FAQ

Disability Benefits Questionnaire (DBQ): $500

Nexus Letter (up to two conditions): $300 

TDIU (Unemployability) Letter: $300

Letter in support of Homebound Status: $300

Payment is due on the day of the appointment, prior to the start of the appointment. Prices are as noted. There are no additional fees or charges. Payment is made in the HIPAA compliant portal.

Private DBQ and nexus letter completion is generally not covered by any insurance. The Racho Group accepts cash, debit and credit card payments.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services. You will receive a Good Faith Estimate for the total expected cost of any scheduled services.

A Disability Benefits Questionnaire (DBQ) is a templated questionnaire used by clinicians in a variety of fields, to evaluate for the presence of a disorder. There are over 70 types of DBQs ranging from those that evaluate for and ask about musculoskeletal or neurological problems, to those used for mental health. There are three specific types of DBQs used to evaluate for mental health disorders. The Initial PTSD DBQ is used when evaluating specifically for a diagnosis of PTSD. The Mental Disorders DBQ is used when evaluating for any mental health disorder other than PTSD or an eating disorder  – such as anxiety, depression, bipolar, or insomnia. The Eating Disorders DBQ is used when evaluating for an eating disorder.

The completion of a mental health DBQ allows the clinician to make any necessary diagnoses and to describe how the symptoms of the diagnosed disorder/s are impacting functioning. In other words, its allows the clinician to explain to the VA how the symptoms you are experiencing are negatively impacting the quality of your relationships, work performance, education, and engagement in friendships, hobbies, interests, and life. The level of impact described in the DBQ helps the VA assign an accurate rating percentage for the disorder diagnosed, when service connection is granted. 

For VA purposes, a nexus letter, or medical opinion, is a conclusion statement written by a qualified examiner, using medico-legal language, summarizing their opinion about the case, based on current medical knowledge and all available evidence. There are three different types of medical opinions – direct, secondary, and aggravated.

A direct medical opinion states that the Veteran’s current condition was caused by, began during, or is otherwise directly related to military service.

Example:

• A Veteran experienced a traumatic event during deployment and now meets criteria for PTSD.
• A psychologist opines that the PTSD is “at least as likely as not” caused by the in-service stressor with supporting evidence.

A secondary medical opinion states that a service-connected condition caused another condition.

Example:

• A Veteran is service-connected for chronic back pain.
• The chronic pain leads to depression.
• A psychologist opines that the depression is “at least as likely as not” secondary to the service-connected back condition.

An aggravation opinion states that a service-connected condition did not necessarily cause the new condition, but permanently worsened it beyond its natural progression.

Example:

• A Veteran had mild anxiety before service or before developing chronic migraines.
• The service-connected migraines significantly worsen the anxiety.
• The psychologist opines that the anxiety has been aggravated beyond its natural progression by the migraines.

All nexus letters/medical opinions must be accompanied by a well-supported rational

Because examiners use clinical judgement, experience, and knowledge to evaluate for a disorder and write a nexus letter, it is possible for different opinions to be formed, based on a review of the same evidence/case. 

You may call, email, or send a message through our website with any questions. or to schedule your DBQ completion.

Once an appointment time is confirmed, you will receive a link to establish a portal account. This is where you will sign consent forms, make payment, join the appointment, and access the DBQ and or nexus letter later that day. 

Any documents you would like use to review can be easily uploaded into the HIPAA compliant portal.

We see patients, Service Members and Veterans throughout the week, by appointment only.

Although days and hours vary, we make it a priority to schedule appointments within 1 week of you reaching out, and  guarantee we will have all documentation to you within 48 hours of the appointment, though usually you will have them later the same day.

As a licensed psychologist, I cannot diagnose any medical disorder. However, research has shown that certain physical disorders very often develope as a result of certain mental health disorders, and the impact of certain mental health symptoms on the body. In these instances, if you are already diagnosed with the medical condition, I can provide a DBQ for mental health and a nexus letter outining the research that supports the link between the physical and mental disorder.

Examples include:

• Sleep apnea secondary to PTSD, anxiety or depressive disorders
• Gastrointestinal disorders (GERD, IBS) secondary to PTSD, anxiety or depressive disorders
• Hypertension secondary to PTSD, anxiety or depressive disorders
• Migraines secondary to PTSD, anxiety or depressive disorders
• Obesity secondary to PTSD, anxiety or depressive disorders
• Type II Diabetes secondary to PTSD, anxiety or depressive disorders
• Erecticle dysfuntion secondary to PTSD, anxiety or depressive disorders

Being denied service connection can feel discouraging, especially when you know your condition began during service or has been significantly impacted by a service-connected disability. Many Veterans leave the process feeling unheard, frustrated, or unsure of what evidence may have been missing from their claim.

A private DBQ and Nexus Letter can provide an opportunity to have your story fully heard and carefully documented. During a comprehensive evaluation, your symptoms, military history, medical records, and functional impairments are reviewed in detail. The resulting DBQ helps clearly communicate the severity and impact of your condition in a format familiar to VA decision-makers.

While no provider can guarantee an outcome, a well-supported private evaluation can help clarify important evidence, address gaps identified in a prior denial, and ensure that your experiences and symptoms are accurately represented. For many Veterans, it provides confidence that their claim is being supported by a detailed, independent medical opinion grounded in both clinical expertise and VA standards.

The DBQ completion will take up to but no more than one hour. DBQs competed for an increase usually take 30 minutes. The completed DBQ and Nexus (and or Unemployability letter) are guaranteed to be accessible to you within 48 hours of the appointment, but most often later the same day.

Yes! The VA must consider competent private medical evidence submitted by qualified healthcare providers. As a licensed psychologist with over 7 years of experience completing VA-assigned C&P mental health examinations, I have extensive familiarity with the exact standards, language, and criteria the VA uses when evaluating disability claims.

A private DBQ can be especially helpful when a Veteran has been previously denied service connection or received an unfavorable C&P exam, as it provides an additional, independent clinical perspective based on a comprehensive evaluation.

All evaluations are conducted in a Veteran-centered, respectful manner and are available via telehealth in Colorado and most PSYPACT-participating states.

A C&P (Compensation & Pension Exam) exam is an evaluation ordered by the VA and conducted by a VA clinician or VA-contracted examiner.

Its purpose is:

• To help the VA decide whether your condition is service-connected
• To assess severity for rating purposes

Key features:

• Controlled by the VA (you don’t choose the examiner)
• Examiner is often working for a VA contractor (e.g., VES, QTC, LHI)
• Focus is on answering the VA’s specific questions
• May rely heavily on record review in addition to interview
• You do not receive treatment from this examiner
• You typically do not get a copy of the full rationale unless you request your file

Important point:
The C&P examiner is essentially an independent evaluator working on behalf of the VA adjudication process.

————-

A private DBQ is completed by a licensed healthcare provider of your choosing (such as a psychologist, physician, or other qualified clinician).

Its purpose:

• To document your diagnosis, symptoms, and functional impairment
• To provide medical evidence you submit in support of your claim

Key features:

• Controlled by the Veteran (you choose the provider)
• Can be completed in-person or via telehealth (depending on provider and licensure rules)
• Based on clinical interview, record review, and professional judgment
• Can include a detailed description of symptoms and occupational/social impairment
• May be accompanied by a Nexus Letter, which addresses service connection

Important point:
A private DBQ is supporting medical evidence, not a VA evaluation. The VA must consider it, but it is weighed along with all other evidence.

All Veteran Disability Services are available in the following states: AL, AZ, AR, CO, CNMI, CT, DE, DC, FL, GA, ID, IL, IN, KS, KY, ME, MD, MI, MN, MS, MO, NE, NV, NH, NJ, NC, ND, OH, OK, PA, RI, SC, SD, TN, TX, UT, VA, WA, WV, WI, and WY.