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The DWC 83 form is an essential document for establishing the relationship between hiring contractors and independent contractors in Texas, particularly in the construction industry. This form serves multiple purposes, including affirming the independent status of contractors and clarifying their entitlements regarding workers' compensation coverage. It outlines the qualifications necessary for a contractor to be classified as an independent contractor under the Texas Workers' Compensation Act, specifically detailing the conditions under which they operate. By signing the DWC 83 form, both parties declare that the independent contractor is not an employee of the hiring contractor, thereby waiving any rights to workers' compensation from the hiring contractor's insurance. The form also includes provisions for cases where the hiring contractor may choose to establish an employer-employee relationship for workers' compensation purposes, specifying the terms under which this agreement takes effect. Furthermore, the DWC 83 requires timely filing with the Texas Department of Insurance and the hiring contractor's workers' compensation insurance carrier, ensuring compliance with state regulations. It is crucial for both parties to retain copies of the completed form for their records.

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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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DWC083

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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Form Specifications

Fact Name Details
Purpose The DWC 83 form is used to establish an independent contractor relationship for certain building and construction workers in Texas.
Governing Law This form is governed by the Texas Workers' Compensation Act, specifically Texas Labor Code, Section 406.141.
Independent Contractor Definition An independent contractor is defined as someone who is paid by the job, can hire helpers, and works for other contractors while under contract.
Workers' Compensation Coverage Independent contractors and their employees are not entitled to workers' compensation coverage from the hiring contractor.
Filing Requirement The form must be filed with the Texas Department of Insurance and the hiring contractor's workers' compensation insurance carrier within 10 days of signing.
Effective Date This declaration takes effect upon receipt by the Texas Department of Insurance.
Agreement Duration The agreement applies to all hiring agreements executed within one year after the declaration is filed.
Subsequent Agreements If a new hiring agreement is made, the Texas Department of Insurance must be notified within 10 days if the declaration does not apply.
Retention of Copies Both the hiring contractor and the independent contractor must retain a copy of the agreement for their records.
Signature Requirement The form must be signed by both the hiring contractor and the independent contractor to be valid.

Dwc 83: Usage Guidelines

Filling out the DWC 83 form is an important step for both Hiring Contractors and Independent Contractors in Texas. This form establishes the relationship between the two parties concerning workers' compensation coverage. Following the steps below will help ensure that the form is completed correctly and submitted in a timely manner.

  1. Obtain a copy of the DWC 83 form. Ensure you have the most recent version available.
  2. Read through the form carefully to understand the requirements and sections.
  3. In the first section, check the box that applies to your situation: either "Joint Agreement to Affirm Independent Relationship" or "Agreement to Establish Employer-Employee Relationship."
  4. Fill in the names of both the Hiring Contractor and the Independent Contractor in the designated spaces.
  5. Provide the Federal Tax I.D. numbers for both parties in the appropriate fields.
  6. Indicate the term (dates) of the agreement by filling in the "From" and "To" fields.
  7. Specify the location of each affected job site or state if this is a blanket agreement.
  8. Estimate the number of employees affected by the agreement and write that number in the designated space.
  9. Both parties must sign and date the form in the specified areas.
  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, and send copies to the Hiring Contractor's workers’ compensation insurance carrier. This must be done within 10 days of execution.
  12. Deliver the form personally or send it via registered or certified mail to ensure proper submission.

Your Questions, Answered

What is the purpose of the DWC 83 form?

The DWC 83 form serves to establish the relationship between a Hiring Contractor and an Independent Contractor within the context of Texas workers' compensation laws. It allows both parties to affirm that the Independent Contractor meets the qualifications outlined in the Texas Workers' Compensation Act. By completing this form, they declare that the Independent Contractor is not considered an employee, thus exempting them from workers' compensation coverage under the Hiring Contractor's policy.

Who qualifies as an Independent Contractor under the DWC 83 form?

An Independent Contractor, as defined by the Texas Labor Code, is an individual who performs work or provides services for another party without being treated as an employee. This includes being paid per job rather than hourly, having the freedom to hire their own helpers, and the ability to work for multiple contractors simultaneously. Understanding these criteria is crucial for both parties to ensure compliance with the law.

What are the implications of signing the DWC 83 form?

By signing the DWC 83 form, both the Hiring Contractor and the Independent Contractor agree to the terms outlined regarding their relationship. This includes the acknowledgment that the Independent Contractor and their employees will not receive workers' compensation coverage from the Hiring Contractor. Additionally, it is important to note that this agreement takes effect upon receipt by the Texas Department of Insurance and applies to all hiring agreements executed within the year following the filing, unless a new agreement is made.

How should the DWC 83 form be filed?

The DWC 83 form must be filed by the Hiring Contractor with both the Texas Department of Insurance, Division of Workers’ Compensation, and their workers’ compensation insurance carrier within ten days of execution. It is essential that this filing is done either through personal delivery or by registered or certified mail. Both parties should also retain copies of the agreement for their records.

What happens if the Hiring Contractor's insurance carrier changes?

If the Hiring Contractor's workers' compensation insurance carrier changes during the effective period of coverage, it is advisable for the Hiring Contractor to file the DWC 83 form with the new insurance carrier. This ensures that the new carrier is aware of the agreement and can uphold the terms regarding the Independent Contractor's status and coverage accordingly.

Is there a time limit for filing the DWC 83 form?

Yes, the DWC 83 form must be filed within ten days of the date it is signed. Timely filing is crucial to maintain compliance with Texas workers' compensation regulations. Failure to file within this timeframe may lead to complications regarding the Independent Contractor's status and coverage, potentially exposing both parties to legal and financial risks.

Common mistakes

  1. Inaccurate Information: Providing incorrect details about the Hiring Contractor or Independent Contractor can lead to delays or rejections. Ensure all names, addresses, and tax identification numbers are accurate.

  2. Missing Signatures: Failing to obtain signatures from both the Hiring Contractor and the Independent Contractor is a common mistake. Both parties must sign the form for it to be valid.

  3. Improper Filing Method: Submitting the form by means other than personal delivery or registered/certified mail can result in non-compliance. Follow the specified filing methods closely.

  4. Not Keeping Copies: Neglecting to retain copies of the completed form for both parties can create issues later. Each party should keep a copy for their records.

  5. Failure to Notify Changes: If there are changes in the Hiring Contractor's workers' compensation carrier, not filing the form with the new carrier can lead to complications.

  6. Incorrect Job Site Information: Providing vague or incomplete details about the job site can cause confusion. Specify the exact location or state if it is a blanket agreement.

  7. Not Meeting Independent Contractor Criteria: Misunderstanding the definition of an independent contractor can result in incorrectly filling out the form. Ensure that all qualifications are met as outlined in the Texas Workers' Compensation Act.

  8. Ignoring Deadline Requirements: Failing to file the form within 10 days of execution can lead to non-compliance. Be mindful of the timeline to avoid penalties.

Documents used along the form

When working with the DWC 83 form, there are several other documents that may be necessary to ensure compliance and clarity in the independent contractor relationship. Here’s a list of forms that are often used alongside the DWC 83 form:

  • Form DWC-1: This is the Employee's Claim for Compensation for a Work-Related Injury. It is used by employees to report work-related injuries to the Texas Division of Workers' Compensation.
  • Form DWC-3: This form is the Employer's First Report of Injury or Illness. It is filed by employers to notify the Division of an employee's injury or illness.
  • Form DWC-4: This is the Employee's Notice of Injury or Occupational Disease. It provides a formal notice to the employer about the employee's injury or occupational disease.
  • Form DWC-5: This form is used for the Notice of Change in Employee's Condition. It allows employers to report changes in an employee's condition following a work-related injury.
  • Form DWC-6: This is the Employee's Request for a Benefit Review Conference. It is used when an employee wants to dispute a decision made by the insurance carrier regarding their claim.
  • Form DWC-7: This form is the Employee's Claim for Additional Compensation. It is used when an employee seeks additional benefits beyond what was initially awarded.
  • Form DWC-8: This is the Employer's Notice of Denial of Compensation. Employers use this form to formally deny a claim for workers' compensation benefits.
  • Form DWC-9: This is the Employee's Waiver of Subrogation. It allows an employee to waive their right to seek compensation from a third party for a work-related injury.

These documents play important roles in managing the relationship between contractors, employees, and insurance providers. Having the right forms ready can help streamline the process and ensure everyone understands their rights and responsibilities.

Similar forms

  • Form DWC-84: Similar to the DWC-83, this form is used to establish an employer-employee relationship for workers' compensation purposes. It outlines the responsibilities of the Hiring Contractor regarding insurance coverage.
  • Form DWC-85: This document serves to declare the status of an independent contractor. It includes details about the contractor's work and clarifies that they are not an employee.
  • Form DWC-86: Used for reporting injuries to independent contractors, this form is essential for documenting incidents and ensuring proper workers' compensation claims.
  • Form DWC-87: This form is similar in that it provides a declaration of coverage for independent contractors, specifying the terms under which they are covered by workers' compensation insurance.
  • Form DWC-88: Like the DWC-83, this form is used for independent contractors to notify the Texas Department of Insurance about their status and coverage under workers' compensation laws.
  • Form DWC-89: This document is used to establish a joint agreement between the Hiring Contractor and the Independent Contractor, detailing the terms of their working relationship.
  • Form DWC-90: Similar to the DWC-83, this form is utilized to affirm the independent status of contractors and clarify their non-employee status for workers' compensation purposes.
  • Form DWC-91: This form is used to report changes in the status of contractors, ensuring that the Texas Department of Insurance is informed of any updates regarding coverage and agreements.

Dos and Don'ts

When filling out the DWC 83 form, there are several important things to keep in mind. Here’s a list of dos and don’ts to help ensure your submission is accurate and complete.

  • Do read the entire form carefully before starting. Understanding the requirements will save you time and prevent mistakes.
  • Do provide accurate information for both the Hiring Contractor and the Independent Contractor. Double-check names, addresses, and tax identification numbers.
  • Do check the box that applies to your situation. This ensures that the declaration aligns with your agreement.
  • Do keep a copy of the completed form for your records. Both parties should retain a copy for future reference.
  • Don't leave any sections blank. Incomplete forms may be rejected or delayed.
  • Don't submit the form without signatures from both parties. Signatures confirm that both the Hiring Contractor and Independent Contractor agree to the terms.
  • Don't forget to file the form within the required 10 days after execution. Timeliness is crucial for compliance.
  • Don't use a non-certified method for mailing. Always use personal delivery or registered/certified mail to ensure it arrives safely.

By following these guidelines, you can help ensure that your DWC 83 form is filled out correctly and submitted on time. This will help maintain clarity in your working relationship and avoid potential issues down the line.

Misconceptions

Understanding the DWC 83 form is crucial for both hiring contractors and independent contractors in Texas. However, there are several misconceptions that can lead to confusion. Here are eight common misunderstandings:

  • Independent contractors automatically receive workers' compensation coverage. This is not true. The DWC 83 form explicitly states that independent contractors and their employees are not entitled to workers' compensation coverage from the hiring contractor unless a separate agreement is made.
  • All contractors are considered independent contractors. Not all contractors meet the qualifications of an independent contractor as defined by Texas law. The DWC 83 form outlines specific criteria that must be satisfied.
  • Filing the DWC 83 form is optional. Filing this form is mandatory if the hiring contractor wants to establish the independent contractor relationship. Failure to file can lead to complications regarding workers' compensation coverage.
  • The DWC 83 form is only relevant for construction work. While it is commonly used in the construction industry, the DWC 83 form can apply to various types of independent contractor agreements in Texas.
  • Once filed, the DWC 83 form never needs to be updated. This is incorrect. If a new hiring agreement is made that does not apply under the current declaration, both parties must notify the Texas Department of Insurance within 10 days.
  • Independent contractors cannot work for multiple clients. This is a misconception. Independent contractors have the freedom to work for other clients while under contract, as long as they meet the criteria outlined in the DWC 83 form.
  • All independent contractors are self-employed. While many independent contractors operate as self-employed individuals, some may have employees or helpers. The DWC 83 form accommodates these scenarios.
  • The DWC 83 form guarantees that the hiring contractor will not face any liabilities. While the form helps establish the independent contractor relationship, it does not completely shield the hiring contractor from potential liabilities. Each situation should be evaluated carefully.

Being aware of these misconceptions can help both hiring contractors and independent contractors navigate their agreements more effectively. Always consider consulting with an attorney if there are uncertainties regarding the DWC 83 form or its implications.

Key takeaways

Here are key takeaways about filling out and using the DWC 83 form:

  • Understand the Definition: The form clarifies that an independent contractor is someone who is paid by the job and is free to hire helpers and work for other contractors.
  • Joint Agreement Requirement: Both the Hiring Contractor and the Independent Contractor must declare their independent relationship to avoid workers' compensation coverage obligations.
  • Filing Timeline: The completed form must be submitted to the Texas Department of Insurance and the Hiring Contractor's insurance carrier within 10 days of signing.
  • Retention of Copies: Both parties should keep a copy of the signed agreement for their records.
  • Effect of the Agreement: The declaration applies to all hiring agreements made within a year unless a new agreement states otherwise.
  • Change in Insurance Carrier: If the Hiring Contractor changes their workers' compensation insurance carrier, they must file the form with the new carrier.