Forms and FAQs

Laws relating to the Workers’ Compensation Exemption Registry is found in the Tennessee Code Annotated at Title 50, Chapter 6, Part 9.

The exemption allows a business owner to exempt him or herself from the requirement to carry workers’ compensation insurance on him or herself.

An applicant must be an individual who is a sole proprietor and owns 100% of the assets of the business, or an officer of a corporation, or a member of a limited liability company with at least a 20% ownership interest, or a partner in a partnership with at least a 20% ownership interest. In addition, an applicant may qualify for the exemption if the applicant and members of the same family of the applicant hold at least 95% ownership of the business.

No. Registration is only available to individual business owners engaged in the construction services industry.

Effective October 1, 2011, each corporation, Limited Liability Company, Limited Liability Partnership, Limited Partnership, General Partnership, and family-owned business may have up to 5 individuals who can qualify to be exempt. A sole proprietor can only have 1 exemption.

Yes.

For applicants with an active contractor’s license issued by the Board for Licensing Contractors, the filing fee for an Initial Workers’ Compensation Exemption is $50.00.

For applicants without an active contractor’s license, the filing fee is $100.00 which includes the cost of the Construction Services Provider Registration and the Initial Workers’ Compensation Exemption Registration.

The fee for each Subsequent Workers’ Compensation Exemption Registration is $20.00.

All business entities, through which an individual is seeking exemption, including sole proprietors, must have an FEIN to apply for exemption. Contact the Internal Revenue Service online or by calling 1-800-829-4933.

Yes, you will have to have a separate FEIN for each subsequent exemption that you file. If you qualify as a sole proprietor, then you can use the same FEIN for all sole proprietor businesses.

Business owners who meet the requirements of T.C.A. § 50-6-901 et seq. must complete an Initial Workers’ Compensation Exemption Registration Application Form (LB-4523) and submit the form along with the required filing fee using the e-file, print and mail, paper submission, or walk-in filing process.

Sixty days prior to expiration, business owners will be able to renew their exemption by completing the exemption renewal form. A notice containing information on how to renew your exemption will be sent to you within 60 days of your exemption expiration date.

If you do not know your Secretary of State Control number, you may search for it online or by contacting the Secretary of State, Business Services Division, at (615) 741-2286.

Good standing means a corporation, limited liability company, limited partnership or limited liability partnership is listed as active and in good standing on the records of the Secretary of State. To be active and in good standing you must have filed formation or registration documents with the Secretary of State and have filed all required annual reports and paid all fees.

To be in good standing with the Tennessee Department of Revenue means the Secretary of State has received and verified that all fees, taxes, and penalties due to the Tennessee Department of Revenue have been paid.

Update your contact information by completing a Change of Address Form.

Only applicants who do not have an active contractor’s license issued by the Board for Licensing Contractors will have a construction services provider number provided to them after the filing of the initial workers’ compensation exemption application.

You will need to contact your county clerk’s office and city to see if you are required to obtain a business license.

Requests for copies of a registration notice may be obtained by completing the required form, or by printing a copy of the required form (LB-4525) and submitting by mail to the Bureau of Workers’ Compensation. There is a filing fee of $20.00 per copy requested.

Yes. An online search of the Workers' Compensation Exemption Registry is available.

An individual on the registry may voluntarily revoke their exemption at any time by completing a Voluntary Revocation Form (LB-4529) and paying the filing fee of $20.00.

If an applicant has an initial workers’ compensation exemption on file and they meet the ownership requirements, then they may file a subsequent exemption.

Business owners who meet the requirements of T.C.A. § 50-6-901 et seq. must complete a Subsequent Workers’ Compensation Exemption Registration Application Form (LB-4530) and submit the form along with the required filing fee using the e-file, print and mail, paper submission, or walk-in filing process.

You can send an email to wc.exemption@tn.gov, or call (615) 532-1319. 

All mailed applications can be sent to the following address:

All notices and information regarding your exemption will be sent via email to the email address on file. If you do not see the email in your inbox, please check your spam folder. If there is not an email address on file, all notices will be sent via mail to the mailing address listed on the registration.

Individuals may submit an application in person at the Bureau of Workers’ Compensation Nashville office located at:

Individuals must have a valid photo ID to enter the building. The walk-in counter will be open Monday – Thursday from 8:00am to 3:00pm.

The exemption registry application works best on a laptop or desktop computer, however you can use a mobile device to apply for the exemption registry. You will need to rotate or turn your phone sideways for the best access to the application on your device.