The Maine Predetermination form is a document used to establish whether an individual qualifies as an independent contractor under Maine law. This form helps clarify the working relationship between the contractor and the employer, ensuring that both parties understand their rights and responsibilities. If you are ready to determine your status, fill out the form by clicking the button below.
The Maine Predetermination form serves as a crucial tool for individuals seeking to establish their status as independent contractors. This form is designed to help applicants demonstrate that they meet specific criteria set forth by Maine law, which distinguishes independent contractors from employees. By completing this application, individuals can clarify their working relationship with an employing unit, thereby gaining a rebuttable presumption of independent contractor status. It’s important to note that the process is voluntary; applicants are not required to obtain a predetermination before engaging in work as independent contractors. However, if they choose to file, the outcome can significantly impact their rights and responsibilities. The form outlines essential criteria that must be met, such as the right to control the means and progress of their work, the opportunity for profit and loss, and the ability to hire assistants. Additionally, applicants must provide accurate information, as submitting misleading details could lead to hefty fines. The predetermination is valid for one year and can be used with any employing unit, provided the work performed aligns with the information submitted. Understanding the implications of this form is vital for anyone navigating the complexities of independent contractor status in Maine.
IMPORTANT: PLEASE READ BEFORE COMPLETING APPLICATION
NOTICE TO APPLICANT: Predetermination of independent contractor status is based upon the information provided in this application. Participation in the submission of a fraudulent or intentionally misleading form can result in fines of up to $1,000 for an individual and up to $10,000 for a corporation, partnership or other legal entity.
The predetermination WILL NOT apply if you do not perform work consistent with the information provided in this application.
Title 39-A M.R.S.A. §13-A establishes that: A person who performs services for remuneration is presumed to be an employee unless the employing unit proves that the person is free from the essential direction and control of the employing unit, both under the person's contract of service and in fact and the person meets specific criteria. In order for a person to be an independent contractor:
A.The following criteria must be met:
(1)The person has the essential right to control the means and progress of the work except as to final results;
(2)The person is customarily engaged in an independently established trade, occupation, profession or business;
(3)The person has the opportunity for profit and loss as a result of the services being performed for the other individual or entity;
(4)The person hires and pays the person's assistants, if any, and, to the extent such assistants are employees, supervises the details of the assistants' work; and
(5)The person makes the person's services available to some client or customer community even if the person's right to do so is voluntarily not exercised or is temporarily restricted; and
B.At least 3 of the following criteria must be met:
(1)The person has a substantive investment in the facilities, tools, instruments, materials and knowledge used by the person to complete the work;
(2)The person is not required to work exclusively for the other individual or entity;
(3)The person is responsible for satisfactory completion of the work and may be held contractually responsible for failure to complete the work;
(4)The parties have a contract that defines the relationship and gives contractual rights in the event the contract is terminated by the other individual or entity prior to completion of the work;
(5)Payment to the person is based on factors directly related to the work performed and not solely on the amount of time expended by the person;
(6)The work is outside the usual course of business for which the service is performed; or
(7)The person has been determined to be an independent contractor by the federal Internal Revenue Service.
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WCB-266 (eff. 08/01/2013)
STATE OF MAINE
WORKERS’ COMPENSATION BOARD
27 STATE HOUSE STATION
AUGUSTA, ME 04333-0027
Tel. 207-287-7071 / Fax 207-287-5413
APPLICATION FOR PREDETERMINATION OF INDEPENDENT CONTRACTOR STATUS
TO ESTABLISH A REBUTTABLE PRESUMPTION
NOTICE
•The predetermination process is voluntary under the Maine Workers’ Compensation Act. The Act DOES NOT require an individual to receive an approved predetermination before working as an independent contractor.
•If you file this application, it may be: Granted or denied (you will receive a letter to this effect); or, instead of denying it, the Board may return your application and request additional information.
•By submitting this Application you are not relinquishing your rights to be covered under the Maine Workers’ Compensation Act—if you are injured you may still file a claim with the Board.
•Approved predeterminations are “portable” (may be submitted to any employing unit) and are valid for one year from the date of approval.
•The predetermination is only valid with respect to an employing unit if you work consistent with the answers on this application
•A predetermination from the Board is not binding on the Department of Labor.
•You must retain a copy of this application for your records. You may be required to produce this application along with the decision that you receive from the Board.
Pursuant to 39-A M.R.S.A. § 105, ______________________________________(Applicant Name (and d/b/a if
you use one)) hereby requests a predetermination by the Maine Workers’ Compensation Board that the Applicant is an independent contractor.
APPLICANT
Name: _______________________________________________________________________________
Doing Business As (d/b/a) (if applicable): ___________________________________________________
Complete Mailing address: ______________________________________________________________
STREET/P.O. BOXAPT. NO.
______________________________________________________________
CITY
STATE
ZIP CODE
Telephone: ___________________________________________________________________________
E-mail address: ________________________________________________________________________
Type of work you do: ___________________________________________________________________
Note: Information provided on this form, not otherwise confidential, may be shared with other state and federal agencies.
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SECTION I
THIS APPLICATION IS NOT COMPLETE UNLESS YOU ANSWER ALL OF THE QUESTIONS IN THIS SECTION AND PROVIDE ALL REQUIRED INFORMATION.
INCOMPLETE APPLICATIONS WILL BE RETURNED.
(1)The person has the essential right to control the means and progress of the work except as to final results.
(a)
Do you have the right to decide how to perform your work?
Yes
No
(b)
Other than the completion date for the work, do you have the right to determine when
you will perform your work?
(2)The person is customarily engaged in an independently established trade, occupation, profession or business.
(a)Please state your trade, occupation, profession or business.
___________________________________________________________________
(b)Please indicate how your business is organized:
sole proprietor
corporation
limited liability company
partnership
professional corporation
(c)How long have you been considered independent in your trade, occupation, profession or business?
____________________________________________________________________
(d)Have you worked for or searched for work from more than one source during the 12
months prior to the date of this application?
Yes No
(e)Did you file a corporate or partnership income tax return last year for the trade, occupation, profession or business listed in Question 2(a)?
Yes No
(f)Did you file Schedule C, Schedule E or Schedule F with your personal income tax return last year for the trade, occupation, profession or business listed in Question
2(a)?
(g)Did you pay self-employment tax and file Schedule SE with the I.R.S. last year for the trade, occupation, profession or business listed in Question 2(a)?
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(h) If you answered “No” to Questions 2 (e), (f) and (g), please explain:
________________________________________________________________________
(3)The person has the opportunity for profit and loss as a result of the services being performed for the other individual or entity.
(a)Check each of the following expenses you paid in the last 12 months in order to perform your work:
rent and utilities
tools and equipment
training
advertising
payments to business managers and agents
wages or salaries of assistants
licensing/certification/ professional dues
insurance
postage and delivery
repairs and maintenance
supplies
travel
leasing of equipment
depreciation
inventory/cost of goods sold
other
(b) Do you ever provide the materials necessary to complete your work? Yes No
(c)Do you ever provide the tools and/or equipment necessary to complete your work?
(d)Can you make more money based on how you do your work? For example, if material costs are lower than expected, or the job does not take as long as expected.
(e)Can you lose money doing your work? For example, if material costs are higher than expected, the job takes longer than expected, or re-work must be done due to a
mistake or flaw, etc.
(f)
Are you responsible for completing the work you agree to do?
(g)
If you fail to do quality work, do you have to redo the work or fix the mistake at no
additional cost to the people or businesses who hired you?
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(4)The person hires and pays the person's assistants, if any, and, to the extent such assistants are employees, supervises the details of the assistants' work.
Can you, if you want, use assistants and/or subcontractors to perform, or help
perform, your work?
If “No” please explain:
_____________________________________________________________________
Do you use assistants to perform your work?
(If “Yes,” answer questions (c), (d) and (e). If “No,” proceed to question (5).)
(c)
Are you responsible for paying your assistants?
(d)Are you personally responsible for supervising the details of your assistants’ work?
(e)Do you provide Workers’ Compensation coverage for any individuals who work
with you?
(5)The person makes the person's services available to some client or customer community even if the person's right to do so is voluntarily not exercised or is temporarily restricted.
(a) Do you advertise?
(b)Do you have the right to work for more than one person or business at a time?
(c)Other than the completion date for the work, do you determine what you work on,
how you will perform the work and when you will work on it?
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SECTION II
YOU MUST ANSWER ALL QUESTIONS IN THIS SECTION. SATISFACTORY ANSWERS TO AT LEAST THREE (3) QUESTIONS ARE REQUIRED TO QUALIFY. INCOMPLETE APPLICATIONS WILL BE RETURNED.
(6)The person has a substantive investment in the facilities, tools, instruments, materials and knowledge used by the person to complete the work.
Have you made a substantive investment in the facilities, tools, instruments, materials
or knowledge you use to complete your work?
Do you provide the essential equipment or knowledge that is used to complete your
work?
Are you required to lease essential equipment from the people or businesses who
hired you?
(d)
If the answer to (6)(c) is “Yes,” are you paying fair market value for the equipment
that you are leasing?
(7) The person is not required to work exclusively for the other individual or entity.
(a) Are you required to work exclusively for one person or business?
(b)Have you worked for more than one person or business during the past 12 months?
(c)Do you have the right to refuse work offered by the people or businesses hiring you?
(8)The person is responsible for satisfactory completion of the work and may be held contractually responsible for failure to complete the work.
(a)If you do not complete the work you agree to do in your contracts (verbal or written),
are you potentially liable to pay the people for the damages they suffer as a result of
this failure?
(b)If you fail to do quality work, do you have to redo the work or fix the mistake at no additional cost to the people who hired you, or potentially pay them money damages
so they can have the work redone or fixed?
(9)The parties have a contract that defines the relationship and gives contractual rights in the event the contract is terminated by the other individual or entity prior to completion of the work.
(a) Do you have agreements (verbal or written) with the people or businesses who hire
you?
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(b)If the people or businesses that hire you cancel your contracts (verbal or written) before you have an opportunity to complete the work, are they potentially liable to pay you the money you would have received if you had completed the work?
(10)Payment to the person is based on factors directly related to the work performed and not solely on the amount of time expended by the person.
Are you paid by the hour for your work?
If paid by the hour, do you negotiate your rates?
Are your contracts (verbal or written) for specific work at a set price?
(d)If the answers to 10 (a),(b) or (c) are “No,” please explain.
(11)The work is outside the usual course of business for which the service is performed.
(a)Is the work you do different than the work performed by the people or businesses that
hire you? Yes No
(b) Have you worked as an employee for any of the people or businesses for which you
currently work? Yes No If yes, please provide the most recent date of your employment: _________________
(12)The person has been determined to be an independent contractor by the federal Internal Revenue Service.
The Internal Revenue Service allows businesses or workers to a request a determination as to whether or not a worker is an independent contractor. These determinations can be requested by filing Form SS-8, Determination of Worker Status for Purposes of Federal Employment Taxes and Income Tax Withholding with the I.R.S.
Have you filed Form SS-8 with the I.R.S.?
If you filed Form SS-8, have you received a determination?
If you received a determination, please check the appropriate box:
Approved
Denied
Other
Please provide the date the I.R.S. issued its determination: __________________.
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THIS APPLICATION MUST BE SIGNED.
UNSIGNED APPLICATIONS WILL NOT BE PROCESSED.
Read carefully and sign below:
I hereby certify the foregoing information is truthful and accurate. I understand if any information contained in this application is found to be intentionally misleading or fraudulent, the predetermination of independent contractor status shall be nullified and I may be subject to fines as described on page 1.
I further understand this predetermination of independent contractor status is based upon the information provided in this application. I understand changes in these circumstances may nullify the predetermination of independent contractor status. I agree to notify the Workers’ Compensation Board of any changes to the information in this application or the circumstances described herein.
You must retain a copy of this application for your records. You may be required to produce this application along with the decision that you receive from the Board.
______________
________________________________
Date
Signature of Applicant
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Filling out the Maine Predetermination form is a straightforward process, but it requires careful attention to detail. This form helps establish whether you qualify as an independent contractor under Maine law. Once you complete the form, you will submit it to the Maine Workers’ Compensation Board for review. They will either grant or deny your application, or they may ask for more information if needed.
The Maine Predetermination form is an application used to determine if an individual qualifies as an independent contractor under Maine law. This determination is important for understanding responsibilities related to workers' compensation and tax obligations.
Anyone who believes they are working as an independent contractor in Maine should complete this form. It helps clarify their status and ensures they meet the necessary criteria to be classified as an independent contractor.
After submission, the Maine Workers' Compensation Board will review your application. You may receive a letter granting or denying your request. In some cases, the Board may ask for more information before making a decision.
No, completing the Predetermination form is voluntary. You do not need an approved predetermination to work as an independent contractor in Maine.
An approved predetermination is valid for one year from the date of approval. It can be used with any employing unit during that time.
If your work does not align with the information provided in the application, the predetermination will not apply. It’s essential to ensure that your work activities match the details you submit.
Submitting fraudulent or misleading information can lead to fines. Individuals may face fines of up to $1,000, while corporations or partnerships could incur fines of up to $10,000.
Yes, submitting the Predetermination form does not affect your right to file a workers' compensation claim if you are injured while working.
To be classified as an independent contractor, you must meet specific criteria, including:
Yes, you should keep a copy of the application for your records. You may need to present it along with the Board’s decision in the future.
Incomplete Information: Failing to answer all questions or provide required details can lead to the application being returned. Ensure every section is filled out completely.
Misrepresentation: Providing false or misleading information can have serious consequences, including fines. Always be honest about your work status and activities.
Inconsistent Work Description: The work performed must align with the information provided in the application. If the work differs from what is stated, the predetermination may not apply.
Neglecting to Retain Copies: Not keeping a copy of the application and the Board's decision can create issues later. Always save these documents for your records.
Ignoring Additional Requests: If the Board asks for more information, failing to respond can result in denial of the application. Respond promptly to any requests.
Assuming Automatic Approval: Many believe that submitting the application guarantees approval. Understand that the application may be granted, denied, or returned for further information.
When applying for a predetermination of independent contractor status in Maine, several other forms and documents may be required or beneficial to the process. Understanding these documents can help streamline your application and ensure compliance with relevant regulations.
Gathering these documents alongside your Maine Predetermination form can enhance your application and provide a comprehensive view of your independent contractor status. Being prepared will help ensure a smoother review process by the Maine Workers' Compensation Board.
The IRS Form SS-8 is similar to the Maine Predetermination form in that it helps determine a worker's classification as an independent contractor or an employee. This form is submitted to the Internal Revenue Service, which reviews the circumstances of the working relationship based on various factors. Both forms assess the level of control exercised by the employer and the independence of the worker. The IRS Form SS-8 requires detailed information about the working relationship, similar to the criteria outlined in the Maine Predetermination form.
The California Department of Industrial Relations (DIR) provides a similar document known as the "Independent Contractor Status Determination." This form evaluates whether a worker is an independent contractor or an employee under California law. Like the Maine Predetermination form, it considers the level of control the employer has over the worker and the worker's independence in performing tasks. Both forms aim to clarify the classification to ensure compliance with labor laws and protect the rights of workers.
The New York State Department of Labor has a form that assesses independent contractor status, which shares similarities with the Maine Predetermination form. This document focuses on the relationship between the worker and the employer, evaluating aspects such as control, independence, and financial arrangements. Both forms are designed to provide clarity and legal standing for workers regarding their employment status, thereby influencing their rights and responsibilities.
The Michigan Unemployment Insurance Agency offers a "Determination of Worker Status" form that is akin to the Maine Predetermination form. This document helps establish whether a worker is an independent contractor or an employee for unemployment insurance purposes. Both forms require detailed information about the working relationship and the criteria for classification. They aim to protect workers' rights while ensuring compliance with state regulations.
The Florida Department of Revenue has a similar form used to determine independent contractor status for tax purposes. This form evaluates the degree of control an employer has over a worker, paralleling the criteria found in the Maine Predetermination form. Both documents help clarify the worker's classification, which impacts tax obligations and benefits, ensuring that both parties understand their rights and responsibilities.
The Texas Workforce Commission provides a "Determination of Employment Status" form that is comparable to the Maine Predetermination form. This document assesses the nature of the working relationship, focusing on control and independence. Both forms are essential for establishing whether a worker is classified as an independent contractor or an employee, which has implications for benefits, rights, and obligations under state law.
The Washington State Employment Security Department offers a "Worker Classification" form that serves a similar purpose as the Maine Predetermination form. This document helps determine whether a worker is an independent contractor or an employee based on control, independence, and financial arrangements. Both forms aim to provide clarity in worker classification to ensure compliance with labor laws and protect workers' rights.
The Illinois Department of Employment Security has a form that assesses independent contractor status, which is similar to the Maine Predetermination form. This document evaluates the working relationship, focusing on factors such as control and independence. Both forms are designed to clarify the classification of workers, which is crucial for determining eligibility for unemployment benefits and other protections.
Lastly, the Pennsylvania Department of Labor and Industry has a form that helps determine independent contractor status. This document shares similarities with the Maine Predetermination form by focusing on the relationship between the worker and employer. Both forms evaluate the level of control and independence, aiming to protect workers' rights while ensuring compliance with state labor laws.
When filling out the Maine Predetermination form, it's essential to follow specific guidelines to ensure accuracy and compliance. Here’s a list of things you should and shouldn't do:
This is incorrect. The process is voluntary under the Maine Workers’ Compensation Act. Individuals do not need to receive an approved predetermination before working as independent contractors.
Submitting the application does not relinquish rights to coverage under the Maine Workers’ Compensation Act. If injured, individuals can still file a claim with the Board.
Approved predeterminations are valid for only one year from the date of approval. After that, a new application must be submitted.
This is not true. A predetermination from the Board is not binding on the Department of Labor or any other agency.
Even if the application is completed accurately, it can still be denied. The Board may also request additional information instead of granting or denying the application.
The predetermination is only valid if the individual works consistent with the answers provided on the application.
Not all independent contractors meet the specific criteria outlined in the application. Individuals must satisfy both the essential criteria and at least three additional criteria to be classified as independent contractors.
Receiving a predetermination does not guarantee that an individual will be classified as an independent contractor in every situation. Each case may be evaluated differently based on specific circumstances.
The application must be fully completed; incomplete applications will be returned. All required information must be provided for the application to be processed.
While the application is under review, it may be possible to provide additional information if requested by the Board. Applicants should be prepared to clarify or expand upon their submissions.
Key Takeaways for Filling Out and Using the Maine Predetermination Form: