About VA Form 21-22a
- Form name: Appointment of Individual As Claimant's Representative
- Related to: Burials and memorials, Careers and employment, Disability, Education and training, Family member benefits, Health care, Housing assistance, Life insurance, Pension, Service member benefits
- Form revision date: July 2023
When to use this form
If you want to have an individual help you with your claim or benefits, have that person complete and submit this form.
Downloadable PDF
Helpful links related to VA Form 21-22a
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An accredited attorney, claims agent, or Veterans Service Organization (VSO) representative can help you file a claim or request a decision review.