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At Workers' Compensation Shop.com we attempt to offer free access to South Dakota's workers' compensation forms, applications and guides. We strive to keep our library up to date with the latest versions of every form you may need.

As with all information we provide, please verify the accuracy of this information with the South Dakota Division of Labor.

If you have questions about a workers' comp form, feel free to contact a specialist at 888-611-7467. We want to be your source for workers' compensation information, rates and quotes in South Dakota.

South Dakota Workers' Compensation Insurance Forms

SD Acord 130 Workers' Compensation Application

The standard Acord 130 application form for workers' comp coverage in South Dakota.

South Dakota First Report of Injury Form

First Report of Injury Form. Employers should complete this form and send to their insurance company each time an injury occurs.

South Dakota Application for Exclusion of Officers and Stockholders

Owners and Officers of corporations should complete this form to exclude themselves from a work comp policy.

South Dakota Application for Exemption for Workers' Compensation Insurance

Complete this form if you are a sole-proprietor, partnership with no employees or an sole officer of a corporation and would like to be exempt from coverage.

Application for Self Insurance

Complete this form if you wish to become self insured for workers' compensation.

Supplemental Application for Self Insurance

Complete this additional form presenting your managed care plan if you wish to become self insured.

Facts for Injured Workers In South Dakota

Information about workers' compensation in South Dakota for workers and employers.

Workers' Comp Exemption

Each state has its own laws and requirements regarding when and how employers are allowed to opt-out of coverage under their workers' compensation policy. Some states make it easier than others because they don't require anything to be filed. Other states require special inclusion or exclusion affidavit documentation. Failure to comply often causes employers to have to pay premium on themselves even when they wanted to be excluded form coverage.

Waiver of Subrogation

A waiver of subrogation means that a business and their insurance company is foregoing all rights to file suit, or seek damages, from another business. This is common in the construction industry as builders attempt to protect their company from negligence. A workers' comp waiver of subrogation does not prevent an injured employee from filing a lawsuit for damages. This coverage typically add about $100 to the cost of a work comp policy.

Certificate of Insurance

A Certificate of Insurance is a document that serves as evidence of insurance or proof of coverage. Certificates indicate your current coverages and policy limits. Insurance Agencies issue on an insured's behalf and they often list a third party as a certificate holder. This means they should be notified if a policy cancels prior to expiration. Requests for any special wording should be carefully checked against the policy language before being added to a certificate as they can create legal issues with coverage.


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State Resources for South Dakota

South Dakota Department of Commerce

Division of Insurance
445 E Capital Dr
Pierre, SD 57501
605-773-3563
http://dlr.sd.gov/insurance/

SD Division of Labor

Kneip Building
700 Governors Drive
Pierre, SD 57501-2291
605-773-3681
http://dlr.sd.gov/workerscomp/

Workers' compensation insurance is required by law for South Dakota employers.

South Dakota forms and applications such as owners inclusion or exclusion forms are sometimes updated by the state. Contact us if you need help or can't find the workers' compensation form your need for South Dakota.

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Visit NCCI for more resources and information about workers' compensation class codes. Visit United States Department of Labor for more information about government agencies managing workers compensation insurance rates.

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