There are thousands of paramedics that work a side-gig as an independent contractor caregiver. They will work an 8-to-18 hour shift as a paramedic at a volunteer ambulance service and get paid per hour. There are no fringe benefits, leave accrual or health insurance coverage. Reviewing an ambulance crash where an independent contractor paramedic was severely injured reminded me of the hazards emergency service providers face when working in the “gig economy.”
It was an economic depression in the 1980’s that started the trend of replacing full-time employees with independent contractors. The carrot was that the independent contractors would get paid at a much higher hourly rate. The reality was that the independent contractor needed to procure health insurance, save for quarterly tax payments and assume risks that the employer covered for full-time staff.
A 2017 NIOSH report showed that EMS workers have higher rates of work-related injuries than the general workforce and three times the lost workday rate of all private industry workers. More than 22,000 EMS caregivers visited emergency departments each year for work-related injuries. The most common injuries are back and neck strains and pains. What happens if you suffer a severe back injury while working as an independent contractor?
An independent contractor gets hurt
I was credentialed as a state fire instructor in a right-to-work state. We were hired as contractors. Another state fire instructor was severely injured while teaching a ladders class. He was looking at orthopedic surgery and a 9 to 12-month rehabilitation period. While the state covered the emergency department costs, it said it was not obligated to pay for the rehabilitation of a contractor.
It gets worse. He was a career firefighter and his employer said that (a) he was ineligible for a light-duty assignment because this was not an on-the-job injury, (b) after he exhausted his sick, vacation, and annual leave he would be placed on Leave With Out Pay – that will result in cancellation of his health insurance and (c) if he could not return to full duty after 6 months he will be terminated.
What if you are killed?
Organizations using independent contractors work to minimize their liability and financial obligations. Since the 2009 recession, some jurisdictions have become even more aggressive at avoiding obligations. A township in a northeast state refused to provide line-of-duty death (LODD) benefits after one of their volunteers died after returning from an incident.
While that situation was recent, I have notes from an earlier online discussion on LODD coverage where a northeast town declined to raise taxes 7% for one year to cover the LODD benefits of a call firefighter in a department that uses 30 call firefighters. (Call firefighters are paid by the incident.)
I shared this incident that occurred in a southern state:
Two off-duty city firefighters, functioning as members of their community volunteer fire department, die in a structure fire. The city retirement board says that the spouses would not obtain LODD retirement benefits because they were not working for the city when they died. (While cruel – they are correct.)
The township where they were volunteers and the township where the fire occurred declined to provide the estimated $460,000 needed to fund the LODD benefits.
If the townships are not covering their own volunteers, I am sure that an independent contractor paramedic LODD will get even less coverage.
You got hurt on your other job
Municipal risk management looks to reduce the jurisdiction’s liability for chronic and disabling medical conditions that generate hundreds of thousands of dollars in obligations. Paramedic neck, back, knee and hip injuries are often caused by repetitive wear-and-tear and then exacerbated by a specific incident. They represent years of expenses. The first official reaction may be that the injury occurred during your side-gig or volunteer service.
“I am doing the same job.”
Most of the paramedics working as independent contractors I have talked to do not know what their coverage is if they get hurt or killed. The erroneous assumption is, since they are providing the same services, they have the same coverage/protection as they do with their full-time job. That is not accurate
Here are 4 suggestions to protect your ability to complete your paramedic career:
- Read your independent contract agreement.
- If needed, consult an attorney who works in labor law.
- Document all of your paramedic work shifts. (6/18/2018: Community Volunteer Ambulance 207, 0800-1800, EMT Eddie driver. 4 responses, two patient assessments, used stair chair and stretcher to transport a 150-pound sick patient.)
- Consider getting appropriate insurance (EMS caregiver, Errors/Omission, and Disability) to cover your independent contractor work.
Specific issues and coverages will be different for each state. EMS providers in most states have a lower level of protection than our fire and law enforcement colleagues. Know the unique risks and coverages as an independent contractor before you get hurt.