CALL 844-967-5247 (844-WORK-5247) FOR A QUICK QUOTE.
View Insurance Certificates

Workers Compensation Exemption Forms by State

Find official workers compensation exemption forms for all 50 states. Download state-specific forms and understand filing requirements for contractors, business owners, and corporate officers.

Important Legal Notice

Workers compensation exemption forms have specific requirements and deadlines that vary by state. Filing these forms incorrectly or missing deadlines can result in penalties, fines, or loss of exemption status.

We strongly recommend consulting with a licensed insurance professional before filing any exemption forms to ensure compliance with your state's requirements and to understand the implications of exempting yourself from coverage.

Understanding Workers Compensation Exemptions

Who Can Apply for Exemptions?

  • Sole proprietors (in most states)
  • Business partners
  • Corporate officers with ownership stakes
  • LLC members in certain states

Key Considerations

  • Loss of injury protection coverage
  • Potential personal liability exposure
  • Impact on business licensing and bonding
  • Annual renewal requirements in many states

State-by-State Exemption Forms

Click on your state below to access official exemption forms and requirements. Forms are provided by each state's workers compensation department or industrial commission.

Alabama

Department:

Alabama Department of Labor

Form Name:

Exemption from Workers' Compensation Coverage

Requirements:

Sole proprietors and partnerships may exempt themselves

Alaska

Department:

Alaska Department of Labor

Form Name:

Election to be Excluded from Coverage

Requirements:

Officers and partners may elect exemption

Arizona

Department:

Arizona Industrial Commission

Form Name:

Election of Exemption

Requirements:

Corporate officers and LLC members may exempt

Arkansas

Department:

Arkansas Workers' Compensation Commission

Form Name:

Corporate Officer Exemption

Requirements:

Corporate officers owning 10% or more may exempt

California

Department:

California Department of Industrial Relations

Form Name:

Notice of Election to be Subject to or Excluded from Workers' Compensation

Requirements:

Corporate officers may elect exemption with conditions

Colorado

Department:

Colorado Division of Workers' Compensation

Form Name:

Corporate Officer Election Form

Requirements:

Corporate officers may elect exemption annually

Connecticut

Department:

Connecticut Workers' Compensation Commission

Form Name:

Election to be Excluded from Coverage

Requirements:

Corporate officers and LLC members may exempt

Delaware

Department:

Delaware Department of Labor

Form Name:

Corporate Officer Exemption Election

Requirements:

Officers with 10% or more ownership may exempt

Florida

Department:

Florida Division of Workers' Compensation

Form Name:

Petition for Exemption from Workers' Compensation Coverage

Requirements:

Corporate officers may petition for exemption

Georgia

Department:

Georgia State Board of Workers' Compensation

Form Name:

Election to Reject Workers' Compensation Coverage

Requirements:

Sole proprietors and partners may reject coverage

Don't see your state listed above? We're continuously updating our database.Contact us for assistance finding forms for additional states.

Additional Resources

Filing Requirements

Learn about deadlines, renewal requirements, and proper filing procedures for your state.

View Requirements →

Risks & Alternatives

Understand the risks of exempting yourself and explore alternative coverage options.

Learn More →

Expert Consultation

Get professional guidance on exemption decisions and coverage alternatives.

Schedule Consultation →

Need Help with Workers Compensation Decisions?

Our experienced team can help you understand exemption requirements, evaluate risks, and find the right coverage for your business.