WC/DB Exemptions

For Contractors /Homeowners

The old form, WC/DB-100, for exemption from workers’ compensation and/or disability benefits insurance was retired from use on December 1, 2008. Instead, Form CE-200, which replaces Form WC/DB-100, must be used for applicants seeking exemptions starting on December 1, 2008.

Form CE-200 reflects a new process for granting exemptions from workers’ compensation and disability benefits insurance coverage requirements. Historically, the WC/DB-100 exemption forms were valid for multiple permits, licenses or contracts where the applicant applied, had to be notarized, and had to be stamped by the NYS Workers’ Compensation Board.

Request for WC/DB Exemption (Form CE-200)

The link listed below belongs to the NYS Workers’ Compensation Board and takes you to the online version of the CE-200 form. Please read the instructions carefully. By accessing the application online you will be able to complete the application and print the certificate immediately. Please bring the completed, numbered certificate with you to the Big Flats Code Department.