VA Form 21-22 Appointment of Veterans Service Organization as Claimant's Representative

What Is VA Form 21-22?

VA Form 21-22, Appointment of Veterans Service Organization as Claimant's Representative, sometimes referred to as the VA Power of Attorney Form 21-22, is used if you prefer to have a service organization assist you with your claim. The Department of Veterans Affairs (VA) does not recognize the Powers of Attorney for the purposes of prosecuting a VA claim. In order to be recognized by the VA, a claimant's representative must be appointed according to the VA guidelines.

The form was released in August 2015 with several new features introduced to the electronic version of the form in February 2017. An up-to-date VA Form 21-22 fillable version is available for digital filing and can be downloaded below. It can also be found on the VA website.

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Download VA Form 21-22 Appointment of Veterans Service Organization as Claimant's Representative

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What Is VA Form 21-22 Used for?

While applying for VA benefits, a service member or a veteran can get help from a Veteran Service Organization (VSO). It is a veterans association that provides assistance for service members on terminal leave, veterans and their families in applying for VA benefits. The list of VSOs is included in the VA 21-22 form.

The form is a legitimate agreement between a claimant and an agency or a Service Organization, such as the Veterans of Foreign Wars (VFW), The American Legion or Vietnam Veterans of America, for a purpose of the permission to represent a veteran, to prepare and prosecute a claim before the VA.

After the form is been signed, the authorized party has access to the veteran's VA file and medical records. They can represent the veteran in court and at medical facilities.

There is a similar form called the VA Form 21-22A or "Appointment of Attorney or Agent as Claimant's Representative", for attorneys and agents, who may charge a fee for their services. No one can obtain information on a claim skipping filing one of these forms (also called a "third party authorization form"), as all of them contain the veteran's consent.

VA Form 21-22 Instructions

You need to have your Social Security Number (SSN) and a Service Number (SN) handy while filling out the form. A VA file number is typically the same as a social security number, though in some cases it is different. There are several ways to find out a VA Service Number:

  • check your correspondence with the VA;
  • call the VA Benefits or VA Education departments;
  • try using your Social Security Number, it works even if a file number is different.

The form should also meet the following requirements:

  • be signed by the claimant or the claimant's guardian,
  • in a case if the claimant is incompetent, minor, or otherwise incapacitated, the form can be filled out by the spouse, parent, other relative or friend, or the director of the hospital where health care, if provided;
  • the form should be submitted to the appropriate VA office.

How to Fill Out VA Form 21-22?

The form includes one page and a list of recognized service organizations. Instructions for VA Form 21-22 are as follows:

    • enter the name of the veteran and the VA file number;
    • enter the name of the organization chosen as their representative;
    • if the person who is filling out the form is not a veteran, provide their social security number, insurance number and your relationship to the veteran;
    • check the box to verify authorization and give consent to disclose medical records if needed.

Reminder for the form completion:

  • enough information to identify the veteran or claimant;
  • the name of the servant organization;
  • signature of the veteran or claimant with the date;
  • signature of a representative acting on behalf of the service organization with the date.

Filing Box 3B of VA Form 21-22 is optional. If completed, there is no need to verify that the specific representative listed in the box 3B is accredited. This form documents the appointment of the entire service organization listed in the Box 3A and does not limit action to a specific representative within the organization.

How to Revoke VA Form 21-22?

The VA 21-22 Form can be revoked at any time, and an agent or attorney may be discharged at any time. Unless a claimant specifically indicates otherwise, the receipt of a new POA completed by the claimant shall constitute a cancellation of an existing one.

The form is revoked by filing a written revocation with the VA. Fill out the VA 21-4138 Form to indicate that the current VSO representative is no longer requires as the veterans representative. A copy of the statement should be submitted by mail or hand delivery to both VA and the current representative. Another copy is kept by the claimant.

A new representative will probably want to review a claim carefully to offer the best guidance; this may take some time. Some VSO do not take representation when an appeal is active at the Board of Veterans Appeals.

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