The VA’s policy now allows for telehealth examinations from private professionals. Dr. Finnerty will examine you via telehealth or in-person for approximately 45 minutes to 90 minutes and complete the most current DBQ form from the VA’s website. The fee is a total fee that includes a records review along with the exam and DBQ. Advisory: The VA’s form has limited space for a historical narrative. Dr. Finnerty will complete this form and may include a cover letter with some additional explanation, however he will not provide a longer psychological evaluation report for this fee or extensive psychological testing. This fee includes a nexus opinion (nexus letter statement) when applicable and completing the DBQ form checkboxes with information that the VA uses for rating purposes.

You can see available appointment times for an examination and schedule an exam for a DBQ here:

You can learn more about Dr. Finnerty’s fees and pay for a nexus letter or DBQ exam here: