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For Clinicians & Providers

Writing a VA Nexus Opinion or DBQ? Start Here.

A short, plain-language guide to what the VA is actually asking a medical provider to do — and what it is not asking you to decide. Built for physicians, NPs, PAs, psychologists, and anyone writing a Disability Benefits Questionnaire or nexus letter for a veteran patient.

Four Short Pages

What's Covered

Each page is a 3–5 minute read. Go in order, or jump to what you need.

1

What's Being Asked of You

The three things a VA claim actually needs from a provider — and the one decision that is never yours to make.

Read Page 1
2

The "At Least As Likely As Not" Standard

What VA's 50% medical-probability standard actually means in clinical terms, and how it differs from "reasonable medical certainty."

Read Page 2
3

Causation and Aggravation Are Two Questions

Why "did this cause it" and "did this make an existing condition worse" require separate answers — and separate opinions.

Read Page 3
4

Writing a Useful Opinion

Practical dos and don'ts for a nexus letter or DBQ narrative that actually holds up — language to use, and language that gets opinions returned.

Read Page 4
Reference

Full List of VA DBQs and Rating Criteria

Every public Disability Benefits Questionnaire in one searchable list, grouped by body system, with direct links to VA’s blank forms. No need to dig through VA’s site to find the right one. The rating criteria page shows what VA looks for when it assigns a percentage to common conditions.

For Practices That Treat Veterans

The Veteran Care Conversion Kit

The free pages above explain what VA is asking of you. This kit goes further: a complete guide, editable drafting frameworks for your EHR, and an intake checklist, so writing a well-structured nexus opinion or DBQ takes less time and fewer rewrites.

1. Provider’s Guide to DBQs & Nexus Letters

Plain-language training on the “at least as likely as not” standard, the record-review requirement, direct vs. secondary vs. aggravation theories, and the mistakes that get opinions discounted.

2. EHR Rationale Framework Templates

Five editable scaffolds (direct, secondary, aggravation, record-review statement, DBQ cover note) to save as macros or dot-phrases. Structure only; the reasoning stays yours.

3. Veteran Patient Intake Checklist

One page of what to gather before you draft: the claimed theory, records to request, history to document, and the fee and expectations conversation.

Single Provider License
$129

For the purchasing provider’s individual practice. Instant digital download: 3 PDFs plus editable Word versions.

Get the Kit on Etsy
Practice License
$299

The same complete kit, licensed for up to 5 providers practicing together at the same practice.

Get the Practice License

Many practices charge a fee for record review and opinion letters, so the kit can pay for itself with your first one. Providers set their own fees; no income is guaranteed.

What it is, and is not: an educational framework for organizing your own clinical opinion. It is not a fill-in-and-submit letter generator, and it does not guarantee any claim outcome. Every template requires your own findings, record review, and reasoning, and you remain solely responsible for any opinion you sign.

Terms of Use and License

Intellectual Property & Single-User License. The Veteran Care Conversion Kit is copyrighted material owned by The Veteran Roadmap. Your purchase grants a limited, non-exclusive, non-transferable license to use the kit exclusively within the purchasing provider’s individual practice (Single Provider License) or, for the Practice License, by up to five providers practicing together at the same practice. Unauthorized copying, sharing, sub-licensing, resale, or redistribution, in whole or in part and in any format, is strictly prohibited.

Limitation of Liability. To the maximum extent permitted by applicable law, the total financial liability of The Veteran Roadmap and its owner arising out of or related to this kit or its use, whether in contract, tort (including negligence), or otherwise, is capped strictly at the purchase price you paid for the kit. The Veteran Roadmap is not liable for any indirect, incidental, special, consequential, or punitive damages, including lost revenue, VA claim outcomes, professional or licensing complaints, or malpractice claims. Some jurisdictions do not allow certain limitations, so these limits apply only to the extent permitted by law.

Software & EHR Compatibility. The templates are provided as Word documents and plain-text frameworks. EHR systems differ in how they handle formatting, special characters, macros, dot-phrases, and smart text. The Veteran Roadmap is not responsible for EHR data formatting errors, system incompatibilities, or any issues arising from installing or using macros, dot-phrases, or Word templates in any EHR system. Test any template in your own system, review all inserted text before signing, and consult your EHR administrator as needed.

Free Download

Free Guide: Supporting Veterans With Legal History or Housing Instability

A free, plain-language resource for clinicians, case managers, and the Veterans they serve. Legal history or homelessness does not automatically lock a Veteran out of VA care or benefits. This guide explains where to start.

  • Veterans Justice Outreach, Veterans Treatment Courts, and re-entry support
  • VA homeless programs: HUD-VASH, SSVF, and the 24/7 National Call Center
  • Discharge upgrades when mental health led to a less-than-honorable discharge
  • Mental health disability claims when there was no in-service treatment
  • Working with an accredited Veterans Service Officer (VSO)

General information only. Not legal, medical, or financial advice.

For Veterans

Bring This to Your Provider

If you're a veteran reading this, you don't need to explain any of it yourself. Just hand your provider the link or a printed copy.

Every page on this site prints cleanly (crisis bar, navigation, and footer are hidden automatically). Use your browser's Print or Save as PDF option, or just share this page's link directly with your provider, VSO, or claims team.

Not a Substitute for Legal or Medical Judgment

These pages explain how VA's rating process reads a medical opinion, so you can write (or request) one that actually answers the question being asked. They don't replace your own clinical judgment, and they aren't legal advice.

Educational information only, not legal, medical, or claims advice. The Veteran Roadmap is not an accredited VSO, attorney, or claims agent and is not affiliated with the Department of Veterans Affairs. For help with a specific claim, a veteran should contact an accredited Veterans Service Officer.

The Veteran Roadmap is an independently operated small business and is not affiliated with, endorsed by, or sponsored by the U.S. Department of Veterans Affairs. Content is for informational purposes only and does not constitute legal, financial, or medical advice.