The DWC 83 form is a declaration used in Texas to establish the independent contractor status of workers in the building and construction industry. This form ensures that independent contractors and their employees are not entitled to workers' compensation coverage from the hiring contractor, thereby clarifying the relationship between the parties involved. Understanding and properly filling out this form is essential for compliance with Texas Workers' Compensation laws.
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The DWC 83 form is a crucial document for establishing the relationship between hiring contractors and independent contractors in Texas, particularly in the building and construction sectors. This form is designed to clarify the independent contractor's status and outline the responsibilities regarding workers' compensation coverage. It includes important declarations, such as confirming that the independent contractor is not an employee of the hiring contractor and that neither party will be liable for workers' compensation claims related to the independent contractor's work. The form also provides options for either affirming an independent relationship or establishing an employer-employee relationship for workers' compensation purposes. It is essential for both parties to understand the implications of their agreement, as it affects their rights and obligations under Texas law. The DWC 83 form must be filed with the Texas Department of Insurance and the hiring contractor's workers' compensation insurance carrier within ten days of signing, ensuring that both parties retain copies for their records. Proper completion and timely submission of this form are vital to ensure compliance with Texas Workers' Compensation regulations.
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
DWC083 Rev. 10/21
Page 1 of 5
12.Hiring contractor's affirmations Check only one:
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:
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.
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)
Page 3 of 5
FAQ
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?
Page 4 of 5
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 DWCLegalServices@tdi.texas.gov or go to the Corrections Procedure section at www.tdi.texas.gov.
Page 5 of 5
Completing the DWC 83 form is an important step in establishing the relationship between a Hiring Contractor and an Independent Contractor in Texas. After filling out the form, it must be filed with the Texas Department of Insurance, Division of Workers’ Compensation, as well as the Hiring Contractor's workers' compensation insurance carrier. This process should be completed within ten days of signing the agreement.
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. It serves to clarify whether the Independent Contractor qualifies as an independent entity under Texas Workers' Compensation laws. This form is crucial for determining workers' compensation coverage responsibilities.
Who needs to fill out the DWC 83 form?
Both the Hiring Contractor and the Independent Contractor must complete the DWC 83 form. It is essential for any situation where a contractor is hired for building and construction work. This form ensures that both parties understand their rights and responsibilities regarding workers' compensation coverage.
What are the qualifications for an Independent Contractor?
An Independent Contractor must meet specific criteria as defined by the Texas Workers' Compensation Act. They should be paid by the job, not hourly, have the freedom to hire helpers, and be able to work for multiple contractors simultaneously. Meeting these criteria is necessary for the declaration to be valid.
What happens if the DWC 83 form is not filed?
If the DWC 83 form is not filed, the Independent Contractor may be considered an employee of the Hiring Contractor. This could lead to unintended liabilities, including the requirement for the Hiring Contractor to provide workers' compensation coverage. It is crucial to file the form within the specified time frame to avoid complications.
How long is the DWC 83 form valid?
The DWC 83 form remains effective for all hiring agreements executed during the year after it is filed. If a new hiring agreement is made that does not apply, both parties must notify the Texas Department of Insurance within 10 days. This ensures that the status of the Independent Contractor is clear and legally recognized.
How should the DWC 83 form be submitted?
The completed DWC 83 form must be filed with both the Texas Department of Insurance and the Hiring Contractor's workers' compensation insurance carrier within 10 days of execution. It should be submitted either by personal delivery or registered/certified mail. Both parties should retain copies for their records.
What should I do if my insurance carrier changes?
If the Hiring Contractor's workers' compensation insurance carrier changes during the effective period of coverage, it is advisable to file the DWC 83 form with the new insurance carrier. This helps maintain clarity regarding coverage and responsibilities under the workers' compensation laws of Texas.
Filling out the DWC 83 form correctly is crucial for both hiring contractors and independent contractors in Texas. However, many individuals make common mistakes that can lead to complications down the line. One significant error occurs when the parties fail to check the appropriate box indicating whether they are affirming an independent relationship or establishing an employer-employee relationship. This choice is foundational, as it dictates the nature of the agreement and the legal implications that follow.
Another frequent mistake is not providing complete information regarding the term dates of the agreement. Leaving the fields for the start and end dates blank can create ambiguity about the duration of the contract. This lack of clarity might lead to misunderstandings about the timeline of work and the applicability of workers' compensation coverage.
Additionally, individuals often overlook the importance of specifying the location of the job site. If the agreement is meant to cover multiple job sites, failing to state that it is a blanket agreement can lead to confusion. Clear communication about where the work will be performed helps ensure that all parties understand their obligations and rights under the agreement.
Another common pitfall is neglecting to include the estimated number of employees affected by the agreement. This information is essential for the insurance carrier to assess risk and determine appropriate coverage. Without this detail, the hiring contractor may face challenges in securing the necessary insurance, which could expose both parties to liability.
Moreover, individuals sometimes forget to sign and date the form properly. Both the hiring contractor and the independent contractor must provide their signatures, and the dates should reflect when the agreement was executed. Incomplete signatures can render the agreement invalid, leading to potential legal issues in the future.
Finally, failing to file the form within the required time frame is a critical mistake. The agreement must be submitted to both the Texas Department of Insurance and the workers’ compensation insurance carrier within ten days of execution. Delays in filing can result in penalties or loss of coverage, which is something both parties want to avoid.
The DWC 83 form is essential for establishing the independent contractor status in Texas. Alongside this form, several other documents may be necessary to ensure compliance with workers' compensation regulations. Here’s a list of related forms and documents commonly used in conjunction with the DWC 83.
Understanding these documents is crucial for both hiring contractors and independent contractors to navigate the workers' compensation landscape effectively. Properly completing and filing these forms helps ensure compliance and protects the rights of all parties involved.
The DWC 83 form serves a specific purpose in establishing the independent contractor relationship under Texas law. It has similarities with several other documents used in various contexts. Here are six documents that share similarities with the DWC 83 form:
When filling out the DWC 83 form, it is crucial to follow certain guidelines to ensure accuracy and compliance. Below is a list of things you should and shouldn't do.
By adhering to these guidelines, you can help ensure that the process runs smoothly and that all parties are protected under the law.
The DWC 83 form is an important document used in Texas to clarify the relationship between hiring contractors and independent contractors, particularly in the context of workers' compensation. However, several misconceptions exist regarding this form. Below are four common misunderstandings:
When filling out and using the DWC 83 form, it is essential to understand its purpose and requirements. Here are four key takeaways: