62-1-20. Contents of affidavit of exempt status.
The affidavit must be on a form prescribed by the director of the Division of Insurance and must be notarized. The director of the Division of Insurance may promulgate rules pursuant to chapter 1-26 to provide definitions, the form and process for filing the affidavit, and documentation required for filing an affidavit of exemption from the South Dakota Workers' Compensation Law.
The affidavit of exempt status shall contain substantially the following:
(1)Statements that the affiant:
(a)Is not an employee and does not want a workers' compensation insurance policy;
(b)Has read, signed, and understands the exempt status fact sheet attachment to the affidavit;
(c)Understands that the affiant will be considered an independent contractor and will not be considered an employee under the South Dakota Workers' Compensation Law;
(d)Understands that the affiant will not be eligible for compensation under the South Dakota Workers' Compensation Law;
(e)Understands that the signing of the affidavit creates a rebuttable presumption that the affiant is not an employee for the purpose of the South Dakota Workers' Compensation Act;
(f)Understands that the signing of the affidavit does not affect the rights or coverage of any employee of the affiant;
(g)Is not signing the affidavit or providing information as a result of force, threat, coercion, compulsion, or duress; and
(h)Understands that knowingly providing false information on an affidavit of exempt status under the South Dakota Workers' Compensation Law is a Class 2 misdemeanor; and
(2)An exempt status fact sheet, to be attached to the affidavit, which:
(a)Delineates the legal requirements recognized in law for determining whether a person is an independent contractor; and
(b)Contains a statement that the affiant believes they are an independent contractor given the preceding list of legal requirements.
Source: SL 2015, ch 262, ยง2.
Structure South Dakota Codified Laws
Title 62 - Workers' Compensation
Chapter 01 - Definitions And General Provisions
Section 62-1-1 - Definition of terms.
Section 62-1-1.1 - Medical practitioner defined.
Section 62-1-1.2 - Determining impairment.
Section 62-1-2 - Employer defined.
Section 62-1-3 - Employee defined.
Section 62-1-4 - Municipal and county officers--Inclusion within definition of employee.
Section 62-1-6 - Conservation officers acting as law enforcement officers.
Section 62-1-8 - Nonprofit corporation complying with title--Executive officer as employee.
Section 62-1-9 - Citation of title.
Section 62-1-10 - Owner-operator of certain vehicles as independent contractor.
Section 62-1-14 - Promulgation of rules.
Section 62-1-15 - Evidence of injury supported by medical findings.
Section 62-1-16 - Employer civilly liable for retaliatory termination of employee--Burden of proof.
Section 62-1-17 - Discrimination in hiring based upon preexisting injury prohibited.
Section 62-1-19 - Independent contractor affidavit of exempt status--Rebuttable presumption.
Section 62-1-20 - Contents of affidavit of exempt status.
Section 62-1-21 - Providing false information on affidavit of exempt status as misdemeanor.
Section 62-1-22 - Acceptance of affidavit of exempt status not required.
Section 62-1-23 - Wheeler v. Cinna Bakers LLC regarding aggregation of wages abrogated.