Harvard-Trained Psychiatrist | Board-Certified MD | 1–2 Week Turnaround | $1,000
Post-Traumatic Stress Disorder (PTSD) is a psychiatric condition that develops after exposure to traumatic events during military service. For veterans, PTSD is one of the most common service-connected mental health conditions, affecting approximately 11-20% of veterans who served in Operations Iraqi Freedom and Enduring Freedom, according to VA research.
PTSD manifests through four primary symptom clusters defined by the DSM-5:
Common traumatic exposures for veterans include combat operations, improvised explosive device (IED) blasts, witnessing casualties, military sexual trauma (MST), and operational stress from repeated deployments.
Did you know?
The VA recognizes PTSD as one of the most common service-connected disabilities, with over 1.3 million veterans currently receiving disability compensation for PTSD.
To establish service connection for PTSD, the VA requires three key elements:
A formal condition documented in medical records
from a qualified mental health professional (psychiatrist, psychologist, or licensed clinical social worker) based on DSM-5 criteria. The documented condition
must be supported by clinical evidence including symptom Independent Medical Opinion, psychiatric history, and functional impairment record review.
Evidence of a traumatic stressor that occurred during active military service. For combat veterans, this can be established through service records, deployment history, combat action ribbons, or lay statements. The VA has relaxed evidentiary standards for combat-related PTSD.
A medical opinion establishing that your current PTSD is “at least as likely as not” (50% or greater probability) caused by or aggravated by your military service. This is where a nexus letter becomes critical.
Primary vs. Secondary Service Connection for PTSD:
Primary Service Connection: Your PTSD is directly caused by a traumatic event during military service (e.g., combat exposure, MST, training accidents).
Secondary Service Connection: Your PTSD developed as a consequence of another service-connected condition. For example:
Important: “At Least As Likely As Not” Standard
The VA uses a 50% probability standard. Your nexus letter must state that it is “at least as likely as not” (≥50%) that your PTSD is related to your military service. This is a lower burden of proof than “more likely than not” (>50%).
A PTSD nexus letter is a critical piece of medical evidence that bridges the gap between your current documented condition and your military service. For background, see our overview of what a nexus letter is. Here’s why it matters:
VA C&P examiners often lack the time or expertise to thoroughly review complex psychiatric histories. A comprehensive nexus letter from a board-certified psychiatrist provides the medical reasoning the VA needs to approve your claim.
If you receive a negative Compensation & Pension (C&P) exam, an independent nexus letter provides a competing medical opinion that the VA must consider. This is especially powerful when from a psychiatrist with superior credentials.
For denied claims, a detailed nexus letter can be the difference between continued denial and approval. The Board of Veterans’ Appeals (BVA) frequently remands cases when strong medical evidence is introduced.
A strong nexus letter cites peer-reviewed research, epidemiological studies, and clinical practice guidelines that support the connection between your military experiences and your PTSD symptoms.
An effective PTSD nexus letter includes:
See how our record review works to get started.
Not every letter labeled a nexus letter for PTSD carries weight with VA raters. A strong one contains specific, verifiable elements:
If you are comparing providers, ask whether their nexus letter for PTSD includes every element above. A one-paragraph note from a clinician who has not reviewed your records rarely does.
✓ Harvard-trained
✓ Board-Certified Psychiatrist
✓ VA System Experience
Board-Certified by the American Board of Psychiatry & Neurology (ABPN)
✓ Trauma-Focused Expertise
✓ Evidence-Based Approach
Dr. Lee specializes in PTSD and trauma-related disorders, with deep understanding of the unique mental health challenges faced by veterans. His nexus letters combine psychiatric expertise with knowledge of VA regulations and evidentiary standards.
Discuss your PTSD claim and military history. We’ll explain the nexus letter process and answer questions.
Provide military service records, VA medical records, C&P exam reports, and any private treatment records.
Dr. Lee conducts a comprehensive records review and psychiatric Independent Medical Opinion. Record reviews and nexus letters are available to veterans in 44 eligible states; a clinical interview via a secure electronic platform is available to verified Massachusetts and Florida residents.
Receive your comprehensive PTSD nexus letter within 1–2 weeks, on average, from the time of the $500 record review/deposit and receipt of all needed records.
No hidden costs. No hourly billing. One comprehensive PTSD nexus letter for $1,000.
Turnaround Time: Within 1–2 weeks, on average of payment and receipt of required documents
Delivery: Digital PDF via secure email, ready to submit to VA
Our PTSD nexus letters are $1,000 per condition. This includes comprehensive records review, psychiatric Independent Medical Opinion, medical literature research, and a detailed nexus opinion letter. No additional charges.
Here’s how to get a nexus letter for PTSD: begin through the chatbot on this website (bottom-right corner), which guides you through registering with CharmHealth and securely uploading your records — DD-214, service treatment records, VA medical records, and any C&P exam reports. Dr. Lee then completes a comprehensive records review and, if the evidence supports it, prepares an Independent Medical Opinion stating whether it is at least as likely as not that your PTSD is connected to your service. The nexus letter is $1,000 per condition, with a separate $500 record review.
Within 1–2 weeks, on average, from the time of the $500 record review/deposit and receipt of all needed records. Expedited processing, for qualifying cases, in 3 business days for $800.
For a PTSD nexus letter, we need:
No. A nexus letter is strong medical evidence, but the VA makes the final decision based on all evidence in your claim file. However, a well-written nexus letter from a board-certified psychiatrist significantly improves your chances of approval, especially when VA examiners provided unfavorable opinions or when the medical causation is complex.
Our comprehensive PTSD nexus letters include:
Typical length: 8-15 pages depending on case complexity.
For verified Massachusetts and Florida residents, a clinical interview can be conducted via a secure electronic platform. For veterans in other eligible states, the Independent Medical Opinion is based on a comprehensive records review. Dr. Lee is board-certified by the American Board of Psychiatry & Neurology (ABPN)
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