For attorneys and accredited representatives
Independent Medical Evidence That Holds Up
Your case theory is solid. The service history is there. What the VA needs next is independent medical evidence that stands up at every level of review. That is the part we handle.
Patriot Path writes physician-authored Independent Medical Opinions (IMOs), nexus letters, and DBQs for veterans law firms and accredited representatives. You litigate. We supply the medical opinion, written by a licensed clinician whose credentials hold up to scrutiny.
How We Support Your Practice
We are the medical evidence partner, not co-counsel. Here is what we deliver.
Independent Medical Opinions (IMOs).
Records-based opinions built for appeals - initial claims, supplemental claims, and Board of Veterans' Appeals matters.
Nexus letters.
Condition-matched medical opinions using the required probability language ("at least as likely as not"), with the rationale spelled out, not just the conclusion.
DBQs.
Disability Benefits Questionnaires prepared to VA evidence requirements where the claim calls for one.
Full record review.
Service treatment records, VA rating decisions, and current medical documentation - read in full before a clinician writes anything. No in-person exam required.
Every opinion is authored and signed by the credentialed clinician named on the letter. No templates. No boilerplate. No AI-generated text.
Capabilities and Specialties
Toxic exposure
Our lead specialty. Burn pits, Agent Orange, Camp Lejeune, radiation, jet fuel, AFFF and PFAS, solvents and asbestos, and the cancers and chronic conditions tied to them, including the newer PACT Act presumptive paths. It is the area where the medical link is hardest to document and where a well-reasoned opinion moves the needle most, so it is where we go deepest.
- Burn pits
- Agent Orange
- Camp Lejeune
- Radiation
- Jet fuel
- AFFF and PFAS
- Solvents
- Asbestos
- PACT Act presumptives
Pick an exposure to see the chemical cross-walk our physicians use to build a direct service-connection link when a presumption does not apply. The same science behind a presumptive condition can support a direct claim, which is where a reasoned medical opinion decides the case.
The chemicals you were exposed to, and what they cause
Burn pits and airborne hazards carries chemicals that also show up in other exposures. Some conditions they cause are already presumptive for a different program. If you have one of these and you are not presumptive here, you are not stuck. The same science can support a direct service-connection claim, which is exactly what a nexus letter is for.
Also found in: burn-pit smoke, sand, dust, and oil-well-fire smoke.
Linked conditions
- Asthma
- Chronic rhinitis
- Chronic sinusitis
Already presumptive under PACT Act (burn pits). If you were exposed to fine particulate matter a different way, you do not get that presumption, but a physician can connect these conditions to your exposure with a nexus letter. It is decided case by case, which is why the medical opinion matters.
Source: Airborne hazards and burn pit exposures (VA Public Health)
Also found in: Agent Orange, plus the smoke from burn pits, diesel exhaust, and jet-fuel combustion.
Linked conditions
- Ischemic heart disease
- Parkinson's disease
- Soft-tissue sarcoma
- Non-Hodgkin's lymphoma
- Chronic B-cell leukemias
- Type 2 diabetes
Already presumptive under Agent Orange. If you were exposed to dioxin (tcdd) a different way, you do not get that presumption, but a physician can connect these conditions to your exposure with a nexus letter. It is decided case by case, which is why the medical opinion matters.
Source: Toxicological Profile for Chlorinated Dibenzo-p-Dioxins (ATSDR via NCBI)
Also found in: jet fuel, burn-pit smoke, and the contaminated water at Camp Lejeune.
Linked conditions
- Acute myeloid leukemia
- Myelodysplastic syndromes
- Multiple myeloma
- Non-Hodgkin's lymphoma
Already presumptive under Camp Lejeune. If you were exposed to benzene a different way, you do not get that presumption, but a physician can connect these conditions to your exposure with a nexus letter. It is decided case by case, which is why the medical opinion matters.
Source: Report on Carcinogens Profile: Benzene (National Toxicology Program, NIH)
This shows possible pathways, not a decision on your claim. Whether a condition connects to your exposure is a medical judgment, made case by case. It is not medical or legal advice.
Beyond toxic exposure
We pair every case with a clinician matched to the condition at issue. Conditions we routinely cover:
- PTSD and MST-related PTSD
- Sleep apnea / OSA
- Depression and anxiety
- TBI
- Tinnitus and hearing loss
- Cancers tied to exposure
- Diabetes
- Heart disease and hypertension
- Knee and joint conditions
- Erectile dysfunction and other secondary conditions
For secondary-condition theories, where one disability flows from another, we document the medical link between them. We do not stretch an opinion past what the record supports. If the evidence is not there, we tell you.
How a Firm Submits a Case
Straightforward, and built so you spend zero time chasing us.
- 1
Complete the intake form
Your firm's contact information and your preferred billing method. No case details needed at this stage.
- 2
We contact you
A Patriot Path coordinator reaches out within 1 to 3 business days to confirm your firm's workflow, billing arrangement, and intake preferences.
- 3
IMOs delivered to your firm
Submit cases as your docket requires. A specialty-matched clinician authors each opinion and delivers it to you, ready for submission.
Records move through a HIPAA-compliant portal. Nothing over email.
What you get back
A finished medical opinion that includes:
- A summary of the evidence reviewed
- A condition-specific nexus rationale, not just a conclusion
- The medical opinion stated in the required probability language
- The signature and verifiable credentials of the authoring clinician
- The benefit-of-the-doubt standard under 38 C.F.R. § 3.102 applied where it fits
Most opinions are delivered within 5 to 10 business days of when we receive the complete records. If a case needs it sooner, rush service delivers within 3 business days for a flat $300.
Why Firms Partner With Patriot Path
- Consistency. Every opinion follows the same evidentiary structure - evidence reviewed, condition-specific rationale, stated conclusion. You know what you are getting each time.
- Physician credentials that hold up. Licensed clinicians, credentials verifiable on request by your firm and by the VA.
- We pre-screen before you commit. We review the file first. If the opinion can't be substantiated, we tell you before you spend a dollar - not after.
- Specialty matching. Each case is paired with a clinician in the relevant discipline.
- Built for appeals. Opinions are written to address the specific nexus deficiencies named in prior rating decisions or Board remands, to the rationale standard in Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008): a medical opinion carries weight because of the reasoning behind it, not just the conclusion.
- Secure by default. HIPAA-compliant records transfer. Nothing over email.
Learn more about our attorney partnership opportunities.
Billing and Volume
Two billing paths, your choice:
- Firm invoicing. We invoice your firm directly. This is the common arrangement for higher-volume practices.
- Direct client billing. Refer your veteran client and we handle billing with them directly, at $1,500 per engagement (up to 5 conditions).
You pick your preference on the intake form.
Volume and retainer: No minimum volume. No retainer. Submit cases as your docket requires, whether that is one case or many.
For VSOs and Accredited Representatives
If you work with veterans through a VSO or as an accredited representative, and an individual veteran in your care needs independent medical evidence, you are welcome to share our name with them. To be clear, this is not a referral arrangement: no fee, no split, no partnership. The veteran reaches out to us directly and works with us on their own. We just want veterans who need a nexus letter or IMO to know we are here.
Frequently Asked Questions
What case information do you need?
All available service treatment records, VA rating decisions, and current medical documentation. Our clinicians document a clear, condition-specific nexus rationale and cite the evidentiary basis for each opinion. No in-person examination is required.
How do your letters hold up on appeal?
Each opinion includes a summary of the evidence reviewed, a condition-specific rationale, and a stated conclusion using the required probability language. Letters are physician-authored and condition-matched, written to the rationale standard in Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008): the supporting reasoning is what gives a medical opinion weight on appeal.
Can my firm pay directly, or does my client pay?
Both work. Firms can be invoiced directly, which is the preferred arrangement for high-volume practices. Or refer your client and we bill them directly at $1,500 per engagement, covering up to five conditions. You select your preference on the intake form.
What is your turnaround?
Most opinions are delivered within 5 to 10 business days of when we receive the complete records. If a case needs it sooner, rush service delivers within 3 business days for a flat $300. Our intake team reaches out within 1 to 3 business days of your submission to confirm details and coordinate records.
Do you work cases at the Board level?
Yes. Initial claims, supplemental claims, and Board of Veterans' Appeals matters. Opinions are written with the appellate record in mind and address the nexus deficiencies named in prior decisions or remands.
Can I submit multiple cases at once?
Yes. After you submit the intake form, our team can set up a preferred intake workflow for ongoing referrals and coordinate multi-case submissions. There is no minimum volume and no retainer; submit as your docket requires.
Are your opinions built to current VA exam-evidence standards?
Yes. Every opinion is individually physician-authored with a condition-specific rationale, not AI-generated or templated. That aligns us with the standards behind the proposed FRAUD in VA Disability Exams Act (H.R. 5723 / S.3000, 119th Congress), which targets boilerplate and fraudulent DBQ submissions. As of June 2026 those bills are still in committee, not yet law.
Ready to Partner?
We work with VA disability attorneys and accredited representatives nationwide, out of Franklin, Tennessee.
3401 Mallory Lane, Suite 100 · Franklin, TN 37067 · Info@patriot-path.com