Missouri Form WC-134, the Employer’s Affidavit of Exception from Workers’ Compensation Benefits, is the sworn document qualifying business owners file to formally opt themselves out of workers’ compensation coverage. There is no filing fee. You complete it, sign in front of a notary, and submit it to the Missouri Division of Workers’ Compensation in Jefferson City either by mail or through the Division’s Box.com portal.1Missouri Department of Labor and Industrial Relations. DWC Electronic Filing via Box.com Once the Division stamps and returns it, that approved copy is your proof of exemption.
Who Can Use the Form
The WC-134 exempts specific owners and officers from being covered under a workers’ compensation policy. It does not let a business skip coverage for its employees. Missouri requires most employers with five or more employees to carry workers’ comp, and construction employers must carry it starting at one employee.2Missouri Department of Labor and Industrial Relations. Does an Employer Have to Carry Workers’ Compensation Insurance?
Sole proprietors and partners are not automatically treated as employees for workers’ comp purposes. RSMo § 287.035 makes their own coverage optional.3Missouri Revisor of Statutes. RSMo Section 287.035 If you have never elected into coverage, you may not technically need the affidavit, but filing one gives you something to hand to general contractors, licensing offices, and insurance auditors.
Corporate officers and LLC members are in a different position. RSMo § 287.037 lets qualifying officers or members reject coverage, and once they do, they give up any right to benefits under the policy.4Missouri Revisor of Statutes. RSMo Section 287.037 The WC-134 is how that rejection gets on file with the state.
Construction contractors use the form most often. Under RSMo § 287.061, any city or county issuing a contractor’s occupational or business license must demand either a certificate of insurance or a signed exemption affidavit before handing over the license.5Missouri Revisor of Statutes. Missouri Code 287.061 A one-person construction business still needs the affidavit to get licensed, even though it has no employees to cover.
What to Have Ready Before You Fill It Out
Download the form from the Division of Workers’ Compensation’s forms page at labor.mo.gov.6Missouri Department of Labor and Industrial Relations. Employer’s Affidavit of Exception from Workers’ Compensation Benefits Gather these items first:
- The business’s legal name as it appears on your Missouri registration, not a DBA.
- Your Federal Employer Identification Number. A sole proprietor without employees who never obtained an FEIN may use a Social Security number as the identifier.
- The Social Security number of each individual seeking the exemption.
- A short description of the business’s activity, which the Division uses to classify the industry.
- The ownership percentage held by each person listed. Construction applicants are asked for this on the form itself.
Complete every field. The affidavit includes a declaration that false information can be referred to the Division’s Fraud and Noncompliance Unit and prosecuted under RSMo § 287.128.6Missouri Department of Labor and Industrial Relations. Employer’s Affidavit of Exception from Workers’ Compensation Benefits Check names, numbers, and ownership figures against your records before you sign anything.
Get It Notarized
The WC-134 is a sworn affidavit. You have to sign it in front of a notary public who will verify your identity, apply the seal, and fill in a commission expiration date in the notarization block on the form. Submissions without valid notarization get rejected, and an expired notary commission invalidates the whole document, so confirm the commission is current before your appointment.
Banks, UPS stores, and shipping centers commonly offer notary services for a small fee. Some Missouri county courthouses notarize for free. Bring a government-issued photo ID.
Where to Submit
By Mail
Send the notarized original to:
Missouri Division of Workers’ Compensation
P.O. Box 58
Jefferson City, MO 65102-00587Missouri Department of Labor and Industrial Relations. Division of Workers’ Compensation
For courier delivery, the street address is 421 East Dunklin Street, Jefferson City, MO 65102. Keep a photocopy of the signed, notarized form before you drop it in the mail.
Electronically
The Division accepts scanned, notarized forms through its Box.com portal at no cost.1Missouri Department of Labor and Industrial Relations. DWC Electronic Filing via Box.com Access instructions are at labor.mo.gov/dwc/electronic-filing. Uploading avoids postal delays and gives you an immediate confirmation.
What Happens After You File
The Division reviews the affidavit and verifies the information against state records, then returns a stamped, approved copy. The stamped version is what actually proves the exemption; the copy you kept is just a backup. Processing time depends on current workload.
Keep the approved affidavit somewhere you can produce it quickly. You will be asked for it in several places:
- City and county licensing offices, before issuing a construction contractor’s business license.5Missouri Revisor of Statutes. Missouri Code 287.061
- General contractors vetting subcontractors before a job starts.
- Insurance premium audits, where the carrier uses the approved affidavit to remove exempted individuals from payroll calculations, lowering the premium.
- State compliance audits, where the stamped affidavit shows you were lawfully uninsured for the people listed.
If your business adds owners, changes structure, or an exempted person leaves, file a new affidavit reflecting the current situation rather than relying on the old one.
What Opting Out Actually Costs You
If you get hurt doing the work, you have no workers’ compensation benefits. No medical coverage for the injury, no wage replacement while you recover. Whether that trade is worth the premium savings depends on your actual injury exposure. The math looks different for a desk-based consultant than for someone framing houses.
Penalties for a False Affidavit
The declaration on the form is not boilerplate. Making a false or fraudulent material statement to obtain or deny workers’ compensation benefits is a class E felony in Missouri, with a fine of up to $10,000 or double the value of the fraud, whichever is greater.8Missouri Revisor of Statutes. Missouri Code 287.128 Misclassifying an employee’s job to get a lower insurance rate is a class A misdemeanor on the first offense and a class E felony on repeat violations.9Missouri Department of Labor and Industrial Relations. Workers’ Compensation Fraud and Noncompliance Employers who knowingly fail to carry required insurance face a class A misdemeanor and a fine of up to three times the annual premium they would have paid or $50,000, whichever is greater. File the WC-134 only if you genuinely qualify, and keep coverage current for every worker who isn’t exempt.