VA Form 21-0845: How to authorize VA to share your personal information
VA Form 21-0845, Authorization to Disclose Personal Information to a Third Party, lets a veteran, beneficiary, or claimant give the Department of Veterans Affairs written permission to share benefit or claim details with one named person or organization. Fill in the veteran’s identification, beneficiary details (if different), and the third party’s contact information, then choose whether to release limited or broader information and select a security question. Sign and date the form, then mail it to the VA Evidence Intake Center or submit it online through VA.gov or access.va.gov.
Key takeaways
- VA Form 21-0845 authorizes VA to share your benefit or claim information with one named person or organization; it does not appoint a representative or release medical records.
- Only the veteran, beneficiary, or claimant can sign it; a family member generally cannot sign on someone else’s behalf unless recognized as their fiduciary.
- You choose whether the release is one-time, ongoing until revoked, or valid until a specific date, and can revoke it in writing, by phone, or online.
- Mail the form to the VA Evidence Intake Center or submit it online through VA.gov or access.va.gov; VA keeps only one authorization on file at a time.
- pdfFiller lets you complete, sign, and download a VA Form 21-0845 fillable PDF from any device, without printing a blank copy first.
Authorizing the VA to share your personal information sounds straightforward. In practice, it raises real questions. Who exactly can receive your records? What details will they be able to access? Can you take that permission back? Getting these answers right before you sign protects your privacy and keeps your claim moving without unnecessary delays.
This guide covers everything you need to know about VA Form 21-0845—what it is, who needs it, how it compares to similar VA release of information forms, and exactly how to fill it out and submit it.
Disclaimer: This article is for general informational purposes and does not constitute legal advice.
What is VA Form 21-0845, and who uses it?
VA Form 21-0845, formally titled “Authorization to Disclose Personal Information to a Third Party,” is a benefits-related authorization form published by the U.S. Department of Veterans Affairs. It permits the VA to release non-medical personal information—such as claims status, payment details, and benefit decisions—to a person or organization that the veteran or claimant names on the form.
The form is grounded in the Privacy Act of 1974, which prohibits federal agencies from disclosing personal records without written consent. VA Form 21-0845 provides that consent in a standardized, legally recognized format.
Who needs to file VA Form 21-0845?
A broad range of people use this form:
- Veterans who want a spouse, adult child, or another trusted person to call VA for updates on a pending claim.
- Beneficiaries and claimants who are not the veteran, such as a surviving spouse receiving survivor benefits, but who still want to name someone else to speak with VA.
- Caregivers who handle appointments and routine VA contact for a veteran who is capable of managing their own affairs but wants help.
- Organizations, such as nonprofits or state veterans’ service offices, when the veteran wants a specific staff member able to discuss claim information directly.
Essentially, anyone who needs the VA to speak freely with a third party—short of granting full legal representation—should file this VA authorization form.
Which VA information-release form do you need?
Not every disclosure situation calls for VA Form 21-0845. VA uses different forms depending on what kind of information you want shared and with whom. Use this quick comparison:
- VA Form 21-0845 authorizes VA to release personal benefit or claim information, not medical records, to one named person or organization for informational purposes only.
- VA Form 10-5345, Request for and Authorization to Release Medical Records, is for sharing health information, such as treatment notes, from a VA medical record with a third party.
- VA Form 21-22, or VA Form 21-22a for an individual, appoints an accredited Veterans Service Organization or individual as a formal representative, with authority to help prepare, present, and pursue a claim, not just receive updates about it.
- VA Forms 21-4142 and 21-4142a, Authorization to Disclose Information to the VA, allow the VA to request medical records or information from a non-VA doctor, hospital, or other private source on your behalf.
If you only want someone able to call and ask about claim status, VA Form 21-0845 is the right choice. If you want someone to submit evidence or argue points on your behalf, you need an accredited representative through VA Form 21-22 or 21-22a instead.
What should you check before authorizing disclosure?
Taking a few minutes before you sign can prevent months of confusion later.
Before you sign: personal-information disclosure checklist
- Identity: Use the third party’s full legal name and current address.
- Need: Ask what specific information the person requires and why.
- Scope: Prefer “limited information” when claim status, payment history, or a benefit letter is enough.
- Duration: Choose one-time or a clear end date when ongoing access is unnecessary.
- Security: Select a security question the authorized person can answer reliably but others cannot guess.
- Storage: Keep the completed form and submission receipt in a protected location.
- Review: Revoke access when the helper’s role ends or your relationship changes.
How to fill out VA Form 21-0845 step by step
Understanding how to fill out VA Form 21-0845 is straightforward once you know what each section asks for. These VA Form 21-0845 instructions follow the current three-page form.
1. Download a current VA Form 21-0845 fillable copy. You can get the VA Form 21-0845 fillable PDF on the VA’s official website or find the current form version in pdfFiller’s PDF library and instantly upload it to our online editor for fill-out.
2. Enter the veteran’s identification information. In Section I, provide the veteran’s name, Social Security number, date of birth, VA file number, and service number if applicable. Double-check every digit- incorrect numbers may prevent the VA from matching the form to the right record.
3. Complete the Beneficiary or Claimant Section when needed. Section II apply when the person receiving the benefit is not the veteran. Add the claimant’s name, address, phone number, and email (if applicable). Do not list the same claimant from Item 6 as the designated third party in Item 10.
Start preparing your VA Form 21-0845 in pdfFiller editor by entering the requested details in Section I (Veteran’s Identification) and Section II (Beneficiary or Claimant Information).
4. Name one person or one organization. In Item 10, complete either the person fields or the organization fields. List only one person or organization, though an organization may identify more than one representative—use full names and addresses so the VA can identify the authorized parties.
In Section III of VA Form 21-0845, enter the contact details for the person or organization authorized to receive VA information.
5. Choose the information VA may disclose. Item 11 asks you to select “limited information” or “any information.” If you choose limited information, Item 12 lets you authorize specific categories: pending claim or appeal status, current benefit and rate, money owed to VA, payment history, a benefit payment letter, change-of-address or direct-deposit information, or another item you describe.
6. Set the authorization period. For “any information,” Item 13 offers one-time release, ongoing authorization until written termination, or authorization through a specific date.
7. Create the security question. In Item 14, check one security question and provide the exact answer. VA may ask this question each time the designated third party contacts the department, so share the answer securely with that person.
8. Sign and date the form. Sign Item 15 and enter the date in Item 16. Before signing, review all pages carefully—a missing signature, conflicting selections, or incomplete contact details may make the information authorization unusable.
Select the VA information you wish to share, then finalize VA Form 21-0845 by adding your date and signature in Section IV.
pdfFiller makes it easy to prepare your VA Form 21-0845 directly in your browser. Fill out your fillable template in our online editor, entering your answers into properly aligned fields and adding checkmarks. Review each page and sign your PDF electronically or print out the completed form right from the editor.
Where do you send VA Form 21-0845?
The form’s first page lists addresses for both paper and online submissions. The current VA form page offers an online tool, so many claimants can submit the authorization directly through VA.gov. For a signed paper form, mail it to:
Department of Veterans Affairs
Evidence Intake Center
PO Box 4444
Janesville, WI 53547-4444
Keep a copy and proof of submission. The current VA Form 21-0845 instructions list online and mail submission only—no universal fax number—so confirm the correct fax with the VA before sending sensitive information that way.
If you complete the form in pdfFiller, you can download a print-ready PDF for mailing or use the Mail by USPS right from your pdfFiller account.
Does VA Form 21-0845 expire?
VA Form 21-0845 has no set expiration date unless you specify one in Section 5. Without an end date, the authorization stays active indefinitely—meaning the VA can keep sharing your information with the named third party even if your situation changes.
It’s a good idea to review existing authorizations at least once a year. If a caregiver’s role ends, your family situation changes, or you no longer need someone to access your information, revoke the authorization promptly.
How do you revoke VA Form 21-0845 authorization?
You may revoke VA Form 21-0845 authorization by notifying VA in writing, calling 1-800-827-1000, or contacting VA through Ask VA. State that you are withdrawing the authorization, identify the veteran or claimant, and name the designated person or organization.
Revocation stops future disclosure after VA processes the request. It does not take back claim information already disclosed based on valid consent. To change the authorized party, revoke the existing authorization and submit a new completed form, then keep records of both actions.
Common mistakes to avoid
Even a carefully completed form can run into trouble. Here are the most common errors that slow processing.
- Using the wrong form. Filing VA Form 10-5345 when you need VA Form 21-0845—or vice versa—means starting over. Confirm the form number before you begin.
- Naming more than one person on a single form. VA Form 21-0845 accepts only one individual or organization per submission. Submit a separate form for each additional person.
- Listing the same person as both beneficiary and third party. VA’s instructions specifically prohibit this, and the form will be rejected.
- Choosing a security question the third party won’t know. If they can’t answer it, VA won’t release information over the phone, even with a valid authorization on file.
- Leaving the duration section blank or unclear. Without a clear choice in Item 13, VA cannot determine how long the authorization stays active.
- Assuming this form covers medical records or grants representative status. For health information, use VA Form 10-5345. For claim representation, use VA Form 21-22 or 21-22a.
- Submitting an illegible handwritten copy. Typing your answers ensures a clean, legible form that processes faster.
Final thoughts
VA Form 21-0845 can reduce communication barriers when a trusted helper needs to speak with VA, but it should not become a permanent, unlimited release by accident. Choose the right form, disclose only what is necessary, and cancel access when the need ends.
With pdfFiller, you can prepare the VA Form 21-0845 PDF in a secure online workspace, check entries for completeness, sign it electronically, and save a protected copy for submission.
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Glossary
- Veterans Benefits Administration (VBA): The branch of the VA responsible for administering compensation, pension, education, home loan guaranty, and other benefit programs. VA Form 21-0845 applies to records held by the VBA.
- Privacy Act of 1974: A federal law that governs how U.S. government agencies collect, maintain, and disclose personal information. The act requires written consent before an agency like the VA can share a person’s records with a third party.
- Accredited representative: An individual or organization formally recognized by the VA to represent claimants in benefits proceedings. Accreditation is required to file VA Form 21-22 or VA Form 21-22a; it is not required to be named on VA Form 21-0845.
- Revocation: The act of formally canceling a previously granted authorization. For VA Form 21-0845, revocation requires a signed, dated written statement submitted to the veteran’s VA regional office.
Trusted sources
- VA Form 21-0845 official form page
- VA Form 21-0845 official PDF and instructions
- VA M21-1, Part I, Subpart i, Chapter 3
- VA Form 10-5345 official page and form
- U.S. General Services Administration—Privacy Act of 1974 overview
FAQ
1. Can I authorize my spouse to speak with the VA about my claim?
Yes. You can name your spouse as the authorized third party on VA Form 21-0845, allowing the VA to share your personal benefit information with them directly. Your spouse can receive updates and discuss claim details, but cannot file documents or formally represent you unless you also file VA Form 21-22a appointing them as an individual representative. If your spouse's role changes or the authorization is no longer needed, submit a written revocation to your VA regional office.
2. Can I name more than one person on VA Form 21-0845?
Not as separate individuals on one active VA Form 21-0845. VA allows one person or one organization at a time. An organization may list more than one representative, and a later authorization should be coordinated with the revocation of the earlier one.
3. Can I limit what information the VA shares with the authorized party?
Yes. Select “limited information” and check only the categories the third party needs, such as pending claim status, current benefit rate, or payment history. Use the “other” field to describe a narrower request when the listed categories are too broad.
4. Can I revoke my authorization after submitting it?
Yes. Contact VA in writing, by phone at 1-800-827-1000, or through Ask VA, and clearly withdraw the authorization. VA will stop future disclosure after processing the revocation, but information already released cannot be recalled.
5. How do I cancel or change an authorization I already filed?
First tell VA that you revoke the existing authorization and identify the current third party. Then submit a new VA Form 21-0845 if you want to authorize a different person, organization, scope, or duration. Keep copies so you can show when each request was made.
6. Is VA Form 21-0845 the same as a power of attorney?
No. VA Form 21-0845 only authorizes VA to share information with a named third party; it does not grant legal authority to make decisions, sign documents, or act on someone's behalf. A power of attorney is a separate legal document, and VA does not recognize general powers of attorney for claims purposes on their own. Use VA Form 21-22 for a recognized Veterans Service Organization or VA Form 21-22a for an eligible accredited individual.
7. Does VA Form 21-0845 release medical records?
No. VA Form 21-0845 covers benefit and claim information, such as claim status and payment history, rather than clinical health records. To share actual medical treatment records, use VA Form 10-5345, Request for and Authorization to Release Medical Records, which is built specifically for health information disclosures.
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