What Are the Instructions for Filling Out a Workers' Compensation Waiver Form?


Quick Answer

Instructions for filling out a workers' compensation waiver form differ depending upon the issuing state. States such as Utah and New York allow participants to apply for and fill out applications to waive workers' compensation benefits online with supporting documentation, according to the Utah Labor Commission and the New York State Workers' Compensation Board.

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Full Answer

In Utah, applicants wishing to waive workers' compensation benefits must fill out an application form, provide required documentation and pay a nonrefundable fee of $50, as of 2015, reports the Utah Labor Commission. Required documents include two of the following: a valid business license; a license to perform an occupation, such as a commercial driver's license; a current certificate of insurance; or a state or federal income tax return for the business. Other supplemental documents include a bank statement, a phone bill or a business advertisement that displays the business name and contact information.

Participants who wish to waive worker's compensation benefits in the state of New York can complete a paper form or submit an application online, according to the New York State Workers' Compensation Board. An online application produces immediate results, with the participant being able to print the certificate once the application processes, while a paper application must be mailed in and can take up to four weeks to process.

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