About Valor 4 Vet

Valor 4 Vet offers medical opinions and examinations for veterans who are seeking VA disability benefits. We work closely with both the veteran and their representative as medical experts, and we strive to ensure that every veteran’s unique situation is understood.

Valor 4 Vet strives to maintain a high standard of service and has assembled a team with superior knowledge and training compared to both VA examiners and contract examiners. Our medical experts receive training from top attorneys who specialize in the field, and they participate in regular training sessions that focus on VA disability.

Valor 4 Vet is commited to ensuring that each veteran receives a medical opinion that truly reflects their individual situation. Cases are carefully reviewed on their own facts, and if the medical evidence does not support a nexus opinion, we communicate that with the veteran or representative. Because each veteran’s story is different, the documentation we produce is unique to that veteran’s history and medical evidence. To support this commitment, our medical experts work collaboratively, with each nexus letter reviewed by more than one team member before it is finalized. All of our medical experts are certified through the VA, ensuring they have the knowledge and training to provide opinions that meet the high standard.

Additionally, Valor 4 Vet is deeply committed to advocacy and education. To achieve this, we collaborate closely with representatives and organizations that offer legal assistance to veterans. Our primary goal is to bridge the gap between medicine and veteran disability laws. Our blog is a great resource that provides valuable information related to benefits that veterans may be entitled to.

It’s important to note that while Valor 4 Vet serves as an advocate with compassion and expertise, we do not offer legal representation.

We invite you to experience the quality and dedication that define Valor 4 Vet.

Medical Expert Leadership

Bethanie Spangenberg, M.S., PA-C, is a Physician Assistant, Accredited VA Agent, and the founder and President of Valor 4 Vet, where she specializes in VA disability medical evidence, including nexus letters, Disability Benefits Questionnaires (DBQs), medical record review, and medical opinions for Veterans’ disability claims. She has worked in VA disability medicine since 2011, beginning within the VA Compensation & Pension system, where she gained first-hand experience with disability examinations, medical opinions, and how medical evidence is evaluated throughout the VA claims process. She began independently authoring nexus letters in 2013 and founded Valor 4 Vet in 2015.

Bethanie’s clinical background includes VA Compensation & Pension, primary care, urgent care, occupational medicine, and federal employee health. Her occupational health experience shapes her approach to Veterans’ disability cases by examining military job duties, repetitive physical demands, environmental exposures, mechanism of injury, disease progression, and functional impact. As an Accredited VA Agent since 2017, she combines clinical reasoning with an understanding of VA evidentiary standards to evaluate direct service connection, secondary service connection, aggravation, toxic exposures, and other complex VA disability issues.

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Bethanie Spangenberg, M.S., PA-C, is a Physician Assistant, Accredited VA Agent, and the founder and President of Valor 4 Vet, a medicolegal consulting company focused on medical evidence for Veterans’ disability claims. Her work centers on VA nexus letters, Disability Benefits Questionnaires (DBQs), medical record review, and the development of medical opinions addressing direct service connection, secondary service connection, aggravation, toxic exposures, and other complex VA disability issues.

Bethanie became a Physician Assistant in 2009 and began working within the Department of Veterans Affairs in 2010. Her involvement with VA disability medicine began in 2011 in the Compensation and Pension (C&P) examination environment. That experience provided first-hand exposure to how VA disability examinations are performed, how medical opinions are developed, and how medical evidence is used throughout the VA claims process. Her VA experience has included work involving Regional Offices, the Board of Veterans’ Appeals, and the Department of Defense.

After leaving the VA, Bethanie began independently authoring nexus letters in 2013. In 2015, she founded Valor 4 Vet to provide Veterans and their representatives with medical evidence based on comprehensive record review, current medical literature, and clearly explained medical reasoning. She became an Accredited VA Agent in 2017, adding formal knowledge of VA representation and adjudication to her clinical background.

A major part of Bethanie’s professional background is occupational medicine. She has practiced occupational health in multiple states and has evaluated work-related injuries, environmental exposures, repetitive physical demands, heat-related illness, fractures, head injuries, and other occupational conditions. She has also performed federally regulated commercial driver medical examinations as a certified Federal Motor Carrier Safety Administration examiner.

That occupational medicine background plays an important role in her approach to Veterans’ disability claims. Military service is also an occupation, with job-specific physical and environmental demands. Depending on a Veteran’s duties, those demands may include repetitive lifting, load carriage, rucking, vibration, prolonged standing, repetitive impact, awkward positioning, shift work, noise, extreme temperatures, airborne hazards, fuels, chemicals, and other exposures. Evaluating a nexus often requires looking beyond the name of a diagnosis and examining whether the Veteran’s actual duties, exposures, medical history, and disease course form a medically plausible relationship.

Bethanie’s clinical experience extends beyond occupational medicine. She has practiced in primary care, urgent care, geriatric medicine, employee health, medical-surgical specialty care, and VA Compensation and Pension. Her work has included management of complex medical conditions, acute illnesses and injuries, perioperative assessments, inpatient coverage, and care of patients with multiple interacting diagnoses.

This broad clinical background influences how she evaluates VA disability cases. Veterans frequently present with conditions that cannot be understood in isolation. Chronic disease, pain, altered function, medication effects, weight changes, mental health conditions, occupational exposures, and other medical factors may interact over many years. Bethanie’s approach is to reconstruct that medical history, identify the relevant mechanisms, review the available evidence, and explain the reasoning in clear language that can withstand review throughout the life of a VA claim.

In addition to her clinical and medicolegal work, Bethanie has developed educational programs for attorneys, Veterans Service Officers, medical professionals, and Veterans regarding VA disability medicine and the Compensation and Pension process. She developed The Compensation & Pension Exam, a Continuing Legal Education course approved through the Supreme Court of South Carolina and the State Bar of California.

Bethanie has also been invited to speak on VA disability and medical evidence for organizations including the National Organization of Veteran Advocates, the New York State Division of Veterans’ Services, and Operation Stand Down Rhode Island. Her presentations have addressed topics including VA Compensation and Pension examinations, evaluating medical opinions, common VA disability claims, and obesity as an intermediate step in secondary service connection.

Bethanie earned her Bachelor of Science with a Physician Assistant emphasis from the University of Findlay and her Master of Science with a Physician Assistant emphasis from A.T. Still University. She is an active Accredited VA Agent, maintains certification through the National Commission on Certification of Physician Assistants, and is a member of the National Organization of Veteran Advocates.

Through Valor 4 Vet, Bethanie continues to combine clinical medicine, occupational health, VA disability experience, medical research, and knowledge of the VA claims process to help develop medical evidence that clearly explains not only what condition a Veteran has, but how and why the medical evidence may relate that condition to military service.

Kelly Schneiders, FNP-C, PMHNP-BC, is a Family Nurse Practitioner and Psychiatric-Mental Health Nurse Practitioner who serves as a medical expert supporting VA disability claims through nexus letters. She has been a practicing Registered Nurse since 2007 and earned her Family Nurse Practitioner degree in 2013, followed by her Psychiatric-Mental Health Nurse Practitioner education in 2019 with certification in 2020.

Kelly brings a rare blend of behavioral health leadership and VA disability-focused work. She joined Valor 4 Vet in 2019. Since that time, she has conducted reviews of Veteran service records to determine claim eligibility, researched and authored nexus letters, and performed final quality reviews of other medical experts’ record reviews and nexus letters for accuracy.

Her clinical work includes psychiatric evaluation, medication management, and psychotherapy across adolescent through geriatric populations, including complex cases with comorbidities and substance use concerns.

Kelly is Disability and Medical Assessment (DMA) Certified.

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Kelly Schneiders, FNP-C, PMHNP-BC, is a dual-certified Family Nurse Practitioner and Psychiatric-Mental Health Nurse Practitioner whose clinical practice and VA disability expertise directly support high-quality medical opinions for veterans. Her work centers on the development of VA nexus letters that translate a veteran’s service history, symptoms, and treatment timeline into clear, medically supported reasoning.

Kelly’s foundation is built on long-term, hands-on patient care and leadership. She has been a practicing Registered Nurse since 2007 and advanced through progressive clinical roles that required careful assessment, documentation, interdisciplinary coordination, and continuity-of-care planning.

She completed her Family Nurse Practitioner education in 2013 and later pursued advanced psychiatric training, completing her Psychiatric-Mental Health Nurse Practitioner education in 2019 with certification in 2020. This dual training is particularly valuable for VA disability claims because many veterans present with overlapping medical and mental health conditions where accurate history, differential diagnosis, and longitudinal analysis are essential to a strong medical opinion.

A distinguishing feature of Kelly’s expertise is the direct VA disability focus embedded in her professional work. Since 2019, she has performed medical reviews of veteran service records and post-service records, reviewed medical research, written nexus letters, and conducted final reviews of other medical experts’ record reviews and nexus letters to ensure accuracy, consistency, and documentation quality.

Kelly’s VA-specific competency is further strengthened by formal Disability and Medical Assessment (DMA) training.

Clinically, Kelly’s psychiatric practice includes obtaining psychiatric histories and reviewing systems, providing medication management and psychotherapy services across adolescent through geriatric populations, managing crisis situations with appropriate escalation when indicated, and treating complex psychiatric conditions that often include multiple comorbidities and substance use issues. This breadth supports high-quality nexus letters because it strengthens her ability to explain symptom patterns over time and the way comorbid psychiatric and medical conditions interact.

In addition, her clinical background spans a range of settings that demand strong documentation and complex care management, including long-term care, home-based care, wound care, hospice-related work, and case management for medically complex patients.

In leadership roles, Kelly has served as a Lead Clinical Provider in a behavioral health program, with responsibilities that include managing a large provider group, performing quality assurance chart audits, conducting coding audits, supporting hiring and onboarding, and developing policies and procedures—all while still providing patient care when needed.

Across every case, Kelly prioritizes clear rationale, careful documentation, and internal consistency—so the medical opinion remains useful throughout the life of a VA claim.

Tyler J. Glisson, PMHNP-BC, FNP-C, is a dual-certified Psychiatric-Mental Health Nurse Practitioner and Family Nurse Practitioner who serves as a medical expert supporting VA disability claims through evidence-based medical opinions. He is licensed across multiple states.

At Valor 4 Vet, Tyler performs record reviews for veteran disability claims and writes and reviews nexus letters for VA claim submissions, focusing on up-to-date evidence and clear rationale.

His clinical background includes psychiatric evaluation and medication management for common mental health conditions such as depression and anxiety, along with broader primary care assessment experience—supporting whole-person analysis when mental health and medical conditions overlap.

Tyler is Disability and Medical Assessment (DMA) Certified.

CREDENTIALS & TIMELINE

AREAS OF FOCUS

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Tyler J. Glisson, PMHNP-BC, FNP-C, is a dual-certified Psychiatric-Mental Health Nurse Practitioner and Family Nurse Practitioner who contributes to Valor 4 Vet’s Medical Expert Leadership through VA disability-focused medical record review and nexus letter development. His work is built on a combination of psychiatric practice, broad primary care assessment skills, and a documentation style shaped by high-volume telemedicine environments—where clarity, completeness, and medically sound reasoning must be communicated efficiently and accurately.

Tyler’s clinical expertise spans both behavioral health and general medical care, which is especially valuable in the VA disability context. Many veterans present with overlapping conditions—mental health symptoms that interact with sleep, chronic pain, medications, metabolic risk factors, and functional impairment. Tyler’s dual certification supports a whole-person approach to reviewing evidence: evaluating the course of symptoms over time, identifying clinically meaningful patterns in treatment history, and translating complex records into a clear medical narrative that is consistent with how VA claims are evaluated.

In psychiatric practice, Tyler provides evaluation and medication management, including initial consultations and follow-up care for common conditions such as depression and anxiety, with ongoing monitoring and titration when indicated. This work strengthens the core skills required for nexus letters: careful diagnostic assessment, differentiation of symptoms, understanding functional impact, and precise documentation of response to treatment over time.

At Valor 4 Vet, Tyler’s role is explicitly VA disability-oriented. He performs record reviews for veteran disability claims, provides current evidence support for conditions related to military duties and exposures, and writes and reviews nexus letters for VA disability claim submissions. This includes synthesizing service and post-service medical records into medical reasoning that addresses common VA opinion needs such as service connection, secondary service connection, and aggravation, when supported by the record.

Tyler has also completed Disability and Medical Assessment (DMA) certification.

In addition, he has experience in educational content writing for family nurse practitioner exam preparation, which supports a teaching-oriented communication style—useful when writing medical opinions that must explain clinical reasoning in plain language for non-clinician decision-makers. Across every case, he prioritizes clear rationale and consistent documentation so the medical opinion remains useful throughout the life of a VA claim, including higher-level review.

Medical Expert Team

Psychologists ● Audiologists ● Physicians ● Physician Assistants ● Nurse Practititoners

In addition to our Medical Expert Leadership, Valor 4 Vet’s medical expert team is intentionally multidisciplinary, combining psychologists, audiologists, physicians, physician assistants, and nurse practitioners so each case is matched to the right clinical specialty and documentation standard for VA disability claims. The team’s work focuses on VA nexus letters and DBQs built from careful record review and clear medical rationale.

Core outputs include medical opinions supporting service connection, secondary service connection, and aggravation when supported by the evidence.

Across the team, our audiology expertise includes Compensation & Pension exam work, with emphasis on VBA documentation standards, forensic audiology testing and review, and medical-legal nexus opinions. The audiology team focuses on nexus letters for hearing loss, tinnitus, Meniere’s disease, vertigo, and secondary conditions.

Our mental health capability includes doctoral-level, licensed psychologists with long-term clinical practice providing diagnosis, evaluation, and treatment services, with direct involvement performing Compensation & Pension examinations.

On the medical side, our clinicians bring primary care and occupational medicine backgrounds, including workplace injury analysis, regulatory compliance, and injury management—an excellent parallel to translating military job demands into later disease development.

A major quality signal within the team is academic and teaching leadership. One of our nurse practitioners serves as graduate faculty in a nurse practitioner program and also holds leadership and teaching roles that include directing MSN programs and serving as an Assistant Professor in a Family Nurse Practitioner program.

This supports the team’s emphasis on evidence-based practice, rigorous documentation standards, and consistent clinical reasoning.

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Valor 4 Vet does not represent veterans for legal claims, does not provide legal advice, and does not provide medical advice.

If you have difficulties navigating the website please call the office at 888-448-1011.