VA Form 21-22A Appointment of Individual as Claimant's Representative

VA Form 21-22A Instructions

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 the 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:

• When it received a request from the General Counsel Professional Group VII regarding representation of claimants in litigation before the U.S. Court of Appeals for Veterans Claims (CAVC);
• When it received a signed statement from the claimant authorizing VA to provide a copy of their folder to the attorney representing them.

How to Fill Out VA Form 21-22A?

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:

1. Box 1. Enter the VA file number of the claim case;
2. Boxes 2-3. Personal information;
3. Box 6. Branch of service of the veteran;
4. Box 7A. Name of the party which will be acting as a representative;
5. Box 7B. If the individual is a service organization representative, agent, or attorney, provide this information. For service organization representatives, the name of the organization should be given;
6. Box 7D. Signature box. If a representative wishes to have access to confidential information, check the Authorization box in Question 9. Otherwise, skip it;
7. Box 10 is to place any limitations on the information a claimant does not want to share.

For a representative:

1. Box 7C. Sign the form;
2. Box 8. Enter the full address;
3. If the representative is an attorney or an agent, any limitations on the representation has to be listed in Box 15.
4. Sign and date the form at the bottom.