2Paratroopers LLC
Independent Medical Opinions
Independent Medical Evaluations
For VA Disability Claimants
YOUR
CLAIM
HERE
When you're sick of d**king with the VA and decide it's time for the Mother of All Nexus Letters
Our Story
-The 2Paratroopers Story-
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Daren and Jim met in April of 1984 while awaiting a flight from Dallas Fort Worth to Basic Training at Fort Sill, OK. They were in the same platoon in Basic Training, AIT, and Jump School at Fort Benning. They were then assigned to the same battalion, 1st Bn 319th FA in the 82d Airborne Division, when they arrived at Fort Bragg, and both served as Forward Observers in the 13F MOS.
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They caroused the streets and nightclubs of Fayetteville NC and staggered their way back to Fort Bragg. They jumped into deserts, jungles, forests, and mountains together, and humped the endless klicks with rucksacks that weighed more than some of the girls they were dating. They froze, burned, and in general busted up their bodies while pushing them to extremes most people don’t think of as possible.
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And they paid the price so many veterans have. They reconnected on social media after over twenty years following ETS, and they learned that both of them had multiple conditions as their reward for their service…”service connected” in VA parlance. But getting them to be recognized as “service connected” by the VA had proven to be a challenge.
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They worked together with VA disability attorneys and learned the regulations the VA uses for evaluating medical evidence, and they built a network of surgeons (and physicists!) who could provide winning Nexus Letters for these conditions, and ultimately got their claims granted. They had cracked the code.
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And winning Nexus Letters they are! These aren’t just blurbs from “any of a list of acceptable medical experts”. These are richly cited scholarly papers from MDs specializing in the field in question, e.g., a real Doctor of Podiatric Medicine speaking to foot and ankle conditions rather than an Oncologist or Physician’s Assistant, and so on. That is the kind of probative weight you need to carry you through every roadblock and speedbump toward service-connection and believe us when we tell you the VA will place many of these in front of you.
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They call their product The Mother of All Nexus Letters, and if you ever see one, you’ll know why.
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And then you, too, will call it The Mother of All Nexus Letters.
Read This First:
A Note About Probative Weight and the 2Paratroopers Difference
We call our Nexus Letters the Mother of All Nexus Letters for a reason- we’ve cracked the code on maximizing probative weight. That is, for those of you unable to obtain a Nexus Letter from your treating physician.
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That right there- a Nexus Letter from your treating physician- is the motherlode of probative weight. Sadly, most treating physicians will not provide you with a Nexus Letter. We discovered this the hard way, and everything we see and hear “out there” confirms that our experiences are not unique.
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Theories vary as to why this is the case- physicians may be unduly concerned about being dragged in front of BVA judges to be deposed; the corporate network they work for may not allow their stable of doctors to provide Nexus Letters; maybe it comes down to their not having a way to bill you for that service.
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Whatever the case, if you can get your treating physician to write you a Nexus Letter, you’ve struck gold. Look no further. If not, look no further than this website.
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After being authored by your treating physician, the credentials of the author are the biggest determinant of the probative weight of a Nexus Letter. You want a Medical Doctor or Surgeon who specializes in the field that your claim falls under.
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You don’t want a Nurse Practitioner. You don’t want a Physician’s Assistant. You don’t want a Chiropractor.
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Similarly, you don’t want a Pulmonologist writing a Nexus Letter for your Post Traumatic Osteoarthritis. You don’t want a Radiologist writing a Nexus Letter for your Plantar Fasciitis.
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With respect to our competitors, most of them cannot offer this difference- the 2Paratroopers difference. Many will pipe up and will be quick to point out that title 38 of the CFR (code of federal regulations, the rulebook that applies to the VA) does allow for any practitioner that is licensed to practice medicine in the US to submit a Nexus Letter for consideration.
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And they’re right- any of them can. There’s a very big BUT however. According to the M21-1, Part 3, Subpart IV, Chapter 5, Section 2E, “Determining the Probative Value of Evidence”:
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“Consider the key elements listed below when evaluating the probative value and relative weight of medical evidence such as a diagnosis/assessment, prognosis, or opinion on etiology/onset:
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1) physician’s qualifications
2) expertise/specialty, and
3) experience”
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That’s the 2Paratroopers difference. If we provide a Nexus Letter, it’s been authored by an MD who specializes in the field under which your claim falls.
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That’s why we currently write Independent Medical Opinions and Evaluations for musculoskeletal claims only. We are well represented in the Orthopedic and Podiatric worlds, and we have Doctors of Physical Therapy writing our Evaluations (DBQs).
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Because we care enough to send only the very best. The Mother of All Nexus Letters.
Read This Second- The VA’s Latest Skullduggery, and
Why We Operate the Way We Do
The VA is no friend to the disability claimant, despite regulatory language to the contrary. They routinely deploy a bag of semantical tricks and absurd, little-known “guidelines” in order to deny your claim. And it’s not that they don’t like you- if they met you, they’d probably be inclined to have drinks with you or even name a child after you. And it’s not exactly their money they’re keeping you from.
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So why the bag of tricks? Why “develop to deny?” Generally, it’s because their Raters have a ginormous caseload, a productivity quota that keeps them from carefully reviewing all the evidence, and they are up against an incentive to deny that is baked into the system- the fact that claims stamped with “Denied” require less justification to their reptilian overlords than claims stamped with “Granted.”
They are also no friend to the nascent cottage industry of Nexus Letter Providers. They have become aware of our existence, and the Eye of Sauron is upon us. Please see the following blurb from a VA bulletin:
“We are safeguarding against fraud. In the past few years, we have seen a growing industry of individuals and companies marketing the service of completing DBQs for Veterans. Some have provided honest, valuable service to Veterans. However, VA has made hundreds of referrals to the VA Office of Inspector General of individuals and companies who are engaged in questionable, even fraudulent, practices that include charging high prices for completing DBQs or submitting DBQs with findings that are vastly different than the other evidence in the Veteran’s claims folder. Also, it is a requirement that DBQs submitted by a private provider must be based on an exam conducted in person. VA’s OIG recently issued an audit report about providers who were completing DBQs for Veterans remotely and recommended that VA revisit its practice of making public-facing DBQs available.”
We take particular note of the phrase “VA has made hundreds of referrals to the VA Office of Inspector General of individuals and companies who are engaged in questionable, even fraudulent, practices that include charging high prices for completing DBQs or submitting DBQs with findings that are vastly different than the other evidence in the Veteran’s claims folder.”
Also, please see the attached excel spreadsheet. This is a VA product circulated internally. This is a “Naughty Doctor List”, or “Sh*tlist” if you prefer [link to spreadsheet here]. This list is a few years old, but you get the point. The physicians referenced on the sheet are accused, in some cases wrongfully we are told, of furnishing veterans with fraudulent Nexus Letters or bilking veterans out of exorbitant sums of money for their services.
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It would seem the VA is on the lookout for “hired guns”, and is compiling lists of physicians whose work is, for good reasons or bad, provoking a side-eye from their raters. We also have reason to believe the VA is sweeping the internet for websites offering services such as ours.
We’re not winding up on that list. Our physicians are not winding up on that list. Their identities are kept private until your Independent Medical Opinion or Independent Medical Examination is ready for review. You have the 2Paratroopers guarantee that our physicians are Medical Doctors specializing in the area your claim falls under. They are also not under any kind of state administrative action or probation, which is not always the case in this business. You may verify their bonafides before paying the full amount. If you find out otherwise (you won’t), then you are entitled to a full refund.
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And we won’t take you on as a client unless our physicians, after review, believe they can help you without acting fraudulently (and they typically can). That’s also part of the 2Paratroopers Difference. We ensure maximum probative weight by maintaining maximum credibility.
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And by not winding up on any list.
Our Specialty and our Product Offerings
-Independent Medical Opinions and Independent Medical Evaluations-
At 2Paratroopers, we specialize, at least for the time being, in musculoskeletal claims (this includes Podiatry claims). There are two reasons for this:
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A) We have DEEP personal experience with these claims, and
B) These claims are sometimes the hardest to get service-connected, and therefore require the 2Paratroopers Difference!
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Depending on the circumstances, musculoskeletal claims (your joints, your spine, your bones, etc.) can be very difficult to get service-connected for a variety of reasons, in particular the One Year rule, and the Continuity of Symptomology principle. Let’s talk about these for a moment.
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The One Year rule directs that claims for a musculoskeletal condition brought to the VA within one year of separation from service shall be considered presumptive. If your symptoms become problematic enough to seek treatment AFTER one year, however, you had better have documented Continuity of Symptomology.
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“What is Continuity of Symptomology?” you may ask. The definition is as follows:
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“"Generally speaking, veterans may qualify for service connection based on continuity of symptomatology if symptoms of a chronic condition have recurred regularly, without some intervening cause, since the time they left the military. Importantly, the symptoms must be present since the time you were in service, or since a short period of time after leaving the service, despite any intermittent periods of improvement."”
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In other words, if you suffered an owie while in service, it better have caused you pain pretty continuously since you separated, and you better have documentation of that pain, ideally in the form of private treatment records.
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You and I (and the entire medical community) know that your body doesn’t work that way; that post traumatic osteoarthritis doesn’t work that way. Joint disease doesn’t occur on a schedule. Plantar Fasciitis doesn’t wait for a starter’s pistol and doesn’t work on a deadline.
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You could be a fifty-year-old office worker who served as an Infantryman thirty years prior. That rucksack that was as heavy as a neutron star and sat nice and low on your lumbar spine? It wasn’t there for your health, that’s for sure. Didn’t go on sick call for that knee pain because your First Sergeant would’ve made you pay dearly for any profile you wound up on? Of course your “service treatment records are silent” (in VA parlance) for any such complaints. Because complaints were punished.
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Nobody told you before you signed up that this would be your reward for your service, and nobody told you when you separated that you had better document any after-effects of that service from Word Go, and that you had better hold onto those documents. And nobody told you that the VA was running a stopwatch on your ailments and injuries.
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This is life as the aging combat arms veteran knows it. And this is where the 2Paratroopers Difference becomes critical. We offer:
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1) Independent Medical Opinions (aka the Mother of All Nexus Letters)
2)Independent Medical Evaluations (aka DBQs, but we offer full comprehensive workups)
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Our nexus letters are by far the best you will be able to honestly obtain for your musculoskeletal claim. They are, in essence, scholarly papers; rich with medical citations and BVA Caselaw citations and capturing the tiniest detail relevant to your claims. Previous denial for your claim? Our Orthopedic Surgeons and Podiatrists will likely spot all flaws in the VA examiner’s rationale and be able to rebut it.
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There are people in this field, acting in good faith no doubt, that will tell you to keep your nexus letter short and sweet. We understand their reasoning, and we respectfully disagree. Every little stressor your body underwent while in service cannot be captured by “short and sweet.” The peak vertical ground reaction force your joints sustained on that bad parachute landing cannot be captured by short and sweet. And…believe us on this one…every flaw in the VA rater’s rationale for denial cannot be captured by short and sweet. Most importantly- if your case goes before BVA judges, short and sweet will not help you.
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Only the Mother of All Nexus Letters will help you.
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Regarding Independent Medical Evaluations and DBQs (Disability Benefits Questionnaires), please note- the VA will, at some point in the claims process, invite you in for one or more C&P examinations and DBQ examinations. The VA’s DBQs and C&P examinations are absurdly inadequate to the task of truly identifying the real degree of disability, any real gait abnormalities (VA examiners will mark your gate as “Normal” without performing Gait Analysis, our Doctors of Physical Therapy offer real Gait Analysis), or any number of compensable conditions. They will use these exams to rule out conditions they are not designed to identify.
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Let me say that again: They will use these exams to rule out conditions they are not designed to identify.
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In theory, the VA examiners are neutral players in a system that is ostensibly “weighted on behalf of the veteran.” In practice, these exams are often used for developing “negative evidence” for “Development to Deny.” Read up on the meaning of Develop to Deny, and you’ll get a better understanding of how the system is “weighted on behalf of the veteran.”
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For an Independent Medical Evaluation, our Doctors of Physical Therapy offer the following:
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Being movement specialists, our Doctors of Physical Therapy will assess your physical movement/mobility that may be caused by stiffness, discomfort, chronic conditions, or damage from injuries. In fact, our Doctors of Physical Therapy are able to assess you for the following:
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-Musculoskeletal system (muscles, bones)
-Nervous system (brain, nerves)
-Cardiopulmonary system (heart, lungs)
-Integument system (skin, touch/feel)
Common conditions Doctors of Physical Therapists assess are:
-Back pain
-Carpal tunnel Syndrome
-Urinary incontinence
-Trigger finger/trigger thumb
-Lymphedema
-Cerebrovascular accident (CVA)
Doctors of Physical Therapy also assess conditions related to trauma which can include, but are not limited to:
-Spinal cord injuries
-Rotator cuff tears
-Temporomandibular joint disorders
-Concussions
-Chronic obstructive pulmonary disease
-Cerebral palsy
-Multiple sclerosis
-Muscular dystrophy
-Parkinson’s disease
-Cystic fibrosis
-Traumatic brain injury
An assessment may identify:
-Range of motion (active/passive) limitations
-Strength deficits
-Gait dysfunction
-Postural abnormalities
-Balance insufficiency
-Motor processing/planning difficulties
-Sensation/coordination impairments
-Cranial nerve deficiency
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If you’re interested in the best Nexus Letter possible or the best Physical Therapy workup possible from the most highly-credentialed medical experts in this business, please contact us and pull the trigger on the 2Paratroopers Difference!
Our Process
For the Mother Of All Nexus Letters, the process is fairly simple:
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Step One- You contact us and we have a chat about your needs and how we can best meet them.
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Step Two- If you choose to proceed with us, you will pay $400 and we will conduct a complete review of your existing evidence (your Claim File if you have it) and we make a determination as to whether or not we can establish nexus. This advanced review and the fee that comes with it are necessary. A physician’s time does not come freely. You can generally expect the review to take place within 7-10 calendar days.
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Step Three- If we determine we can establish nexus, and you’d like us to proceed, you will pay $650 and we will get started on the nexus letter. You can generally expect a turnaround of 7-10 business days for this. Once it is completed, we will present it to you in redacted form. You don’t get the whole thing yet. You will get a sense, though, of the majesty of the Mother of All Nexus Letters. If you like what you see (you will), we move on to Step Four.
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Step Four- You will pay the final $650 and receive the signed and unredacted Mother of All Nexus Letters.
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We understand it’s not the swiftest turnaround in this business, nor is it the slowest. Also, we do not offer rushed service. As much as we love all veterans, our physicians cannot make your lack of planning their emergency. Our physicians have thriving practices of their own, and those dominate their time. Once they are able to turn their attention to your case, however, you’ll be over the moon with the result and overjoyed you retained 2Paratroopers.
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Independent Medical Examinations- these are determined on a case-by-case basis. They are much more involved in terms of moving parts, and require an in-person appearance in Las Vegas (more on this shortly) in order to be examined by one of our Doctors of Physical Therapy. The rewards far outweigh the costs of the journey, however. After being presented with one of our Independent Medical Evaluations, your lawyer or agent may be able to prevent you from having to cooperate with the VA’s scheme of obtaining negative evidence (remember Develop to Deny?) in the form of their VA-provided DBQs.
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Regarding the requirement for an in-person examination: an in-person exam is required for the completion of a DBQ. For any Independent Medical Evaluation to have any probative value, the exam NEEDS to be completed in-person. Many physicians have come under scrutiny for completing these without an in-person examination. At best, the evaluation will have no probative value; at worst, the physician and veteran are both exposing themselves to the risk of criminal indictment for lying about an in-person exam that never took place.
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If you are interested in obtaining that evidence, we will arrange a time for you to speak in advance with one of our Doctors of Physical Therapy so that they can determine the kind of workup you need.
For the Mother of All Nexus Letters- $1500 total per nexus. What do we mean when we say “Per nexus” you may ask. We mean per single event or circumstance that resulted in one or more conditions.
For example, you may have had a bad parachute landing. That landing resulted in spine, hip, and knee conditions. That’s a single nexus that resulted in one or more compensable conditions.
On the other hand, you may have also fallen off the hood of a jeep and sprained your ankle. That’s an entirely different nexus from the first one, and therefore would require an entirely separate nexus letter.
Additionally, force calculations may be necessary or desirable in your case. Again, an example would be a bad parachute landing as the event, and you’d like us to calculate the peak vertical ground reaction force your joints were subjected to upon landing. We have retired physicists and mathematicians that provide those calculations for us. The fee for this service is $250-$500, depending on the complexity of the circumstance and the calculations.
For Independent Medical Evaluations/DBQs, these fees are determined on a case-by-case basis. If you’re interested in this offering, we’ll connect you with one of our Doctors of Physical Therapy and the two of you can discuss the workup you need and the fees that would be applicable.
Our Fee Structure
