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Appointment of Individual as Claimant's Representative

Use this form to appoint an individual (usually an attorney or claims agent) to represent you in your VA claims. Unlike VSO representation, attorneys may charge fees for their services.

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Used in these claim stages:

supplemental_claim higher_level_review board_appeal

Last updated by VA: January 1, 2024

How to Complete This Form

Complete the form to appoint an individual representative:

**Section I - Veteran/Claimant Information**
Your personal and contact information.

**Section II - Representative Information**
Information about the attorney or claims agent:
- Full name
- Address and contact information
- VA accreditation number

**Section III - Authorization**
Authorize the representative to:
- Access your VA records
- Receive copies of correspondence
- Act on your behalf

**Section IV - Fee Agreement**
Indicate whether there is a fee agreement. Note: Fees are limited by VA regulations.

**Section V - Signature**
Sign and date the form.

**Important:** Only VA-accredited attorneys and claims agents can be appointed using this form.

Helpful Tips

- Verify the representative is VA-accredited before appointing
- Understand the fee agreement before signing
- Attorney fees are limited - usually 20-33% of past-due benefits
- Attorneys cannot charge for initial claims, only appeals
- You can revoke representation at any time
- Consider VSO (free) representation first for initial claims
- Appointing a new representative revokes the previous one

Common Mistakes to Avoid

- Appointing someone who isn't VA-accredited
- Not understanding the fee agreement
- Not realizing attorneys can't charge for initial claims
- Signing a fee agreement without reading it carefully
- Not getting a copy of the fee agreement for your records

Deadline Information

No deadline to appoint representation. Can be done at any stage of the claims process.