Request to Change/Update Claim Representative

Who should use this request form

A claimant or claimant’s authorized representative who has terminated an attorney/client relationship
An authorized Representative, Administrator/Executor of claimant's estate
An individual whose purpose is to enter a substitution of counsel
An attorney or firm retained by a claimant who was previously pro se
An individual who no longer has access to the email address associated with their filing(s)

Who should NOT use this request form

An individual who wishes to amend a claim. For instructions on amending a claim, visit the Claim Support page.
An individual who wishes to withdraw a claim. For instructions on withdrawing a claim, visit the Claim Support page.

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Required Documentation

ALL REQUESTS: Supporting documents to substantiate request
This section applies to ALL administrative requests filed with the Department of the Navy.

A. WHAT to provide to support your request

The burden of proof is on the requestor to provide documentation to fulfill the requirements of a claim representative change.

If you have terminated an attorney/client relationship for the purpose of proceeding without an attorney, you must submit the following documents with your request:

Confirmation from the attorney/law firm that their representation has been terminated or a letter, dated and signed by the claimant or claimant’s agent, with the following criteria:

I, [Claimant’s Full Name or Agent’s Full Name on behalf of Claimant’s Full Name], born on [Claimant’s Date of Birth], declare under penalty of perjury that:

I have attempted to notify [prior attorney/firm] of my desire to terminate their representation of my administrative claim filed under [Claim Number] pursuant to the Camp Lejeune Justice Act. I notified my prior attorney/firm via written [email/letter] on [date]. I have not received a response or acknowledgment from the attorney/firm.
I understand that I will now be representing myself on my Camp Lejeune Claim, but I may choose another attorney or firm to representment me at any time in the future.
I understand that this document is a binding declaration of my intent regarding legal representation for my claim and that any dispute involving terminated firm(s) must be dealt with between myself and my representative and any terminated firm(s).

If you are the Authorized Representative or the Administrator/Executor of the claimant's estate, and wish to proceed as an authorized representative, you must submit the following documents with your request:

Claimant's death certificate;
My photo identification;
Proof of authorization to act on the claimant's behalf (e.g., Letters of Administration, Letters Testamentary, Power of Attorney, Proof of Guardianship, etc.); and
If an attorney was previously, or now is, retained for the purposes of advancing this claim, a copy of that attorney's termination or Retainer's Agreement must be provided

If you wish to enter a substitution of counsel, you must submit the following documents with your request:

Written notice of termination to the prior attorney/law firm;
Confirmation from the attorney/law firm that their representation has been terminated or a letter, dated and signed by both the claimant and the attorney or firm representative, with the following criteria:

I, [Claimant’s Full Name or Agent’s Full Name on behalf of Claimant’s Full Name], born on [Claimant’s Date of Birth], declare under penalty of perjury that:

I, thru my attorney, have attempted to notify [prior attorney/firm] of my desire to terminate their representation of my administrative claim filed under [Claim Number] pursuant to the Camp Lejeune Justice Act. I notified my prior attorney/firm via written [email/letter] on [date]. I have not received a response or acknowledgment from the attorney/firm.
I affirm that I wish to be represented solely by [Name of Attorney or Law Firm] in this matter.
I understand that this document is a binding declaration of my intent regarding legal representation for my claim and that any dispute involving terminated firm(s) must be dealt with between myself and my representative and any terminated firm(s).

Proof of authorization to act as claimant's attorney; and
A copy of the Attorney Retainer Agreement

If you have been retained by a claimant who was previously pro se, and wish to enter an appearance of counsel, you must submit the following documents with your request:

Proof of authorization to act as claimant's attorney; and
A copy of the Attorney Retainer Agreement

If you wish to gain access to a claim that was previously filed using an email address that is no longer accessible, you must submit the following documents with your request:

My photo identification that matches the filer information

To expedite review of your request, you are encouraged to submit any relevant records that you have in your possession.

B. HOW to provide supporting documents

The requestor will be asked to provide all supporting documents when completing the request form.

Getting Started

IMPORTANT: You will need to complete your profile in the Claims Management Portal to access your existing request, file a new request, track status, and receive communications about your request.

1. You must create an account before filing a request. Please make sure you choose an email address that you check often when creating your account.

2. Once your account has been created, complete your profile. Going forward, the Department of the Navy will communicate with you about your request via the portal, with e-mails or phone calls as needed. Periodic status notifications are sent to you via e-mail. Please ensure your contact information in your Profile remains current at all times.

3. After completing your profile, you are ready to submit a change request. Click "Proceed to Request" at the bottom of this page.

4. To view an existing request, visit the "My Requests" page in the top navigation bar. If a request is in draft status and has not yet been submitted, click on your request. Then in the "Actions" menu, choose "Edit Request" to review, update, and substantiate your request.