*Current turnaround time for Nexus Letters is 2 weeks maximum. 48-hour turnaround is available for a fee.
*Exam/DBQ appointments are scheduling 1-2 weeks out, but expedited services are available for a fee.
Services We Provide
Independent Mental Health Exam with DBQ
For Dr. Miller to complete a nexus letter, a confirmed diagnosis for your claimed mental health condition must be documented in your current medical records. If this is not the case, you would need a mental health evaluation (performed via VA required secure video telehealth), resulting in a "DBQ" - an official VA form that documents your current mental health diagnosis, symptoms, and level of severity. You will also need an exam/DBQ (NOT a nexus letter) if you are applying for an increase in your current service-connected mental health disability. We can perform telehealth exams in Florida (TPPY1790), and in 40 states covered by PSYPACT - click here to see if your state is on the list*. We CANNOT currently provide DBQs outside of the USA or for the following states/territories: Alaska, California, Guam, Hawaii, Iowa, Louisiana, Montana (until 10/1/2025), New Mexico, New York (pending legislation), Massachusetts (pending legislation), Oregon, Puerto Rico, U.S. Virgin Islands. If you need to establish a current mental health diagnosis and symptom severity level, click below.
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Independent Medical Exam Fee: $650; add a nexus letter for $325 ($975 total for DBQ + Nexus)
Nexus Letter/
Medical Opinion
The crux (or "nexus") of your case is to connect your current disability to your time in service through a direct, secondary, or aggravation connection. This requires a medical opinion from a mental health expert. Dr. Miller has expertise in writing nexus letters and medical opinions that meet a high quality standard and adhere to the very specific language that the VA requires in medical opinions. We understand the elements necessary for a nexus letter to be considered strong by VA reviewers. Nexus letters may be written based on your existing records (without the need for an exam), but if your records do not contain enough information we will advise you on this during our record review process and recommend a full exam to create the strongest letter in support of your claim. Dr. Miller can provide Nexus Letters in all 50 states if you have a confirmed, active mental health diagnosis in your current medical files, or if you have a confirmed physical disability that is caused by your service-connected mental health condition (e.g. migraines caused by PTSD).
Nexus Letter Fee: $650 for one condition; $100 for each additional condition (multiple mental health disorders count as 1 condition)
Total Disability Individual Unemployability (TDIU)
Total Disability Individual Unemployability, or TDIU, is a rating for veterans who can’t work due to their service-connected disability. You might qualify for TDIU if you have either a single service-connected disability rated at 60% or higher, or two or more service-connected disabilities with a combined rating of 70% or higher, and at least one of those disabilities must be rated 40% or higher. Additionally, you must demonstrate that you are unable to maintain "substantially gainful employment" due to their service-connected disabilities. If you qualify for TDIU, it may be helpful to your case to have a letter of support from a medical expert who can provide an official opinion on the ways your service-connected mental health disability keeps you from being able to work. Dr. Miller has conducted TDIU exams on behalf of the VA, so she knows the specific details the VA considers important for TDIU cases. You would need to supply your mental health disability information, employment records, and a strong personal statement about how your mental health affects your ability to work.
TDIU Letter Fee: $650
Claims We Assist
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Direct Service Claims
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Secondary Service Claims
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Aggravation Claims
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Severity Increase Claims
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TDIU
Conditions We Assist
Our providers can assist with claims for mental health and psychiatric conditions only. This includes but is not limited to direct, secondary, or aggravation claims for disorders on a direct basis or secondary to your other service-connected disorders like tinnitus, hearing loss, and chronic pain conditions:
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Somatic symptom disorder
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Adjustment disorders
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Mood disorders - Depression, Bipolar, etc.
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Anxiety disorders
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Eating disorders
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Psychotic disorders - Schizophrenia, etc.
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Insomnia
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PTSD
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and more
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Physical conditions secondary to mental health:
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sleep apnea secondary to depression, anxiety, PTSD, etc.
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diabetes secondary to depression, anxiety, PTSD, etc.
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headaches secondary to depression, anxiety, PTSD, etc.
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autoimmune disorders secondary to depression, anxiety, PTSD, etc.
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Our Practice Locations
We can provide services based on records reviews for veterans in any location. Exams can only be provided in certain locations within the US - no exams can be provided for veterans located outside of the USA due to licensing regulations.
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We can perform video telehealth exams in Indiana (20042889A), Florida (TPPY1790), and states covered by PSYPACT - click here to see if your state is on the list*. *PSYPACT states are colored in dark blue on the map We CANNOT currently provide DBQs for the following states:
Alaska
California
Guam
Hawaii
Iowa
Louisiana
Montana (until 10/1/2025)
New Mexico
New York (pending legislation)
Massachusetts (pending legislation)
Oregon
Puerto Rico
U.S. Virgin Islands
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We do not provide in-person exams. Telehealth only.
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Total Price List
We keep our fee structures clear and low to best serve veterans. We only charge what is necessary for our actual time and expertise. We never inflate our costs beyond the time required to complete your services. We deeply respect our veterans and consider it an honor to provide high quality services at a lower cost than many other providers. The prices below are FINAL costs with no extra surprise fees.
Nexus Letter: $650 total for one condition; $100 for each additional condition (Multiple mental health disorders count as 1 condition)
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Independent Exam/DBQ: $650 total
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TDIU Letter: $650 total
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Exam/DBQ plus Nexus: $975 total for one condition; $100 extra for each additional condition
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Current turnaround time for completing your DBQ and/or nexus letter is 2 weeks maximum.
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