Sworn Medical Review: Nexus Letter Prices, Physician and Terms

Sworn Medical lists a standard nexus letter at $995, including the records review. If you buy its $395 records analysis first, that payment counts toward the letter. The remaining standard-letter balance is $600.

That is useful information to have before a sales call. So is the name of the physician: Doug Mayeux, MD, whom the practice identifies as its sole opinion author. The harder questions are whether his expertise fits your medical issue, what happens if he cannot support a favorable opinion, and what follow-up work your fee includes.

I built Claim Raven, which sells software to veterans preparing claims and competes for some of the same spending. Sworn Medical contacted us requesting an accurate entry in our comparison. This review follows that request. I have not purchased the service, interviewed customers or reviewed a delivered opinion. It is an assessment of public documents checked September 12, 2026, with the limits identified below.

The short version

Sworn Medical offers a physician's independent medical opinion based on existing records. Its homepage lists a free screening call, $395 analysis credited toward a letter, $995 standard letter and $1,495 complex opinion. The practice says it does not provide VA representation or guarantee an award.

The named physician and published payment sequence make the offer easier to evaluate. Each additional related condition is $500. A secondary claim alone remains in the standard tier; a prior denial, adverse C&P opinion or appeal posture can put it in the complex tier. Get the applicable tier and total in writing.

I found no attributable independent customer accounts for this particular service in the searches described below. That leaves delivery quality, revision experience and customer satisfaction unestablished. My assessment is that the service merits consideration for a defined medical-opinion need, with the written quote and engagement terms doing important work before purchase.

What you are buying

A nexus opinion addresses a medical connection relevant to a VA claim. The buyer needs a clinician to examine the evidence and explain a medical conclusion. A useful purchasing question is therefore specific: what disputed connection will this engagement address?

Sworn Medical's service terms describe consultation, review of supplied records, a written opinion and, where appropriate, rebuttal of an adverse medical opinion. They exclude physical examination, treatment, claim preparation and representation.

That scope matters when comparing prices. A letter cannot supply an examination finding that nobody measured. A records analysis also differs from a full signed nexus opinion. Ask to see a fictional or properly de-identified example of each deliverable before choosing the paid stage.

For a prior denial, bring the decision and examination report to the screening discussion. The value of another document depends on whether it addresses the actual missing medical evidence. A general explanation of your condition may leave the reason for denial untouched.

The physician behind the practice

The website identifies the business as Sworn Medical PLLC in Utah and describes Dr. Mayeux as a board-certified emergency physician and Air Force veteran. It says he writes and signs every opinion without contractors or form-letter templates. Those are practice statements; this review did not inspect its internal production process or military records.

I checked the official NPI registry record, using its public API. NPI 1033503495 belongs to Jonathan Douglas Mayeux, M.D., with emergency-medicine taxonomy and the Nevada, Utah and Washington license identifiers advertised by the practice. The registry returned an active record, last updated September 4, 2026.

There is also an independent institutional reference: Northeastern Nevada Regional Hospital's 2025 Medical Executive Board page lists Jonathan Doug Mayeux, MD, as chair of emergency medicine. That supports a clinical professional history. The page's 2025 label does not establish his current schedule, title or availability for a new opinion.

I did not obtain a current business-registry standing certificate for the PLLC. Its entity name and state are reported from its own terms, rather than presented as independently confirmed corporate standing.

What the credential checks establish

An NPI identifies a healthcare provider. It is useful for matching a name to a professional record, but it should not be treated as proof of current license standing, board certification or competence for every possible condition.

The website supplies Nevada license 21680, Utah license 13052767-8905 and Washington license MD.70129840. It links the Nevada physician record, Utah lookup and Washington credential search. Those identifiers match NPPES, but I did not complete current standing and disciplinary-history verification inside all three state systems.

Before paying, confirm the license applicable to your engagement and the physician's current board certification directly with the issuing authorities. Also ask why emergency-medicine experience fits the particular causation question in your records. The answer should connect his experience to your issue, rather than rely entirely on the MD credential.

The site asks where you live. A records-based service should not be assumed available everywhere merely because documents can be uploaded online. Obtain confirmation that the practice can accept your case in your state.

Published prices and the credited analysis

These are the homepage prices rechecked September 12, 2026, before publication. They are the basis for the examples below.

Using that menu, analysis followed by a standard letter is $395 plus $600, totaling $995. Analysis followed by a complex opinion is $395 plus $1,100, totaling $1,495. Stopping with the analysis costs $395 for that delivered stage.

A standard letter plus one related condition would total $1,495. The equivalent complex engagement would total $1,995. Rush service would bring those examples to $1,795 and $2,295. These are arithmetic examples, not quotes for an individual case.

The site advertises flat fees without contingency or a share of back pay. It says payment occurs before review, insurance is not accepted, and reduced-fee or pro-bono capacity exists for hardship. Availability and eligibility for hardship assistance need confirmation. I found no published installment schedule to calculate or compare.

What makes an opinion complex

The practice's September 12 cost comparison and refreshed homepage agree on the $500 additional-condition charge and the standard tier for an ordinary secondary claim. Earlier versions differed during our research; the public homepage had been corrected by our final check.

The current complex tier is tied to the claim's posture: a prior denial of the condition, a response to an adverse Compensation and Pension examination opinion, or an appeal. The homepage says page count, time spent and the difficulty of the medical causation question do not independently raise the price.

I would ask for one written quote naming the condition, tier, extra-condition charge and total. For a secondary condition, describe any earlier denial or adverse opinion during screening. That lets the physician price the actual engagement rather than discover its history after work begins.

The homepage also describes a limited repricing situation when records reveal a previously unknown complex-tier trigger. Ask how consent to a revised price is recorded and what you receive if you stop after the analysis. A clear invoice should settle this before the physician begins the next paid stage.

Refunds depend on when work begins

The published terms make the start of review an important cutoff. They say advance fees are fully refundable before work begins, while analysis and letter fees become non-refundable once review starts. If the physician declines the requested opinion, unused fees for an unperformed stage are to be returned.

There is a wording gap worth resolving. The terms allow partial fees for time spent when an unfavorable assessment emerges after review. The homepage describes stopping with the delivered analysis in its repricing example. The quote should state the exact maximum retained if you pay for a letter up front and the physician later cannot support it.

Ask which event starts review, how you will be notified, and what written work you receive if the engagement stops. Those details matter more than the general phrase “honest assessment.” You may reasonably value an explanation that the evidence does not support a favorable opinion, but you should know its cost beforehand.

The terms do not promise a refund because VA denies the claim. The fee purchases professional work, with no guaranteed rating, award or acceptance of the opinion.

Revisions and disputed opinions

Several different tasks can be called a revision: correcting a wrong date, considering a record supplied late, explaining an existing conclusion, or answering a new adverse opinion. Their effort and price need not be the same.

The attorney referral page discusses revisions and separately lists rebuttal work. The terms also say an attorney-referred case's engagement letter controls when it conflicts with the public terms. A direct veteran buyer should obtain their own revision entitlement in writing rather than assume the referral offer applies.

Ask about the correction window, number of included rounds, new-record charges and the cost of a later VA response. Keep the delivered original. If a factual error needs repair, request a corrected signed version; the terms prohibit altering the physician's opinion yourself.

Records review and condition fit

The service's records-only approach can fit a question that existing medical evidence allows a physician to assess. Its limits become important when the record lacks a diagnosis, objective test, physical measurement or another necessary finding.

The practice excludes primary psychiatric opinions. A veteran seeking a PTSD or other primary mental-health opinion should ask for an appropriately qualified provider rather than infer coverage from the site's broad medical scope.

Prepare a complete set of relevant records, including adverse evidence and prior opinions. Ask for confirmation of the files received and whether missing documents prevent an opinion. More pages do not automatically produce a better analysis; a reader should be able to see which facts support the reasoning and which remain uncertain.

A nexus letter and a Disability Benefits Questionnaire are different deliverables. VA's public DBQ guidance explains the role of those forms and provider information. Confirm separately if you need a DBQ or examination. The Sworn Medical letter price should not be read as a bundle containing every medical document your claim might require.

The claims process still matters

Sworn Medical says it provides physician services rather than accredited claims representation. That is an important scope distinction. Someone can supply medical evidence without also managing your filing, deadlines or choice of review option.

One detail in the service terms deserves care: they list Higher-Level Review among possible uses of an opinion. VA's Higher-Level Review guidance states that you cannot submit new evidence in that review. Buying a new opinion does not change that restriction. Discuss the proper use and timing of any new document with an accredited representative before ordering it for a pending review.

VA also explains its own claim examination process. A private purchase does not cancel a scheduled examination. If an appointment creates a problem, contact VA or the examination contractor using the appointment instructions.

Public reviews and complaints checked September 12, 2026

Positive feedback: I did not locate an attributable independent customer account describing a completed Sworn Medical nexus-letter engagement. The physician's professional listings and the company's educational articles are not customer testimonials or evidence of a successful purchase.

Negative feedback: I did not locate an attributable complaint about a completed Sworn Medical nexus-letter engagement in the searched results. This absence does not establish satisfaction, a clean disciplinary record or a lack of disputes outside public search results.

What this means for a buyer: There is no selected customer sample from which to assess communication, delivery, factual corrections or refund handling. Ask for a fictional work sample and written service commitments. Sparse public feedback cannot establish a success rate or predict your result.

How I checked: Searches used Sworn Medical, Sworn Medical PLLC, swornmedical.com and the physician's name, including targeted Reddit, BBB and Trustpilot queries. No qualifying independent customer source pages were selected, so the selected source-page count is zero. Review dates, purchases, company responses and resolutions are unavailable. The linked practice website documents the current offer, not customer experience.

Searches also returned unrelated medical businesses and generic uses of “sworn medical.” I excluded those rather than attribute another practice's feedback to this company. The search did not constitute a complete litigation or regulatory-history audit.

Medical records and privacy

The website privacy policy describes a contact-information form and identifies Cloudflare, Resend and Google as providers involved in the website or inquiry flow. It says clinical records use a separate intake process. The practice describes that process as HIPAA compliant; I did not access or audit it.

The practical question is what happens after the consultation. Ask which clinical portal receives records, who can access them, how long they are retained, and how to obtain a copy or request deletion when permitted. A website contact-information deletion request may not govern clinical records subject to separate retention requirements.

Keep diagnoses and records out of the initial contact form and ordinary email. Use the agreed secure channel. You should not need to surrender a VA.gov or identity-provider password to hand a physician records you have downloaded yourself.

Cancellation and dispute terms

The terms select Utah law and Utah state or federal courts unless the parties agree otherwise. They include limits on certain damages and a fee-based liability cap, with an exception for liability that cannot legally be limited. Their effect in a particular dispute requires qualified legal advice.

For purchasing purposes, retain the quote, engagement letter, terms version and receipt. Make sure any promises about refunds or corrections appear in that record. If an attorney arranged the service, identify whether you or the attorney is the contracting party and which engagement document applies.

Who may find the service useful

A plausible fit is a veteran who already knows the medical question that needs answering, has the relevant records, and wants direct accountability to one named physician. The credited analysis may be useful when the veteran wants a written assessment before deciding on the full letter.

Another route may fit better when the immediate need is treatment, a new diagnosis, a psychiatric opinion, a physical examination or representation through a disputed claim. A veteran who cannot explain what the proposed letter would add should first ask an accredited representative to review the existing evidence.

Budget also matters. Before spending another $500 or more for a complex tier, establish exactly why it applies. Before buying multiple conditions, ask how each will be addressed and whether the shared records actually support separate opinions.

Alternatives and Claim Raven's different role

VA says the services of an accredited VSO representative are always free. An available representative can help review the claim and identify what assistance is needed. That does not mean the VSO supplies a physician's opinion, but it may help you avoid buying the wrong service.

A treating clinician is another person to ask about a medical opinion. Willingness, qualifications and fees vary. If comparing paid providers, use the complete written cost and specific deliverable, rather than treating every “nexus letter” as interchangeable. Our nexus-letter company comparison provides a starting point, with its source dates attached.

My commercial interest also belongs here: Claim Raven offers self-service software for understanding and organizing claim material. It does not supply a physician's signed medical opinion or accredited representation. Its public explanation describes a different role in preparation. Software cannot replace a clinician's independent judgment when that is the evidence you need.

Questions I would settle before paying

1. Which tier applies to my condition, and why?
2. Does each additional condition qualify for the $500 related-condition price?
3. Does my secondary claim have a separate complex-tier trigger?
4. What is the total after the analysis credit and every add-on?
5. What amount is retained if a favorable opinion cannot be supported?
6. Which relevant records and medical question will the opinion address?
7. Can you accept this engagement in my state, and how do I verify current credentials?
8. What corrections, revisions and later responses are included?
9. When does the delivery clock start, and is my requested deadline accepted?
10. Which clinical portal and retention policy apply to my records?

My assessment and research limits

Sworn Medical provides enough public detail to belong in a serious price comparison. I particularly value being able to identify the proposed signer and calculate the standard payment sequence before making contact. Incomplete independent credential verification and the absence of customer evidence keep this from being a recommendation based on demonstrated service performance.

For a buyer, the next useful step is a screening conversation followed by a specific written agreement. It should confirm the applicable tier and define what you pay if the medical answer is unfavorable.

This review checked public sources on September 12, 2026. Links beside the claims identify the homepage, cost article, terms, privacy policy, referral offer, NPI record, hospital listing and official VA guidance used. No clinical portal, delivered opinion, private contract, customer outcome, military record or current business-standing certificate was independently examined. State-board standing and direct board-certification verification remain incomplete. Prices and terms require another check before purchase.