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The DWC 83 form is a crucial document within the Texas workers' compensation system, specifically designed for establishing the relationship between hiring contractors and independent contractors in the construction industry. This form serves to clarify whether an independent contractor qualifies as such under the Texas Workers' Compensation Act, as outlined in the Texas Labor Code. It includes significant declarations regarding the independent contractor's status, emphasizing that they are not considered employees of the hiring contractor. This distinction is vital, as it affects eligibility for workers' compensation coverage. The form requires both parties to affirm their understanding that the independent contractor and any associated employees will not be entitled to workers' compensation benefits from the hiring contractor's insurance. Furthermore, the DWC 83 form stipulates that this declaration remains in effect for one year, unless a new hiring agreement is established. It also provides guidelines for notifying the Texas Department of Insurance if any changes occur. Proper filing of the DWC 83 is essential, as it must be submitted to both the Texas Department of Insurance and the hiring contractor's workers' compensation insurance carrier within ten days of signing. This ensures compliance and protects both parties involved in the agreement.

Sample - Dwc 83 Form

Job-site specific agreement
3. Agreement end date (mm/dd/yyyy)

DWC083

Joint agreement to affirm independent relationship for certain building and

construction workers

Agreement to establish employer-employee relationship for certain building

and construction workers

Este formulario está disponible en español en el sitio web de la División en www.tdi.texas.gov/forms/form20numeric.html

Para obtener asistencia en español, llame a la División al 800-252-7031.

Part 1. Agreements

Check only one:

Joint agreement to affirm independent relationship for certain building and construction workers

Agreement to establish employer-employee relationship for certain building and construction workers (Complete items 1-7 as appropriate.)

1. Type of agreement Blanket agreement

2. Agreement start date (mm/dd/yyyy)

4.Estimated number of employees affected Location of job sites covered under agreement

5.Address (street or PO box, city, state, ZIP code)

6.Address (street or PO box, city, state, ZIP code)

7.Address (street or PO box, city, state, ZIP code)

📎📎 Attach a sheet with additional locations if needed.

Part 2. The hiring contractor must complete this part.

8. Hiring contractor name

9. Federal tax ID number

10. Address (street or PO box, city, state, ZIP code)

11. Email

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12.Hiring contractor's affirmations Check only one:

Joint agreement to affirm independent relationship for certain building and construction workers

I declare that the independent contractor meets the qualifications under Texas Labor Code Section 406.141, and the independent contractor is not an employee of the hiring contractor. The independent contractor and the independent contractor's employees are not entitled to workers' compensation insurance coverage from the hiring contractor. The hiring contractor's workers' compensation insurance carrier will not require the hiring contractor to pay premiums to cover the independent contractor or the independent contractor's employees, helpers, or subcontractors. Once this agreement is signed, the subcontractor and the subcontractor's employees will not be entitled to workers' compensation coverage from the hiring contractor unless a subsequent written agreement is signed, and filed according to division rules, expressly stating that this agreement does not apply.

Agreement to establish employer-employee relationship for certain building and construction workers

I will

withhold

not withhold the cost of workers' compensation insurance coverage from the

independent contractor's price. I agree that the hiring contractor will purchase workers' compensation

insurance coverage for the independent contractor and the independent contractor's employees.

I agree that I am the employer of the independent contractor for the purpose of providing workers’ compensation insurance coverage, and no other purpose.

13. Signature of hiring contractor

14. Date of signature (mm/dd/yyyy)

Part 3. The independent contractor must complete this part.

15. Independent contractor name

16.

Federal tax ID number

 

 

 

17. Address (street or PO box, city, state, ZIP code)

18.

Email

 

 

 

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19.Independent contractor's affirmations Check only one:

Joint agreement to affirm independent relationship for certain building and construction workers

I declare that I meet the qualifications under Texas Labor Code Section 406.141, and I am not an employee of the hiring contractor. My employees and I are not entitled to workers' compensation insurance coverage from the hiring contractor. The hiring contractor's workers' compensation insurance carrier will not require the hiring contractor to pay premiums to cover me, my employees, helpers, or subcontractors.

Agreement to establish employer-employee relationship for certain building and construction workers

I agree that the hiring contractor employs the independent contractor for the purpose of providing workers’ compensation insurance coverage, and no other purpose.

20. Signature of independent contractor

21. Date of signature (mm/dd/yyyy)

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FAQ

Joint agreement to affirm independent relationship for certain building and construction workers

Agreement to establish employer-employee relationship for certain building and construction workers

Who may use this agreement?

Texas Labor Code Section 406.145 allows certain building and construction workers, specifically, hiring contractors and independent contractors, to agree that the independent contractor is not an employee of the hiring contractor, and the hiring contractor is not responsible for workers' compensation insurance coverage for the independent contractor.

Texas Labor Code Section 406.144 allows certain building and construction workers, specifically, hiring contractors and independent contractors, to agree on who will provide workers' compensation insurance coverage to the subcontractor and the employees of the subcontractor.

Who is an independent contractor?

Texas Labor Code Section 406.141(2) defines an independent contractor as a person who contracts to perform work or provide a service for the benefit of another, and who is:

paid by the job, not by the hour or some other time-measured basis;

free to hire as many helpers as desired and determine what to pay each helper; and

free to work for other contractors or send helpers to work for other contractors, while under contract with the hiring employer.

How do I know if I should sign this agreement?

You may want to talk to an attorney if you are not sure if all parties meet the requirements to enter into these agreements.

When does the agreement take effect?

The agreement takes effect the date both parties have signed it or on the start date of the agreement, whichever is later.

How long is the joint agreement to affirm an independent relationship in effect?

Texas Labor Code Section 406.145 states that the agreement to affirm an independent relationship applies to all hiring agreements the hiring contractor and the independent contractor make until the first anniversary of the date the hiring contractor filed the agreement with their workers' compensation insurance carrier. The agreement does not apply to a new hiring agreement if the new agreement states this agreement does not apply.

The hiring contractor and independent contractor must notify the hiring contractor's workers' compensation insurance carrier in writing within 10 days after the date they make a hiring agreement that does not apply to this agreement.

The subcontractor and the subcontractor's employees are not entitled to workers' compensation coverage from the hiring contractor once this agreement is signed. The hiring contractor and independent contractor must make a new written agreement to establish an employer-employee relationship and provide workers' compensation insurance coverage. The new written agreement must state that this agreement does not apply. The hiring contractor and independent contractor can use DWC Form-084, Exception to Application of a Joint Agreement to Affirm Independent Relationship for Certain building and Construction Workers. Find our forms at www.tdi.texas.gov/forms/form20numeric.html.

Where should I send this agreement?

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The hiring contractor must file a legible and complete copy of this agreement with their workers’ compensation insurance carrier within 10 days after signing the agreement. The hiring contractor must keep the original. The independent contractor should also keep a copy. If the hiring contractor changes workers' compensation insurance carriers during the effective dates of the agreement, the hiring contractor should file this form with their new insurance carrier.

You may file this form with Texas Department of Insurance, Division of Workers' Compensation (DWC) under Labor Code Section 406.145.

Note: With few exceptions, you are entitled to:

be informed about the information DWC collects about you;

receive and review the information (Government Code Sections 552.021 and 552.023); and

have DWC correct information that is incorrect (Government Code Section 559.004). 

For more information, contact [email protected] or go to the Corrections Procedure section at www.tdi.texas.gov.

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File Specs

Fact Name Fact Description
Governing Law The DWC 83 form is governed by the Texas Workers' Compensation Act, specifically Texas Labor Code, Section 406.141.
Purpose This form establishes the independent contractor status for workers in building and construction, ensuring they are not classified as employees.
Filing Requirements Four copies of the completed form must be filed with the Texas Department of Insurance and the hiring contractor's workers' compensation insurance carrier within 10 days of execution.
Effective Date The agreement takes effect upon receipt by the Texas Department of Insurance and remains valid for one year unless a new agreement is made.
Coverage Exemption Once the DWC 83 form is signed, the independent contractor and their employees are not entitled to workers' compensation coverage from the hiring contractor.

Dwc 83 - Usage Guidelines

Filling out the DWC 83 form is a straightforward process that helps establish the relationship between a Hiring Contractor and an Independent Contractor under Texas law. After completing the form, it must be filed with the Texas Department of Insurance and the relevant workers' compensation insurance carrier. Ensure you keep copies for your records.

  1. Begin by downloading the DWC 83 form from the Texas Department of Insurance website or obtain a physical copy.
  2. Fill in the Hiring Contractor's name and address at the top of the form.
  3. Enter the Independent Contractor's name and address in the designated section.
  4. Check the appropriate box that indicates whether you are affirming an independent relationship or establishing an employer-employee relationship.
  5. In the section for the term of the agreement, fill in the start and end dates of the agreement.
  6. Specify the location of each affected job site or indicate if this is a blanket agreement.
  7. Provide an estimate of the number of employees affected by this agreement.
  8. Both the Hiring Contractor and Independent Contractor must sign and date the form in the designated areas.
  9. Include the Federal Tax ID numbers for both parties where indicated.
  10. Make four copies of the completed form for your records.
  11. File the original form with the Texas Department of Insurance, Division of Workers' Compensation, and send copies to the Hiring Contractor's workers' compensation insurance carrier within 10 days of signing.
  12. Ensure the form is delivered either by personal delivery or registered/certified mail.

Your Questions, Answered

What is the DWC 83 form?

The DWC 83 form is a declaration used in Texas to establish the relationship between a Hiring Contractor and an Independent Contractor in the context of workers' compensation. It clarifies whether the Independent Contractor qualifies as an independent contractor under Texas law and outlines the responsibilities regarding workers' compensation coverage. This form is essential for ensuring that both parties understand their rights and obligations regarding insurance coverage and liability.

Who needs to fill out the DWC 83 form?

Both the Hiring Contractor and the Independent Contractor must complete the DWC 83 form. The Hiring Contractor is typically a business or individual hiring the contractor for specific work, while the Independent Contractor is the individual or entity performing the work. It’s important for both parties to understand the implications of their relationship, especially regarding workers' compensation coverage.

What are the qualifications for an Independent Contractor under Texas law?

According to Texas law, an Independent Contractor is defined as someone who is paid by the job rather than by the hour. They have the freedom to hire helpers and determine their pay. Additionally, they can work for multiple contractors simultaneously. This definition helps distinguish Independent Contractors from employees, who have different rights and protections under workers' compensation laws.

What happens once the DWC 83 form is signed?

Once the DWC 83 form is signed and filed, it takes effect immediately upon receipt by the Texas Department of Insurance, Division of Workers' Compensation. This declaration applies to all hiring agreements executed during the following year unless a new agreement states otherwise. Importantly, it indicates that the Independent Contractor and their employees are not entitled to workers' compensation coverage from the Hiring Contractor.

How should the DWC 83 form be submitted?

The DWC 83 form must be filed by the Hiring Contractor with both the Texas Department of Insurance and their workers' compensation insurance carrier. This submission should occur within 10 days of signing the agreement. The form can be delivered personally or sent via registered or certified mail. Both parties should keep a copy for their records.

What if there are changes to the hiring agreement?

If a hiring agreement is made that does not align with the DWC 83 declaration, both the Hiring Contractor and the Independent Contractor must notify the Texas Department of Insurance and the insurance carrier in writing within 10 days of the new agreement. This ensures that all parties remain compliant with the regulations and that there are no misunderstandings regarding coverage.

Can the DWC 83 form be revoked or modified?

Yes, the DWC 83 form can be modified or revoked through a new written agreement. If either party wishes to change the terms of their relationship or the coverage provided, they must execute a new agreement that explicitly states the changes. This new agreement must also be filed according to the workers’ compensation rules to ensure proper documentation and compliance.

What are the implications of signing the DWC 83 form?

By signing the DWC 83 form, both parties acknowledge that the Independent Contractor is not an employee and therefore not entitled to workers' compensation benefits from the Hiring Contractor. This has significant implications for liability and insurance coverage. It is crucial for both parties to fully understand these implications before signing the form.

Is legal consultation recommended before signing the DWC 83 form?

Yes, it is advisable for both parties to consult with an attorney if they are uncertain about the qualifications or implications of the DWC 83 form. Legal advice can provide clarity on responsibilities and rights, ensuring that both the Hiring Contractor and the Independent Contractor are making informed decisions about their working relationship.

Common mistakes

  1. Incomplete Information: Failing to provide all necessary details can lead to delays or rejection of the form. Ensure that all sections are filled out completely, including names, addresses, and tax identification numbers.

  2. Incorrect Signatures: Both the Hiring Contractor and the Independent Contractor must sign the form. Neglecting to obtain the proper signatures can invalidate the agreement.

  3. Missing Submission Deadlines: The form must be filed within 10 days of execution. Missing this deadline may result in loss of coverage or legal complications. Stay aware of the timeline.

  4. Improper Filing Method: The form must be submitted via personal delivery or registered/certified mail. Using an incorrect method can lead to issues with the processing of the form.

  5. Not Retaining Copies: Both parties should keep copies of the signed agreement. Failing to do so can create problems if disputes arise later regarding the terms of the agreement.

Documents used along the form

The DWC 83 form serves as a crucial document in establishing the independent contractor status under Texas Workers' Compensation laws. Alongside this form, several other documents are frequently utilized to ensure compliance and clarity in the relationship between hiring contractors and independent contractors. Each of these documents plays a specific role in the overall framework of workers' compensation and contractor agreements.

  • Form DWC-3: This form is used to report an injury to an employee. It provides essential information about the nature of the injury and the circumstances surrounding it, helping to initiate the claims process.
  • Form DWC-1: This is the Employee's Claim for Compensation form. It allows injured workers to formally request workers' compensation benefits and outlines the necessary details regarding the injury and employment.
  • Form DWC-7: The Employer's Report of Injury form is submitted by employers to report workplace injuries. This form is vital for documenting incidents and ensuring compliance with reporting requirements.
  • Form DWC-5: This form is used for the Notice of Denial of Claim. It is issued by the insurance carrier when a claim is denied, providing the reasons for the denial to the claimant.
  • Form DWC-6: The Request for Designation of Treating Doctor form allows injured workers to designate their treating physician for workers' compensation purposes, which is essential for managing medical care.
  • Form DWC-4: This is the Employee's Notice of Injury or Illness form, which employees use to inform their employers about work-related injuries or illnesses, ensuring that the employer is aware of the situation.
  • Form DWC-8: The Request for Hearing form is utilized when a dispute arises regarding workers' compensation claims. It allows parties to seek a formal hearing to resolve disagreements.
  • Form DWC-9: This form is the Employee's Claim for Benefits form, which provides a structured way for workers to claim compensation benefits for injuries sustained on the job.

Understanding the various forms associated with the DWC 83 is essential for both hiring contractors and independent contractors. Each document contributes to the clarity and legality of the working relationship, ensuring that all parties are informed of their rights and responsibilities under Texas law.

Similar forms

The DWC 83 form is similar to the DWC 84 form, which is also used in the context of independent contractor agreements. The DWC 84 form serves to affirm the independent contractor status while also detailing the specific work being performed. Both forms require the hiring contractor and the independent contractor to declare their relationship under Texas law, ensuring that the independent contractor does not receive workers' compensation benefits from the hiring contractor. The DWC 84 form may include additional details about the nature of the work, whereas the DWC 83 focuses on the general declaration of independent status.

Another document that parallels the DWC 83 is the DWC 85 form. This form is used to establish a formal agreement for workers' compensation coverage for independent contractors. Like the DWC 83, the DWC 85 requires both parties to agree on the independent contractor's status. However, the DWC 85 goes further by outlining the specifics of the workers' compensation coverage that will be provided. This ensures clarity regarding the responsibilities of the hiring contractor in terms of coverage, while the DWC 83 primarily emphasizes the independent contractor's lack of entitlement to such benefits.

The DWC 86 form is another document that shares similarities with the DWC 83. This form is used to notify the Texas Department of Insurance about the hiring of an independent contractor. Both documents require a declaration of the independent contractor's status. However, the DWC 86 includes more administrative details, such as job site locations and the duration of the contract. This form helps maintain proper records with the state, similar to the DWC 83's purpose of establishing the independent relationship.

The DWC 87 form also resembles the DWC 83 in that it is used to confirm the independent contractor status for specific construction projects. The DWC 87 form, however, focuses on the project-specific nature of the work, requiring information about the particular job site and the nature of the work being performed. While both forms aim to clarify the relationship between the contractor and the independent contractor, the DWC 87 emphasizes project details more than the general declarations found in the DWC 83.

Additionally, the DWC 88 form is similar to the DWC 83 in that it is used to establish a written agreement between a hiring contractor and an independent contractor. The DWC 88, however, is specifically tailored for situations where the independent contractor is providing services that may not traditionally fall under construction work. Both forms require the parties to affirm their relationship and the independent contractor's status, but the DWC 88 allows for more flexibility in the types of services covered.

The DWC 89 form is another document that shares characteristics with the DWC 83. This form serves as a notice of intent to hire an independent contractor, similar to the declarations made in the DWC 83. However, the DWC 89 is primarily focused on the notification aspect, ensuring that the Texas Department of Insurance is informed about the hiring of an independent contractor. This differs from the DWC 83, which is more about affirming the independent contractor's status and the implications regarding workers' compensation.

The DWC 90 form also has similarities to the DWC 83, as it is used to confirm the independent contractor's status for tax purposes. Both forms require the parties to declare their relationship, but the DWC 90 focuses on tax implications and responsibilities. This form ensures that the hiring contractor does not withhold taxes for the independent contractor, while the DWC 83 emphasizes the lack of workers' compensation coverage.

Finally, the DWC 91 form is akin to the DWC 83 in that it is used to document the independent contractor's status and the agreement between the parties. The DWC 91, however, is often used in cases where there are multiple contractors involved in a project. It requires more detailed information about each contractor's role and responsibilities, while the DWC 83 is more streamlined, focusing primarily on the independent contractor's relationship with the hiring contractor.

Dos and Don'ts

When filling out the DWC 83 form, there are important dos and don'ts to keep in mind. This ensures that the process goes smoothly and complies with legal requirements.

  • Do read the form carefully before starting to fill it out.
  • Do ensure that both the Hiring Contractor and Independent Contractor sign the form.
  • Do provide accurate information regarding dates and job sites.
  • Do keep copies of the completed form for your records.
  • Don't leave any required fields blank.
  • Don't forget to file the form within 10 days of signing.

Following these guidelines will help avoid complications and ensure compliance with Texas Workers' Compensation laws.

Misconceptions

Misconceptions about the DWC 83 form can lead to confusion for both Hiring Contractors and Independent Contractors. Here are six common misunderstandings:

  • Misconception 1: The DWC 83 form guarantees workers' compensation coverage.
  • This form does not provide coverage. Instead, it clarifies that the Independent Contractor and their employees are not entitled to workers' compensation from the Hiring Contractor.

  • Misconception 2: Signing the DWC 83 form makes the Independent Contractor an employee.
  • In fact, the form affirms the Independent Contractor's status as a non-employee for workers' compensation purposes. The relationship remains independent unless otherwise stated.

  • Misconception 3: The DWC 83 form is only necessary for specific types of work.
  • This form applies broadly to certain building and construction workers, but it can also be relevant for other types of contracts where independent status is claimed.

  • Misconception 4: Once filed, the DWC 83 form is permanent and does not require updates.
  • The form must be updated if a new hiring agreement is made that does not fall under the original declaration. Notification to the Texas Department of Insurance is necessary.

  • Misconception 5: The DWC 83 form can be submitted electronically.
  • This form must be filed by personal delivery or through registered or certified mail. Electronic submission is not permitted.

  • Misconception 6: Only one copy of the DWC 83 form is needed.
  • Four copies must be completed. The Hiring Contractor must file the original with the Division and retain copies for their records.

Key takeaways

When filling out and using the DWC 83 form, it is essential to understand the key components to ensure compliance and clarity in the contractor relationship. Here are the critical takeaways:

  • The DWC 83 form is used to declare the independent contractor status of workers in the construction industry.
  • It is vital to confirm that all parties meet the qualifications outlined in the Texas Workers' Compensation Act.
  • Independent contractors must be paid by the job, not by the hour, and have the freedom to hire helpers.
  • Once the form is signed, independent contractors and their employees will not be entitled to workers' compensation coverage from the hiring contractor.
  • This declaration takes effect upon receipt by the Texas Department of Insurance, Division of Workers' Compensation.
  • The declaration applies to all hiring agreements executed within a year unless a new agreement specifies otherwise.
  • In case of a non-applying agreement, both parties must notify the Texas Department of Insurance within 10 days.
  • Four copies of the completed form must be submitted to the appropriate parties, including the Texas Department of Insurance.
  • The form should be delivered personally or sent via registered or certified mail to ensure proper filing.

Understanding these points can help streamline the process and avoid potential legal complications. Ensure that all required information is accurate and complete to facilitate a smooth agreement.