VA Form 21-22a, Appointment of Individual as Claimant's Representative, is an official form used by the Department of Veteran Affairs (VA) in order to select a veteran's representative to claim VA benefits. This form will allow the VA to identify a representative and have their contact information on file. VA Form 21-22, Appointment of Veterans Service Organization as Claimant's Representative is a related form used when a veteran wants a Service Organization to represent them.
VA Form 21-22a is used by accredited attorneys, accredited agents, private individuals, or service organization representatives who assist claimants in the preparation, presentation, and prosecution of claims for VA benefits. The form contains two pages with instructions in the fields. The individual named on this form should be copied on all correspondence issued by the VA regarding the claimant.
A VA Form 21-22a fillable version is available for digital filing and download below.
Send the form to a local VA Office or present it in person.
A representative has the authority to review information in the claimant's folder. If the representative holds Power of Attorney (or POA) for only one claim, they may review the information in the file pertaining only to that claim, unless the claimant specifically consents or authorizes the release of other information. The release of claimant's information will not occur without a completed 21-22a Form.
If VA Form 21-22a is not signed by the claimant, a representative is not eligible to review the claims file or receive any correspondence from VA including development letters, decision letters, or copies thereof.
A VA Regional Office (RO) may release a claimant's records to an attorney without a signed 21-22 Form in the following cases:
The form is fairly straightforward and shouldn't take more than 5 minutes to complete. Getting all the necessary signatures in the appropriate fields is essential. The claimant and the representative each sign on every page.
Most of the other fields are self-explanatory.
An important moment that can be easily overlooked is that there is a hidden field with no number on it on the second page in the section called "Conditions of Appointment." The small print should be readable. In the space that follows, a claimant can list all non-accredited team members who may call the VA regarding the status of their claim.
The form should be submitted as Intent to File a Claim box or as a Fully Developed Claim. It should also be included with any other correspondence, particularly when the third party is the individual signing the correspondence.
Step-by-step VA Form 21-22a Instructions are as follows:
For a representative: