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Workers Compensation Waiver Form
"I need a Workers Compensation Waiver Form for my construction company in Texas, to be used with independent contractors who have their own insurance coverage starting March 2025."
1. Parties: Identification of employer and employee
2. Background: Context of employment relationship and purpose of waiver
3. Definitions: Key terms used in the waiver including workers' compensation, claims, and rights
4. Rights Being Waived: Specific description of workers' compensation rights being waived and implications
5. Acknowledgment of Voluntary Action: Statement confirming employee's voluntary agreement and understanding
6. Legal Rights Notice: Notice of right to seek legal counsel and acknowledgment of implications
1. Alternative Insurance Coverage: Details of replacement insurance coverage, if provided by employer
2. Time Limitation: Duration of waiver effectiveness and terms for renewal if applicable
3. State-Specific Disclaimers: Additional disclaimers and provisions required by specific state laws
1. State-Required Forms: Official state workers' compensation waiver forms and documentation
2. Insurance Documentation: Details of alternative insurance coverage including policy numbers and coverage terms
3. Employment Agreement Reference: Relevant sections of employment agreement affected by this waiver
Authors
Employer
Employee
Waiver
Effective Date
Alternative Coverage
Work-Related Injury
Occupational Disease
State Workers' Compensation Act
Benefits
Compensation Claims
Coverage Period
Workplace
Medical Expenses
Disability Benefits
Death Benefits
Independent Contractor Status
Insurance Provider
Acknowledgment
Consideration
Governing Law
Jurisdiction
Notice Period
Statutory Rights
Voluntary Agreement
Waiver of Coverage
Voluntary Election
Alternative Insurance
Scope of Waiver
State Compliance
Duration
Revocation Rights
Legal Consultation
Consideration
Severability
Governing Law
Representations and Warranties
Entire Agreement
Amendment
Notice Requirements
Indemnification
Assumption of Risk
Release of Liability
Medical Benefits
Disability Benefits
Death Benefits
Certification
Attestation
Enforcement
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