Workers Comp Waiver for the United States

Workers Comp Waiver Template for United States

A Workers' Compensation Waiver is a legal document used in the United States where a worker, typically an independent contractor, voluntarily waives their rights to workers' compensation coverage. The document must comply with both federal labor laws and state-specific workers' compensation regulations, which vary significantly by jurisdiction. Some states prohibit such waivers entirely, while others require specific language or filing requirements.

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What is a Workers Comp Waiver?

A Workers Comp Waiver is utilized when an independent contractor or certain eligible workers choose to opt out of workers' compensation coverage. This document is particularly important in industries with high contractor utilization, such as construction or professional services. The waiver must carefully comply with state-specific requirements, as some U.S. states prohibit such waivers or impose strict conditions on their use. The document typically includes acknowledgment of rights being waived, alternative insurance arrangements if applicable, and specific state-mandated disclosures.

What sections should be included in a Workers Comp Waiver?

1. Parties: Identification of employer and worker/contractor including full legal names, addresses, and relevant registration numbers

2. Background: Context of employment relationship, nature of work, and reason for workers' compensation waiver

3. Definitions: Key terms used in the waiver including 'Workers' Compensation Benefits', 'Waiver Period', and state-specific terminology

4. Waiver Statement: Express waiver of workers' compensation benefits, clearly stating the rights being waived and the voluntary nature of the waiver

5. Acknowledgment of Rights: Worker's explicit acknowledgment of the rights being waived and confirmation of understanding the implications

6. Duration: Specific period for which the waiver is valid, including start date and any termination conditions

What sections are optional to include in a Workers Comp Waiver?

1. Alternative Insurance: Details of alternative insurance coverage provided by the employer, including policy numbers and coverage limits

2. State-Specific Disclosures: Additional disclosures and statements required by specific state laws regarding workers' compensation waivers

3. Revocation Rights: Terms and conditions under which the worker may revoke the waiver, including notice requirements and procedures

What schedules should be included in a Workers Comp Waiver?

1. Schedule A - Proof of Alternative Insurance: Documentation of alternative insurance coverage including policy details and certificates

2. Schedule B - State-Required Forms: Copies of any state-mandated forms or certificates required for valid workers' compensation waivers

3. Schedule C - Independent Contractor Agreement: Copy of the underlying independent contractor agreement if the waiver relates to contractor status

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Jurisdiction

United States

Publisher

Genie AI

Document Type

Waiver

Cost

Free to use
Industries

OSHA Compliance: The Occupational Safety and Health Act sets national workplace safety standards that must be considered even when implementing workers' compensation waivers

ADA Requirements: The Americans with Disabilities Act must be considered to ensure the waiver doesn't discriminate against or improperly affect disabled workers

FLSA Considerations: The Fair Labor Standards Act's provisions regarding employee classification and rights must be incorporated into waiver considerations

State Workers' Compensation Statutes: Each state has unique workers' compensation laws that govern the validity and requirements of waivers, including whether they're permitted at all

State Monopolistic Status: Whether the state is 'monopolistic' (requiring all insurance to be purchased from state fund) affects waiver implementation

Notice Requirements: State-specific requirements for notifying workers of their rights and the implications of signing a waiver

Time Limitations: State-specific time restrictions on how long waivers remain valid and when they can be implemented

Filing Requirements: State-specific requirements for filing and registering workers' compensation waivers with appropriate authorities

Industry-Specific Regulations: Special requirements for specific industries like construction, maritime, or agriculture that affect waiver validity and implementation

Worker Classification Rules: Regulations governing whether a worker is an employee or independent contractor, which affects waiver applicability and requirements

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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