How to Complete the Oklahoma Workers' Compensation Exemption Form

Eligibility and When the Form Is Needed

In Oklahoma, the workers' compensation exemption form applies only to employers who qualify for the exemption under the Workers' Compensation Act. Exemption applies to employers who have not had any claim in the past two years, have a total of less than five employees, and maintain a good record of compliance with safety regulations. Employers must file the exemption form with the Oklahoma Workers' Compensation Board (OWCB) before the start of a new fiscal year to retain exemption status.

Gathering Required Information

Before starting the form, collect:

• Employer's legal name, address, and Oklahoma employer identification number.
• Number of employees and total payroll for the previous year.
• History of claims: dates, claim numbers, and outcomes.
• Safety program documentation, including training records and incident logs.

Filling Out the Form

The form is divided into three sections:

• Section A – Employer Information: Basic company details and contact information.
• Section B – Claim History: Provide dates and brief descriptions of any claims in the last two years. If none, check the appropriate box.
• Section C – Safety Compliance: Sign statements affirming adherence to OSHA standards and any state‑specific safety requirements.

Use black ink or a typed, printed form. Handwritten entries must be clear and legible. Avoid abbreviations that could be misinterpreted.

Submitting the Form

File electronically via the OWCB's online portal or mail a hard copy to:

Submit no later than March 1st of the year you wish to claim exemption. Late submissions may result in a temporary loss of exemption status until the next filing cycle.

Common Mistakes to Avoid

• Failing to disclose a claim that was settled out of court; all claims, regardless of settlement method, must be reported.
• Using outdated employee counts; update figures to reflect the most recent payroll data.
• Neglecting to attach safety audit reports; these are required proof of compliance.

What Happens After Submission

Once received, the OWCB reviews the application. If approved, the employer receives a written confirmation and the exemption status is effective for the upcoming fiscal year. If denied, the board will provide reasons and guidance on how to appeal or correct deficiencies.