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The DWC 83 form is utilized in Texas to officially declare the relationship between a hiring contractor and an independent contractor, specifically in relation to workers' compensation insurance according to the Texas Workers' Compensation Act, Texas Labor Code, Section 406.141. It is designed to affirm whether an independent contractor is not considered an employee of the hiring contractor for workers' compensation purposes. This is critical for ensuring proper coverage and compliance with state regulations. For detailed guidance on filling out this form, click the button below.

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In the realm of construction and building work in Texas, navigating the intricacies of worker classification can often seem daunting. At the heart of this complex landscape sits the DWC 83 form, a critical document housed under the Texas Department of Insurance, Division of Workers' Compensation. This form embodies the legislature's attempt to clarify the often murky waters surrounding the independent contractor status versus employee designation. Specifically, it serves two pivotal roles. Firstly, it acts as a joint agreement between hiring contractors and independent contractors, asserting the latter's status and establishing that independent contractors and their employees will not be entitled to workers' compensation coverage from the hiring contractor. Secondly, it introduces an agreement option for establishing an employer-employee relationship, hence allowing the hiring contractor to withhold workers' compensation insurance premiums from the independent contractor's payment and agree to provide coverage for them and their employees. Notably, the form delineates the specifics around such agreements, including the term, location of job sites, and the estimated number of employees affected, ensuring every aspect is meticulously documented. Integral to the process is the requirement for the form to be filed with the Texas Department of Insurance, Division of Workers' Compensation, and the hiring contractor’s workers’ compensation insurance carrier, making compliance a meticulously tracked affair. This document not only highlights the state's commitment to protecting workers but also provides a structured pathway for employers and independent contractors to clearly define their working relationships, making it an indispensable tool in the Texas construction sector.

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TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION

7551 Metro Center Drive, Suite 100

Austin, Texas 78744

If you are not certain whether all parties meet the requirements for entering into this agreement, you may wish to consult an attorney.

Texas Workers' Compensation Act, Texas Labor Code, Section 406.141(2) defines "independent contractor" as follows: (2) "Independent contractor" means a person who contracts to perform work or

provide a service for the benefit of another and who: (A) is paid by the job, not by the hour or some other time-measured basis; (B) is free to hire as many helpers as he desires and to determine what each helper will be paid; and (C) is free to work for other contractors, or to send helpers to work for other contractors, while under contract to the hiring employer.

CHECK BOX OF STATEMENT THAT APPLIES

JOINT AGREEMENT TO AFFIRM INDEPENDENT

RELATIONSHIP FOR CERTAIN BUILDING

AND CONSTRUCTION WORKERS

Notice of Declaration

The undersigned Hiring Contractor and the undersigned Independent Contractor hereby declare that the Independent Contractor meets the qualifications of an Independent Contractor under Texas Workers' Compensation Act, Texas Labor Code, Section 406.141, that the Independent Contractor is not an employee of the Hiring Contractor, and that:

(A)the Independent Contractor and the Independent Contractor's employees shall not be entitled to workers' compensation coverage from the Hiring Contractor; and

(B)the Hiring Contractor's workers' compensation insurance carrier shall not require premiums to be paid by the Hiring Contractor for coverage of the Independent Contractor or the Independent Contractor's employees,

helpers, or subcontractors.

__________________________________________________________________

THIS DECLARATION TAKES EFFECT UPON RECEIPT BY THE TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION. THIS DECLARATION APPLIES TO ALL HIRING AGREEMENTS EXECUTED BY THE HIRING CONTRACTOR AND THE INDEPENDENT CONTRACTOR DURING THE YEAR AFTER THIS DECLARATION IS FILED UNLESS A SUBSEQUENT HIRING AGREEMENT IS MADE TO WHICH THE DECLARATION DOES NOT APPLY. IN THE EVENT THAT A HIRING AGREEMENT TO WHICH THIS DECLARATION DOES NOT APPLY IS MADE, THE HIRING CONTRACTOR AND INDEPENDENT CONTRACTOR SHALL SO NOTIFY THE TEXAS DEPARTMENT OF INSURANCE, DIVISION OF WORKERS' COMPENSATION AND THE HIRING CONTRACTOR'S WORKERS' COMPENSATION INSURANCE CARRIER (IF ANY) IN WRITING WITHIN 10 DAYS AFTER THE NON-APPLYING AGREEMENT IS MADE. ONCE THIS AGREEMENT IS SIGNED, THE SUBCONTRACTOR AND THE SUBCONTRACTOR'S EMPLOYEES SHALL NOT BE ENTITLED TO WORKERS' COMPENSATION COVERAGE FROM THE HIRING CONTRACTOR UNLESS A SUBSEQUENT WRITTEN AGREEMENT IS EXECUTED, AND FILED ACCORDING TO WORKERS’ COMPENSATION RULES, EXPRESSLY STATING THAT THIS AGREEMENT DOES NOT APPLY.

AGREEMENT TO ESTABLISH EMPLOYER- EMPLOYEE RELATIONSHIP FOR CERTAIN BUILDING AND CONSTRUCTION WORKERS

Notice of Agreement

The undersigned Hiring Contractor and the undersigned Independent Contractor hereby agree

that the Hiring Contractor will withhold will not withhold the cost of workers' compensation insurance coverage from the Independent Contractor's contract price and that the Hiring Contractor will purchase workers' compensation insurance coverage for the Independent Contractor and the Independent Contractor's employees. Once this agreement is signed, for the purpose of providing workers' compensation insurance coverage, the Hiring Contractor will be the employer of the Independent Contractor and the Independent Contractor's employees. This agreement makes the Hiring Contractor the employer of the Independent Contractor and the Independent Contractor's employees only for the purposes of workers' compensation laws of Texas and for no other purpose.

TERM (DATES) OF AGREEMENT:

FROM: _____________________

 

TO: ________________________

LOCATION OF EACH AFFECTED JOB SITE (OR STATE WHETHER THIS IS A BLANKET AGREEMENT):

_________________________________________________________________

__________________________________________________________________

___________________________________________________________________

ESTIMATED NUMBER OF EMPLOYEES AFFECTED: _________________

THIS AGREEMENT SHALL TAKE EFFECT NO SOONER THAN THE DATE IT IS SIGNED.

Hiring Contractor's Affirmation

If the Hiring Contractor's workers' compensation carrier change

 

during the effective period of coverage, it is advisable for the Hiring Contractor

__________________________________

to file this form with the new insurance carrier.

 

Federal Tax I.D. Number

______________________________________________

______________________

________________________________________________________________

Signature of Hiring Contractor

Date

Address (Street)

________________________________________________________________________

________________________________________________________________

Printed Name of the Hiring Contractor

 

Address (City, State, Zip)

 

Independent Contractor's Affirmation

____________________________

 

 

 

Federal Tax I.D. Number

______________________________________________

______________________

________________________________________________________________

Signature of Independent Contractor

Date

Address (Street)

 

________________________________________________________________________

________________________________________________________________

Printed Name of the Independent Contractor

 

Address (City, State, Zip)

 

Four copies of this form must be completed: This agreement must be filed by the Hiring Contractor with both the Texas Department of Insurance, Division of Workers’ Compensation and the workers’ compensation insurance carrier of the Hiring Contractor within 10 days of the date of execution. The original must be filed with the Division. The agreement must be filed by PERSONAL DELIVERY OR REGISTERED OR CERTIFIED MAIL. Both the Hiring Contractor and the Independent Contractor must also retain a copy of the agreement.

Division Date Stamp Here

DWC FORM-83 (Rev. 10/05)

DIVISION OF WORKERS’ COMPENSATION

Form Breakdown

Fact Number Detail
1 The DWC 83 is a form used in Texas for declaring the relationship between hiring contractors and independent contractors within the construction sector.
2 This form allows parties to affirm that an independent contractor is not considered an employee of the hiring contractor for purposes of workers' compensation coverage.
3 It is governed by the Texas Workers' Compensation Act, specifically under Texas Labor Code, Section 406.141, which provides a definition for "independent contractor".
4 The form must be filed with the Texas Department of Insurance, Division of Workers' Compensation, and the hiring contractor's workers’ compensation insurance carrier within 10 days of execution.
5 Both hiring and independent contractors must retain a copy of the filled form, indicating that it requires completion in quadruplicate.
6 It specifically includes provisions for the independent contractor and their employees to be excluded from workers' compensation coverage provided by the hiring contractor unless otherwise stated in a subsequent agreement.

Guidelines on Filling in Dwc 83

Once you've decided to fill out the DWC 83 form, you're taking a crucial step in clarifying the relationship between a hiring contractor and an independent contractor, particularly in the context of building and construction work. This form is essential whether you're aiming to establish or affirm an independent relationship, or set up an employer-employee connection for the purpose of workers' compensation insurance. Understanding the precise nature of your working relationship will help both parties comply with Texas Workers' Compensation Act and manage expectations regarding workers' compensation coverage. Here’s how to fill out the DWC 83 form systematically.

Steps to Fill Out the DWC 83 Form

  1. Start by reading the definition of "independent contractor" as outlined in the TEXAS Workers' Compensation Act to ensure the role fits this designation.
  2. Decide which statement applies to your situation—whether affirming an independent relationship or establishing an employer-employee relationship for workers' compensation purposes—and check the appropriate box.
  3. Under the "Notice of Declaration" or "Notice of Agreement," depending on your earlier choice, both the hiring contractor and the independent contractor need to provide their signatures to declare or agree to the terms outlined regarding workers' compensation coverage and employment status.
  4. Fill in the "Term (Dates) of Agreement" section with the start and end dates of the agreement.
  5. Specify the location of each job site affected by this agreement or indicate if this is a blanket agreement.
  6. Enter the estimated number of employees affected by this agreement.
  7. Both the independent contractor and the hiring contractor must affirm the agreement by entering their Federal Tax I.D. numbers and providing their signatures and the date signed.
  8. Include addresses for both the independent and hiring contractors, along with the printed names beneath their signatures.
  9. Once completed, ensure you make four copies of the form. It is necessary for the hiring contractor to file this form with the Texas Department of Insurance, Division of Workers’ Compensation, and the workers’ compensation insurance carrier within 10 days of execution. It can be done via personal delivery or registered or certified mail.
  10. Remember, both parties should retain a copy of the agreement for their records.

Filling out the DWC 83 form correctly is a vital step in making sure everyone involved understands their responsibilities and rights regarding workers' compensation. Once submitted properly, it sets clear boundaries and expectations for the working relationship between the hiring contractor and the independent contractor, in compliance with Texas law.

Learn More on Dwc 83

What is the DWC 83 form?

The DWC 83 form, provided by the Texas Department of Insurance, Division of Workers' Compensation, is a crucial document for establishing the nature of the relationship between hiring contractors and independent contractors in the construction and building industry in Texas. It is used to declare whether an independent contractor will be considered an employee for the purposes of workers' compensation coverage, based on the criteria set under the Texas Workers' Compensation Act, Texas Labor Code, Section 406.141.

Who needs to fill out the DWC 83 form?

Both the Hiring Contractor and the Independent Contractor engaging in construction or building work in Texas need to fill out the DWC 83 form. This form is necessary when the parties want to either affirm the independent contractor status, removing entitlement to the hiring contractor's workers' compensation coverage, or when they agree to establish an employer-employee relationship solely for workers' compensation purposes.

When should the DWC 83 form be filed?

The DWC 83 form must be completed and 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 executing the agreement. Filing can be done through personal delivery or by sending it via registered or certified mail. This timely filing is essential to ensure that the agreed terms are recognized and effective for workers' compensation purposes.

What happens after the DWC 83 form is filed?

After the DWC 83 form is filed, the agreement detailed within it takes effect. This means that the independent contractor and any of their employees or subcontractors are not entitled to workers' compensation coverage from the hiring contractor, unless a subsequent written agreement, filed according to workers’ compensation rules, states otherwise. For agreements that establish an employer-employee relationship, the hiring contractor assumes responsibility for providing workers' compensation insurance coverage to the independent contractor and their employees, limited to the terms and estimated duration specified in the agreement.

Are there any specific requirements for the contents of the DWC 83 form?

  1. The form must clearly state whether it is affirming an independent contractor relationship or establishing an employer-employee relationship for workers' compensation coverage.
  2. The term (start and end dates) of the agreement, along with the location(s) of the affected job site(s), must be specified. A blanket agreement covering multiple locations is also permissible.
  3. The estimated number of employees affected by this agreement must be provided.
  4. Both the hiring contractor and the independent contractor must include their signatures, federal tax ID numbers, and complete addresses.
  5. Four copies of the completed form are required: one to be filed with the Division, one for the workers’ compensation insurance carrier, and one for each party to retain.

Common mistakes

When filling out the DWC 83 form, aimed at affirming independent contractor statuses for certain building and construction workers in Texas, individuals can make a number of mistakes that may hinder the process. Understanding these common pitfalls can be instrumental in ensuring that the declaration is accepted without unnecessary delays. Here are five mistakes to avoid:

  1. Not checking the appropriate box to indicate the statement that applies can lead to confusion about the nature of the agreement. It is critical to clearly specify whether the declaration aims to affirm an independent relationship or establish an employer-employee relationship for workers' compensation purposes.

  2. Failing to provide complete and accurate information about the term dates and job site location(s). Whether it's a blanket agreement or specific to one job site, every detail must be meticulously accounted for to avoid any ambiguity in the agreement's scope.

  3. Omitting the estimated number of employees affected by the agreement can lead to complications in coverage. This estimate helps the Texas Department of Insurance and the workers' compensation insurance carrier assess the extent of the agreement's impact.

  4. Forgetting to include Federal Tax I.D. Numbers for both the hiring contractor and the independent contractor. This oversight can complicate the verification process and delay the agreement's acceptance.

  5. Overlooking the requirement to file the agreement through personal delivery or registered or certified mail with the Texas Department of Insurance, Division of Workers’ Compensation, as well as with the workers' compensation insurance carrier within 10 days of execution can invalidate the agreement. Additionally, retaining a copy of the agreement for both the hiring contractor and the independent contractor is a crucial step that is often missed.

Avoiding these mistakes not only streamlines the process but also ensures that all parties involved have a clear understanding of their roles and responsibilities under the Texas Workers' Compensation Act. Paying close attention to detail and following the filing instructions carefully can facilitate a smoother transaction for all parties involved.

Documents used along the form

When navigating the complexities of workers' compensation in Texas, particularly involving independent contractors, the DWC 83 form serves as a critical document. However, several other forms and documents often accompany or follow the DWC 83 to ensure compliance with Texas workers' compensation regulations and to safeguard the interests of all parties involved. Understanding these documents is essential for anyone navigating this intricate area of labor law.

  • DWC 84: This form is used to notify the Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) about the cancellation of the agreement established by the DWC 83 form. It ensures that both parties—the hiring contractor and the subcontractor—are on the same page regarding the termination of the agreed-upon independent contractor relationship.
  • DWC 74: Employers use this form to report work-related injuries or illnesses to the TDI-DWC. It's crucial for cases where an independent contractor agreement does not apply, and the worker's status may be in question regarding entitlement to workers' compensation benefits.
  • DWC 3: This wage statement form completed by employers provides detailed information about the employee's earnings. Although aimed at employees rather than independent contractors, it can become relevant in disputes over the classification of a worker's status.
  • IRS Form W-9: Request for Taxpayer Identification Number and Certification is often used alongside the DWC 83 form to ensure the independent contractor's business is properly registered and tax-compliant. This reinforces the distinction between independent contractors and employees.
  • Contractor Agreement: A detailed contract outlining the scope of work, compensation, and terms of the independent contractor relationship complements the DWC 83 form by providing in-depth specifications of the job and expectations from both parties.
  • Certificate of Insurance: This document proves that the independent contractor has their own workers' compensation insurance or equivalent coverage, relieving the hiring contractor from potential liabilities. It's a critical piece of assurance for hiring entities under the DWC 83 agreement.

Together with the DWC 83 form, these documents form a comprehensive framework for managing the relationship between hiring contractors and independent contractors under Texas's workers' compensation laws. They serve to clarify the responsibilities, rights, and protections of each party involved, thereby fostering a secure and compliant working environment. For those navigating these waters, familiarizing oneself with these forms and documents is not only recommended but essential for ensuring that all legal and regulatory requirements are met.

Similar forms

  • IRS Form W-9, Request for Taxpayer Identification Number and Certification: Similar to the DWC 83 form where independent contractors disclose their federal tax identification number, the IRS Form W-9 is used in the United States by independent contractors and freelancers to provide their taxpayer identification number (such as a Social Security number) to entities that will pay them income. Both forms are integral in delineating the tax responsibilities and the nature of the relationship between the hiring entity and the contractor.

  • IRS Form 1099-NEC, Nonemployee Compensation: Just as the DWC 83 form documents the agreement between a hiring contractor and an independent contractor concerning the latter's status and entitlements (or lack thereof) to workers' compensation, IRS Form 1099-NEC is used to report payments made to independent contractors. It highlights the independent nature of the working relationship by reporting income paid that is not subject to income tax withholding, underscoring the contractor's tax obligations directly to the IRS.

  • Workers' Compensation Exemption Form: In various states, this form is used by individuals who are independent contractors or who operate certain types of businesses to declare their exemption from workers' compensation insurance. Like the DWC 83, which elaborates on the independent contractor’s waiver of entitlement to workers' compensation from the hiring contractor, this exemption form legally documents the contractor’s understanding and relinquishment of workers' comp coverage, a common requirement in industries such as construction.

  • Subcontractor Agreement Form: This document outlines the terms and conditions between a contractor and a subcontractor, much like the DWC 83 form delineates between a hiring contractor and an independent contractor. It details the nature of the work, compensation, and, importantly, clauses about insurance and liability, highlighting the independent contractor status and its implications on responsibilities and benefits such as workers' compensation.

  • Employee Classification Form: Certain states use forms for the purpose of classifying workers as employees or independent contractors, based on the nature of their working relationship with the hiring entity. Similar to sections of the DWC 83 form, these documents help determine the status of a worker and thereby their rights to benefits like workers' compensation insurance. They often involve detailing the level of control the worker has over their work and their economic independence from the hiring entity.

Dos and Don'ts

When filling out the DWC 83 form, it is vital to be precise and informed to ensure that your submission efficiently meets the legal requirements and accurately reflects the intended agreement between parties. Below are crucial dos and don'ts to guide you through this process.

Things You Should Do:

  1. Review the definition of "independent contractor" according to the Texas Workers' Compensation Act, Texas Labor Code, Section 406.141(2), to ensure the eligibility of the agreement.
  2. Ensure that both the Hiring Contractor and Independent Contractor clearly understand their rights and responsibilities under the agreement, particularly regarding workers' compensation coverage.
  3. Complete all required sections of the form accurately, including Federal Tax I.D. Numbers, signatures, dates, and addresses to avoid processing delays.
  4. Retain a copy of the completed form for both the Hiring Contractor's and Independent Contractor's records, as per the filing instructions on the form.

Things You Shouldn't Do:

  1. Do not leave any mandatory fields blank. Incomplete forms may result in rejection or delays.
  2. Do not misrepresent the relationship between the Hiring Contractor and the Independent Contractor. Misclassification can lead to legal consequences.
  3. Do not forget to file the agreement with both the Texas Department of Insurance, Division of Workers’ Compensation, and the workers' compensation insurance carrier within 10 days of execution.
  4. Do not disregard the notification requirement if a subsequent hiring agreement is made that does not adhere to the originally filed declaration.

Misconceptions

There are several common misconceptions about the DWC 83 form, which is used in the state of Texas to clarify the working relationship between contractors and subcontractors in the construction industry, particularly in relation to workers' compensation insurance coverage. Understanding these misconceptions is crucial for both hiring contractors and subcontractors to properly navigate their responsibilities and rights under the law.

  • Misconception 1: The DWC 83 form automatically provides workers' compensation coverage to subcontractors.

    This is incorrect. The form is used either to declare that an independent contractor (and their employees) is not entitled to workers' compensation coverage from the hiring contractor or to establish an employer-employee relationship for the purpose of workers' compensation coverage. Coverage depends on the agreement made and properly filing the form.

  • Misconception 2: Once signed, the DWC 83 form applies indefinitely.

    Not true. The declaration or agreement made on the form applies only to the hiring agreements executed within one year after the DWC 83 form is filed, unless a subsequent hiring agreement states otherwise. Any changes or new agreements require notification and potentially a new DWC 83 form.

  • Misconception 3: Filing the DWC 83 form is optional.

    Incorrect. For those wishing to establish or affirm a particular working relationship in the context of workers' compensation in Texas, properly completing and filing the DWC 83 form is mandatory. This includes filing the form by personal delivery or registered or certified mail to the Texas Department of Insurance, Division of Workers' Compensation, and the workers' compensation insurance carrier within 10 days of execution.

  • Misconception 4: The DWC 83 form applies to all workers and contractors.

    False. The form specifically applies to building and construction workers and outlines the relationship between hiring contractors and subcontractors (independent contractors) in this sector. Its provisions do not automatically apply to other types of workers or industries.

  • Misconception 5: Either party can file the DWC 83 form.

    Actually, it is the responsibility of the hiring contractor to file the completed DWC 83 form with the appropriate entities. Both the hiring contractor and the independent contractor must retain a copy of the agreement, but initial filing duties fall on the hiring contractor.

  • Misconception 6: The DWC 83 form affects all aspects of the employer-employee relationship.

    This is a misconception. For parties that agree to establish an employer-employee relationship for the purposes of workers' compensation coverage, this relationship is confined to the context of workers' compensation laws in Texas. It does not affect other aspects of the employer-employee relationship or obligations under other employment laws.

Clarifying these misconceptions about the DWC 83 form helps ensure that both hiring contractors and subcontractors in Texas fully understand their rights and obligations, particularly in relation to workers' compensation insurance. Properly executing and filing the form is essential for compliance with Texas law and for protecting the interests of all parties involved.

Key takeaways

Filling out and using the DWC 83 form properly is crucial for hiring contractors and independent contractors in Texas, especially in the context of workers' compensation. Here are five key takeaways:

  • The DWC 83 form serves as a formal declaration of the relationship between a hiring contractor and an independent contractor, specifically stating whether the independent contractor and their employees or subcontractors are covered under the hiring contractor's workers' compensation insurance.
  • It is essential for both parties to carefully review the qualifications for an independent contractor under the Texas Workers' Compensation Act, Texas Labor Code, Section 406.141, to ensure compliance. This includes being paid by the job, having the freedom to hire helpers, and the ability to work for other contractors.
  • Upon agreement, the form must be filed with the Texas Department of Insurance, Division of Workers’ Compensation and the hiring contractor's workers' compensation insurance carrier within 10 days of execution, emphasizing the importance of timely filing to avoid potential legal issues.
  • There are two main types of agreements that can be made using this form: one that affirms an independent contractor relationship, where the independent contractor's team will not receive workers' compensation from the hiring contractor, and one that establishes an employer-employee relationship for the purposes of workers' compensation insurance.
  • Both the hiring contractor and the independent contractor must retain a copy of the agreement, highlighting the need for both parties to maintain records of their agreement for future reference or in case of disputes.

Understanding and accurately completing the DWC 83 form is vital for ensuring that both hiring contractors and independent contractors are protected and compliant with Texas workers' compensation laws. This not only helps in defining the working relationship but also sets clear expectations regarding workers' compensation coverage. Given the complexities and legal implications, hiring contractors and independent contractors may benefit from consulting an attorney to ensure they meet all requirements before entering into an agreement.

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