VA Form 21-22a

Appointment of Individual as Claimant's Representative

Power of AttorneyOfficial VA form on VA.gov

Who fills it

veteran

Journey phase

Before You File

Estimated time

15-30 minutes.

When to file

When you decide to retain an attorney or agent. Many veterans start with a VSO and switch to an attorney at the appeals stage.

You want professional legal representation (typically for a complex claim, denied claim, or appeal) instead of (or in addition to) a free VSO.

Gather before you start

—Your full legal name, SSN, VA File Number, address, phone

—Name and accreditation status of the individual you are appointing (attorney, agent, or one-time rep)

—Their address, phone, and email

—Fee agreement terms (if any) - attorneys/agents will provide separately

—Decision on sensitive-records consent (same as 21-22)

Attach with the form

—Fee agreement (if attorney/agent will charge a fee) - separate document, see 38 CFR 14.636

Section I - Veteran/Claimant Identification

1 field

Blocks 1-8Name, SSN, VA File Number, DOB, address, phone, emailPII

Match exactly to your VA records.

Example

(use legal name from DD-214)

Common mistakes

Mismatched name/SSN with VA records - POA fails to attach.

Section II - Representative Information

1 field · 2 citations

Blocks 9-13Representative name, accreditation type, address, phone, email

Three accreditation types: (a) ACCREDITED ATTORNEY (verify at va.gov/ogc/apps/accreditation), (b) ACCREDITED AGENT (also verifiable at OGC), (c) INDIVIDUAL ONE-TIME REPRESENTATIVE (e.g., a friend or family member helping with one specific claim - cannot charge fees, must be approved by VA per case).

Example

e.g., Jane Smith, Esq. - Accredited Attorney - VA Bar #12345

Common mistakes

Hiring a "claim shark" without checking accreditation - non-accredited individuals charging fees is illegal under 38 USC 5904.
Confusing attorney vs agent - both can charge fees but agent fees often capped lower; verify accreditation type matches what you signed.
Using a one-time individual representative for a complex claim - they cannot charge fees and lack the experience for appeals.

Authority

38 CFR 14.626 - Who may represent claimants before VA.

38 CFR 14.629 - Accreditation requirements.

Section III - Fee Agreement Terms

1 field · 1 citation

Block 14Fee agreement attached / disclosed

Attorneys and agents may charge fees ONLY for past-due benefits awarded after a Notice of Disagreement is filed (legacy) or after AMA HLR/Supplemental/Board appeal triggers. Initial-claim representation is generally fee-prohibited. Fees are typically capped at 33% of past-due benefits and must be reasonable per 38 CFR 14.636. The fee agreement is a separate signed document attached to this POA.

Example

Fee agreement attached (separate document)

Common mistakes

Signing a fee agreement above 33% - VA can review and reduce. Reject anything higher and pick a different attorney.
Not understanding when fees can be charged - initial claims (pre-NOD) are fee-prohibited; you should not be paying for a first-claim attorney.
Paying upfront fees - reputable VA-accredited attorneys take fees as a percentage of past-due benefits, paid by VA directly to the attorney.

Authority

38 CFR 14.636 - Attorney/agent fee rules and 33% cap on past-due benefits.

Section IV - Sensitive Records Authorization

1 field · 1 citation

Blocks 15a-15dAuthorize disclosure of sensitive records (drug, alcohol, HIV, sickle cell)

Same four boxes as 21-22 - default NO unless checked.

Example

Check yes/no for each

Common mistakes

Defaulting NO when those records are central to the claim - attorney can't advocate without them.

Authority

38 USC 1720D - MST counseling and care without regard to service connection.

Section V - Signature

1 field

Blocks 16-17Veteran signature, date, attorney/agent counter-signaturePII

Sign and date. The attorney/agent counter-signs. POA is effective when both have signed.

Example

(signature/date when filing)

Common mistakes

Forgetting to sign - returned for completion.
Forgetting that POA can be revoked - file a new 21-22 / 21-22a or a written revocation letter.

Statutory & regulatory authority

38 CFR 14.626 - Who may represent claimants before VA.

38 CFR 14.629 - Accreditation requirements.

38 CFR 14.631 - Form, content, and revocation of POA appointments.

38 CFR 14.636 - Attorney/agent fee rules and 33% cap on past-due benefits.

38 USC 5101 - Standardized form requirement.

VA Form 21-22a

Appointment of Individual as Claimant's Representative

Power of AttorneyOfficial VA form on VA.gov

Who fills it

veteran

Journey phase

Before You File

Estimated time

15-30 minutes.

When to file

When you decide to retain an attorney or agent. Many veterans start with a VSO and switch to an attorney at the appeals stage.

You want professional legal representation (typically for a complex claim, denied claim, or appeal) instead of (or in addition to) a free VSO.

Gather before you start

—Your full legal name, SSN, VA File Number, address, phone

—Name and accreditation status of the individual you are appointing (attorney, agent, or one-time rep)

—Their address, phone, and email

—Fee agreement terms (if any) - attorneys/agents will provide separately

—Decision on sensitive-records consent (same as 21-22)

Attach with the form

—Fee agreement (if attorney/agent will charge a fee) - separate document, see 38 CFR 14.636

Section I - Veteran/Claimant Identification

1 field

Blocks 1-8Name, SSN, VA File Number, DOB, address, phone, emailPII

Match exactly to your VA records.

Example

(use legal name from DD-214)

Common mistakes

Mismatched name/SSN with VA records - POA fails to attach.

Section II - Representative Information

1 field · 2 citations

Blocks 9-13Representative name, accreditation type, address, phone, email

Example

e.g., Jane Smith, Esq. - Accredited Attorney - VA Bar #12345

Common mistakes

Hiring a "claim shark" without checking accreditation - non-accredited individuals charging fees is illegal under 38 USC 5904.
Confusing attorney vs agent - both can charge fees but agent fees often capped lower; verify accreditation type matches what you signed.
Using a one-time individual representative for a complex claim - they cannot charge fees and lack the experience for appeals.

Authority

38 CFR 14.626 - Who may represent claimants before VA.

38 CFR 14.629 - Accreditation requirements.

Section III - Fee Agreement Terms

1 field · 1 citation

Block 14Fee agreement attached / disclosed

Example

Fee agreement attached (separate document)

Common mistakes

Signing a fee agreement above 33% - VA can review and reduce. Reject anything higher and pick a different attorney.
Not understanding when fees can be charged - initial claims (pre-NOD) are fee-prohibited; you should not be paying for a first-claim attorney.
Paying upfront fees - reputable VA-accredited attorneys take fees as a percentage of past-due benefits, paid by VA directly to the attorney.

Authority

38 CFR 14.636 - Attorney/agent fee rules and 33% cap on past-due benefits.

Section IV - Sensitive Records Authorization

1 field · 1 citation

Blocks 15a-15dAuthorize disclosure of sensitive records (drug, alcohol, HIV, sickle cell)

Same four boxes as 21-22 - default NO unless checked.

Example

Check yes/no for each

Common mistakes

Defaulting NO when those records are central to the claim - attorney can't advocate without them.

Authority

38 USC 1720D - MST counseling and care without regard to service connection.

Section V - Signature

1 field

Blocks 16-17Veteran signature, date, attorney/agent counter-signaturePII

Sign and date. The attorney/agent counter-signs. POA is effective when both have signed.

Example

(signature/date when filing)

Common mistakes

Forgetting to sign - returned for completion.
Forgetting that POA can be revoked - file a new 21-22 / 21-22a or a written revocation letter.

Statutory & regulatory authority

38 CFR 14.626 - Who may represent claimants before VA.

38 CFR 14.629 - Accreditation requirements.

38 CFR 14.631 - Form, content, and revocation of POA appointments.

38 CFR 14.636 - Attorney/agent fee rules and 33% cap on past-due benefits.

38 USC 5101 - Standardized form requirement.

VA Form 21-22a

Appointment of Individual as Claimant's Representative

Power of AttorneyOfficial VA form on VA.gov

Who fills it

veteran

Journey phase

Before You File

Estimated time

15-30 minutes.

When to file

When you decide to retain an attorney or agent. Many veterans start with a VSO and switch to an attorney at the appeals stage.

You want professional legal representation (typically for a complex claim, denied claim, or appeal) instead of (or in addition to) a free VSO.

Gather before you start

—Your full legal name, SSN, VA File Number, address, phone

—Name and accreditation status of the individual you are appointing (attorney, agent, or one-time rep)

—Their address, phone, and email

—Fee agreement terms (if any) - attorneys/agents will provide separately

—Decision on sensitive-records consent (same as 21-22)

Attach with the form

—Fee agreement (if attorney/agent will charge a fee) - separate document, see 38 CFR 14.636

Section I - Veteran/Claimant Identification

1 field

Blocks 1-8Name, SSN, VA File Number, DOB, address, phone, emailPII

Match exactly to your VA records.

Example

(use legal name from DD-214)

Common mistakes

Mismatched name/SSN with VA records - POA fails to attach.

Section II - Representative Information

1 field · 2 citations

Blocks 9-13Representative name, accreditation type, address, phone, email

Example

e.g., Jane Smith, Esq. - Accredited Attorney - VA Bar #12345

Common mistakes

Hiring a "claim shark" without checking accreditation - non-accredited individuals charging fees is illegal under 38 USC 5904.
Confusing attorney vs agent - both can charge fees but agent fees often capped lower; verify accreditation type matches what you signed.
Using a one-time individual representative for a complex claim - they cannot charge fees and lack the experience for appeals.

Authority

38 CFR 14.626 - Who may represent claimants before VA.

38 CFR 14.629 - Accreditation requirements.

Section III - Fee Agreement Terms

1 field · 1 citation

Block 14Fee agreement attached / disclosed

Example

Fee agreement attached (separate document)

Common mistakes

Signing a fee agreement above 33% - VA can review and reduce. Reject anything higher and pick a different attorney.
Not understanding when fees can be charged - initial claims (pre-NOD) are fee-prohibited; you should not be paying for a first-claim attorney.
Paying upfront fees - reputable VA-accredited attorneys take fees as a percentage of past-due benefits, paid by VA directly to the attorney.

Authority

38 CFR 14.636 - Attorney/agent fee rules and 33% cap on past-due benefits.

Section IV - Sensitive Records Authorization

1 field · 1 citation

Blocks 15a-15dAuthorize disclosure of sensitive records (drug, alcohol, HIV, sickle cell)

Same four boxes as 21-22 - default NO unless checked.

Example

Check yes/no for each

Common mistakes

Defaulting NO when those records are central to the claim - attorney can't advocate without them.

Authority

38 USC 1720D - MST counseling and care without regard to service connection.

Section V - Signature

1 field

Blocks 16-17Veteran signature, date, attorney/agent counter-signaturePII

Sign and date. The attorney/agent counter-signs. POA is effective when both have signed.

Example

(signature/date when filing)

Common mistakes

Forgetting to sign - returned for completion.
Forgetting that POA can be revoked - file a new 21-22 / 21-22a or a written revocation letter.

Statutory & regulatory authority

38 CFR 14.626 - Who may represent claimants before VA.

38 CFR 14.629 - Accreditation requirements.

38 CFR 14.631 - Form, content, and revocation of POA appointments.

38 CFR 14.636 - Attorney/agent fee rules and 33% cap on past-due benefits.

38 USC 5101 - Standardized form requirement.

VA Form 21-22a

Appointment of Individual as Claimant's Representative

Power of AttorneyOfficial VA form on VA.gov

Who fills it

veteran

Journey phase

Before You File

Estimated time

15-30 minutes.

When to file

When you decide to retain an attorney or agent. Many veterans start with a VSO and switch to an attorney at the appeals stage.

You want professional legal representation (typically for a complex claim, denied claim, or appeal) instead of (or in addition to) a free VSO.

Gather before you start

—Your full legal name, SSN, VA File Number, address, phone

—Name and accreditation status of the individual you are appointing (attorney, agent, or one-time rep)

—Their address, phone, and email

—Fee agreement terms (if any) - attorneys/agents will provide separately

—Decision on sensitive-records consent (same as 21-22)

Attach with the form

—Fee agreement (if attorney/agent will charge a fee) - separate document, see 38 CFR 14.636

Section I - Veteran/Claimant Identification

1 field

Blocks 1-8Name, SSN, VA File Number, DOB, address, phone, emailPII

Match exactly to your VA records.

Example

(use legal name from DD-214)

Common mistakes

Mismatched name/SSN with VA records - POA fails to attach.

Section II - Representative Information

1 field · 2 citations

Blocks 9-13Representative name, accreditation type, address, phone, email

Example

e.g., Jane Smith, Esq. - Accredited Attorney - VA Bar #12345

Common mistakes

Hiring a "claim shark" without checking accreditation - non-accredited individuals charging fees is illegal under 38 USC 5904.
Confusing attorney vs agent - both can charge fees but agent fees often capped lower; verify accreditation type matches what you signed.
Using a one-time individual representative for a complex claim - they cannot charge fees and lack the experience for appeals.

Authority

38 CFR 14.626 - Who may represent claimants before VA.

38 CFR 14.629 - Accreditation requirements.

Section III - Fee Agreement Terms

1 field · 1 citation

Block 14Fee agreement attached / disclosed

Example

Fee agreement attached (separate document)

Common mistakes

Signing a fee agreement above 33% - VA can review and reduce. Reject anything higher and pick a different attorney.
Not understanding when fees can be charged - initial claims (pre-NOD) are fee-prohibited; you should not be paying for a first-claim attorney.
Paying upfront fees - reputable VA-accredited attorneys take fees as a percentage of past-due benefits, paid by VA directly to the attorney.

Authority

38 CFR 14.636 - Attorney/agent fee rules and 33% cap on past-due benefits.

Section IV - Sensitive Records Authorization

1 field · 1 citation

Blocks 15a-15dAuthorize disclosure of sensitive records (drug, alcohol, HIV, sickle cell)

Same four boxes as 21-22 - default NO unless checked.

Example

Check yes/no for each

Common mistakes

Defaulting NO when those records are central to the claim - attorney can't advocate without them.

Authority

38 USC 1720D - MST counseling and care without regard to service connection.

Section V - Signature

1 field

Blocks 16-17Veteran signature, date, attorney/agent counter-signaturePII

Sign and date. The attorney/agent counter-signs. POA is effective when both have signed.

Example

(signature/date when filing)

Common mistakes

Forgetting to sign - returned for completion.
Forgetting that POA can be revoked - file a new 21-22 / 21-22a or a written revocation letter.

Statutory & regulatory authority

38 CFR 14.626 - Who may represent claimants before VA.

38 CFR 14.629 - Accreditation requirements.

38 CFR 14.631 - Form, content, and revocation of POA appointments.

38 CFR 14.636 - Attorney/agent fee rules and 33% cap on past-due benefits.

38 USC 5101 - Standardized form requirement.