VA Form 21-22 appoints a Veterans Service Organization to represent you before VA. VA Form 21-22a appoints an individual, usually an accredited attorney or claims agent. Both current PDFs carry a July 2023 edition date. Choosing the right form matters because appointing an organization and hiring an individual give VA different instructions about who represents you.

I checked both forms against VA's current appointment guidance. The signature lines are only part of the decision: you also choose permissions for certain medical records, address changes and, on 21-22a, access by affiliated personnel. Start with the official 21-22 download page or 21-22a download page.

Who files these forms, and when?

Use the appropriate appointment form when you want a representative to help prepare, present or pursue your VA benefits claim. A claimant may be the veteran or someone claiming benefits based on the veteran's service, such as a surviving spouse. The forms provide separate spaces for those people.

Before signing, contact the person you want to work with, confirm availability and check accreditation in VA's official search. For a VSO representative, ask which recognized organization belongs in Item 15. An office's familiar local name may differ from that organization's name.

VA's representation guidance says VSO representation is free; accredited attorneys and agents may charge fees. The appointment form is not a substitute for reviewing an attorney's or agent's fee agreement. Ask what work the person accepts, what any fee covers and who will track deadlines.

An appointment also does not file your disability claim or decision review. Those applications have their own forms and deadlines.

VA Form 21-22: appointing the organization

The July 2023 PDF has five numbered sections, followed by the recognized-organization list and mailing instructions.

Fictional worksheet example: A veteran is appointing a recognized VSO to help with a compensation claim. The veteran has spoken with the representative and confirmed the organization's identity. No names, addresses or identifying numbers below are real entries to copy.

Section I: veteran's information, Items 1 through 9

  • Item 1: Enter the veteran's first name, middle initial and last name.
  • Item 2: Enter the veteran's Social Security number.
  • Item 3: Give the VA file number if applicable.
  • Item 4: Enter the veteran's date of birth in month/day/year format.
  • Item 5: Give the service number if applicable.
  • Item 6: List applicable insurance numbers, including letter prefixes.
  • Item 7: Enter the mailing address, including unit, country and postal code where needed.
  • Item 8: Give a working telephone number with area code.
  • Item 9: Email is optional.

The fictional veteran uses personal information from their own records. A helper's phone or address should not silently replace the claimant's information.

Section II: another claimant, Items 10 through 14

Complete this section only when the claimant is someone other than the veteran. Item 10 is that person's name; 11A is date of birth; 11B is relationship to the veteran. Items 12, 13 and 14 are the claimant's mailing address, telephone number and optional email.

The fictional veteran leaves this section unused because the veteran is also the claimant. A surviving spouse seeking their own benefits would identify the veteran in Section I and themselves here.

Section III: organization, Items 15 through 18

Item 15 identifies the recognized service organization. Items 16A and 16B identify the official representative acting for it and that person's job title. Item 17 asks for the organization's email, and Item 18 asks for the appointment date.

The form expressly appoints the entire organization. Naming a particular staff member in 16A does not restrict representation to that person. Ask the representative to check this section before either of you signs. Membership in the organization is not required to appoint it, according to page 3.

Section IV: permissions, Items 19 through 21

Item 19 authorizes access to specially protected records concerning drug abuse, alcohol abuse or alcoholism, HIV infection and sickle cell anemia. Read the permission before checking it.

Item 20 lets you exclude listed categories from that consent. These boxes limit disclosure; they are not a checklist of conditions you are claiming.

Item 21 separately allows the organization to change your address in VA records. Discuss whether you want that authority. Agreeing to representation does not require thoughtlessly selecting every optional authorization.

In the fictional example, the veteran reviews these choices with the representative rather than copying someone else's selections. A consent decision should reflect which records the representative needs and what the claimant wishes to authorize.

Section V: signatures, Items 22 and 23

The veteran or claimant signs 22A and dates 22B. The VSO representative named in 16A signs 23A and dates 23B. Both signatures belong on the completed form. The form says notarization is not required.

Read the appointment language above the signatures. It authorizes broad representation and records access, subject to the stated restrictions, and says the organization will not charge for services under the appointment. Leave VA's internal acknowledgment and processing boxes alone.

VA Form 21-22a: appointing an individual

The July 2023 21-22a PDF uses different item numbers. Do not transfer the VSO form's answers by number.

Fictional worksheet example: A veteran has agreed with an accredited attorney that the attorney will represent a specified denied issue. The attorney and veteran must make the appointment's scope match that agreement. This example supplies no recommended fee or outcome.

Sections I and II: identification, Items 1 through 15

Section I identifies the veteran:

  • Items 1 through 5: Name, Social Security number, applicable VA file number, date of birth and applicable service number.
  • Item 6: Branch of service. Unlike Item 6 on 21-22, this is not an insurance-number field.
  • Items 7 through 9: Mailing address, telephone number and optional email.

Section II is for a different claimant. Items 10 through 12 give that person's name, date of birth and relationship to the veteran. Items 13 through 15 give their address, telephone and optional email. The fictional veteran does not complete this section for the attorney; the attorney belongs in Section III.

Section III: representative, Items 16 through 18

Item 16A names the individual. 16B identifies the type of representative. 16C through 16E give the individual's address, telephone number and optional email.

The fictional appointment selects attorney in 16B. The form also includes agent, service organization representative and an individual acting under 38 CFR 14.630.

That last category has its own required no-compensation statement. If it applies, the claimant signs and dates 17A and 17B, and the representative signs and dates 18A and 18B. Otherwise, the form directs you to skip to Item 19. This limited provision is not a general credential for someone to sell VA representation.

Section IV: authorizations, Items 19 through 22

Item 19A concerns disclosure to affiliated attorneys, agents and support staff when the appointed attorney or agent has the specified VA information-system approval. It asks for the firm or organization. 19B concerns named administrative employees and disclosures outside that electronic access arrangement.

Item 20 authorizes the protected medical-record categories described earlier. Item 21 states limitations on that consent. Unlike the 21-22 exclusions, this is a written limitation field.

Item 22 authorizes the individual to change the claimant's address. The form says that authority is not granted unless you check the box.

Ask who will actually see your records. A firm name, administrative employee list and medical-record permission answer different questions.

Conditions of appointment, Items 23 through 25

The claimant signs 23A and dates 23B. Item 24 is where an agent or attorney limits representation. The form warns that, unless limited by an agent or attorney, the appointment revokes previously existing powers of attorney. The representative signs 25A and dates 25B.

In the fictional example, the attorney uses Item 24 to describe the agreed issue limitation. The veteran reads that wording before signing. Leaving it blank while assuming a narrow appointment can create a mismatch between your agreement and VA's record.

Where to submit the signed appointment

VA's appointment page gives these options:

  • Online preparation and upload: Start from VA's appointment tool. If it generates a PDF for signature, finish both signatures and submit through QuickSubmit in AccessVA. Completing a preparation screen alone is not proof VA accepted the appointment.
  • Mail for compensation: Department of Veterans Affairs, Evidence Intake Center, PO Box 4444, Janesville, WI 53547-4444.
  • Mail for pension and survivor benefits: Department of Veterans Affairs, Pension Intake Center, PO Box 5365, Janesville, WI 53547-5365.
  • Mail for a Board appeal: Department of Veterans Affairs, Board of Veterans' Appeals, PO Box 27063, Washington, DC 20038.
  • In person: Bring the signed form to a VA regional office.

For correspondence concerning a compensation claim, VA also lists 844-531-7818 as its domestic fax number and 248-524-4260 for foreign claimants on its compensation intake page. These are compensation intake numbers, not universal numbers for every benefit or Board filing.

Participating VSOs can also accept electronic 21-22 requests through the Accredited Representative Portal. VA says that feature requires an activated VSO organization and is not currently available to attorneys or claims agents. Follow the route offered for your chosen representative and retain the confirmation.

Mistakes to catch before you send it

The form's requirements give you a practical final check:

  • The organization or individual is correctly identified and has agreed to help.
  • Veteran, claimant and representative details appear in their own sections.
  • Both required signatures and dates are present.
  • Records permissions reflect your choices.
  • Any attorney or agent limitation appears in Item 24.
  • You kept a copy and know who will submit it.

After submission, confirm with the representative that VA recognizes the appointment and that the person has the decision notices and deadlines needed to start work. VA's representation page also lets signed-in users check existing representation. Keep pursuing any claim or appeal deadline while the appointment is being processed.

Bring an organized claim to the first meeting

Make a short list of the issues, decision dates, missing records and questions you want answered. Claim Raven's Evidence Checklists can help you track condition-specific evidence tasks and notes before that conversation. A checked box records your progress; it does not establish that evidence meets VA's requirements.

For a factual statement you want the representative to review, Raven Scribe offers a free personal statement builder. You supply the facts and review the draft. Representation and filing remain separate steps.

The appointment supports later work on forms such as 20-0995 for a Supplemental Claim, 20-0996 for Higher-Level Review and 10182 for a Board appeal. A statement on 21-4138 does not replace the appointment form.

Verified September 25, 2026: both official form pages, all pages of both July 2023 PDFs, VA's appointment instructions, portal guidance and compensation intake details. Both PDFs display an OMB expiration date of July 31, 2026, but they remain the downloads VA currently provides. That printed date is recorded here separately from the edition date. Examples are fictional and demonstrate form organization, not an actual representation agreement.

Where to go next

Claim Raven is data analysis, not legal, medical, or VA-accredited advice. For advice about your appointment or representation agreement, consult an accredited representative.

-Landon Founder, Claim Raven | U.S. Army Veteran