Get Dwc 83 Form

Get Dwc 83 Form

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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Structure

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.

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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 DWCLegalServices@tdi.texas.gov or go to the Corrections Procedure section at www.tdi.texas.gov.

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Document Data

Fact Name 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 is used to establish the independent contractor status of individuals working in certain building and construction jobs.
Independent Contractor Definition According to Texas law, an independent contractor is someone who is paid per job, can hire helpers, and can work for multiple contractors.
Coverage Exemption By signing this form, the independent contractor and their employees are not entitled to workers' compensation coverage from the hiring contractor.
Effectiveness The declaration takes effect upon receipt by the Texas Department of Insurance, Division of Workers' Compensation.
Duration of Agreement This agreement applies to all hiring agreements made during the year after it is filed unless a new agreement states otherwise.
Notification Requirement If a new hiring agreement is made that does not apply, both parties must notify the Texas Department of Insurance within 10 days.
Employer-Employee Relationship In certain cases, the hiring contractor may choose to establish an employer-employee relationship for workers' compensation purposes.
Filing Copies Four copies of the form must be completed and filed with the Texas Department of Insurance and the hiring contractor's insurance carrier.
Signature Requirement Both the hiring contractor and the independent contractor must sign the form for it to be valid.

How to Use Dwc 83

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.

  1. Obtain the DWC 83 form from the Texas Department of Insurance website or your legal representative.
  2. Read through the entire form carefully to understand the requirements and implications of the agreement.
  3. In the designated area, check the box that applies to the statement regarding the joint agreement to affirm the independent relationship or the agreement to establish an employer-employee relationship.
  4. Fill in the names of the Hiring Contractor and the Independent Contractor in the appropriate sections.
  5. Provide the Federal Tax I.D. Number for both the Hiring Contractor and the Independent Contractor.
  6. Specify the term (dates) of the agreement by entering the start and end dates in the designated fields.
  7. Indicate the location of each affected job site or state whether this is a blanket agreement.
  8. Estimate the number of employees affected by this agreement and enter that number in the provided space.
  9. Both parties must sign and date the form where indicated.
  10. Make four copies of the completed form for your records and for submission.
  11. File the original form with the Texas Department of Insurance, Division of Workers’ Compensation, either by personal delivery or registered/certified mail.
  12. Submit a copy of the form to the Hiring Contractor's workers' compensation insurance carrier.

Key Facts about Dwc 83

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.

Common mistakes

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.

Documents used along the form

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.

  • DWC 82 - Employee's Notice of Injury or Occupational Disease: This form is used by employees to report any injuries or occupational diseases sustained while working. It helps initiate the claims process for workers' compensation benefits.
  • DWC 1 - Employee's Claim for Compensation for a Work-Related Injury: This document is crucial for employees seeking compensation for work-related injuries. It outlines the details of the injury and the benefits being claimed.
  • DWC 3 - Employer's First Report of Injury or Illness: Employers must complete this form to report any workplace injuries or illnesses to the Texas Department of Insurance. It provides essential information about the incident.
  • DWC 4 - Employee's Notice of Change of Address: If an employee moves, this form must be submitted to ensure that all correspondence regarding their claim is sent to the correct address.
  • DWC 5 - Notice of Refusal to Pay Benefits: This form is used by employers or insurance carriers to formally notify an employee that their claim for benefits has been denied.
  • DWC 6 - Notice of Injury or Illness: This document serves as a notification to the employee regarding the status of their claim and any actions taken by the employer or insurance carrier.
  • DWC 7 - Request for Medical Examination: Employers may use this form to request a medical examination of the injured employee to assess the extent of the injury and the need for benefits.
  • DWC 8 - Notice of Payment of Compensation: This form is issued by the insurance carrier to inform the employee that compensation benefits are being paid, including details about the payment.

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.

Similar forms

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:

  • Independent Contractor Agreement: This document outlines the terms of the relationship between a hiring party and an independent contractor, similar to the DWC 83 form. Both documents clarify the nature of the work arrangement and confirm that the contractor is not an employee.
  • Workers' Compensation Waiver: A waiver may be signed to release a hiring contractor from liability for workers' compensation claims. Like the DWC 83, this document emphasizes that the contractor and their employees are not entitled to workers' compensation coverage from the hiring contractor.
  • Subcontractor Agreement: This agreement details the terms under which a subcontractor will work for a contractor. It shares similarities with the DWC 83 form in defining the independent status of the subcontractor and clarifying responsibilities regarding workers' compensation.
  • Employer-Employee Relationship Agreement: This document establishes an employer-employee relationship for specific purposes, such as workers' compensation. It is similar to the DWC 83 form in that it addresses the classification of workers and the responsibilities of the hiring contractor.
  • Affidavit of Independent Contractor Status: This affidavit is used to affirm an individual's status as an independent contractor. Like the DWC 83 form, it serves to protect the hiring contractor from liability related to employee benefits and workers' compensation.
  • General Contractor Agreement: This document outlines the relationship between a general contractor and subcontractors. It often includes clauses regarding independent contractor status, similar to the DWC 83 form, ensuring that all parties understand their rights and responsibilities.

Dos and Don'ts

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.

  • Do read the form carefully before starting. Understanding the requirements will help avoid mistakes.
  • Do ensure all parties involved meet the qualifications for independent contractors as defined by Texas law.
  • Do provide accurate information, including Federal Tax I.D. numbers and addresses.
  • Do file the form within 10 days of execution to avoid potential issues with workers' compensation coverage.
  • Don't leave any sections blank. Every part of the form must be completed to be valid.
  • Don't submit the form without retaining copies for both the Hiring Contractor and the Independent Contractor.

By adhering to these guidelines, you can help ensure that the process runs smoothly and that all parties are protected under the law.

Misconceptions

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:

  • The DWC 83 form guarantees workers' compensation coverage for independent contractors. This is not true. The form explicitly states that independent contractors and their employees are not entitled to workers' compensation coverage from the hiring contractor. Instead, it affirms that the independent contractor operates independently and is responsible for their own insurance.
  • Once the DWC 83 form is filed, it cannot be changed. This misconception overlooks the fact that the agreement can be revised. If a new hiring agreement is made that does not align with the original declaration, both parties must notify the Texas Department of Insurance and the hiring contractor’s insurance carrier within 10 days. Changes can be made as necessary.
  • All independent contractors automatically qualify for the DWC 83 form. Not all independent contractors meet the qualifications outlined in the Texas Workers' Compensation Act. The form requires that the contractor must be paid by the job, have the freedom to hire helpers, and be able to work for other contractors. If these criteria are not met, the DWC 83 form may not be applicable.
  • The DWC 83 form is only relevant for construction workers. While the form is commonly used in the construction industry, it is not limited to that sector. Any hiring contractor and independent contractor relationship that meets the criteria can utilize this form, regardless of the industry involved.

Key takeaways

When filling out and using the DWC 83 form, it is essential to understand its purpose and requirements. Here are four key takeaways:

  • Clarification of Relationship: The form serves to clarify the independent contractor relationship between the Hiring Contractor and the Independent Contractor, ensuring that the Independent Contractor is not considered an employee for workers' compensation purposes.
  • Filing Requirements: The completed form must be filed with both the Texas Department of Insurance, Division of Workers' Compensation, and the Hiring Contractor's workers' compensation insurance carrier within 10 days of signing. This filing can be done through personal delivery or registered/certified mail.
  • Retention of Copies: Both parties should retain copies of the signed agreement for their records. This ensures that there is documentation of the relationship and the terms agreed upon.
  • Notification of Changes: If a new hiring agreement is made that does not apply under this declaration, both parties must notify the Texas Department of Insurance and the insurance carrier in writing within 10 days of the new agreement.