Hotline advice from a paramedic
Social security obligation
While a dependent employment relationship generally triggers compulsory health, pension and unemployment insurance, a self-employed activity does not give rise to a social insurance obligation. For physicians, the question always arises in cases of various remunerated "sideline activities" as to how these activities are to be assessed under social insurance law.
The case
A rescue physician was active in a medical emergency hotline for divers. The facility was part of the support package of a travel and foreign health insurance. Two physicians were on duty per shift at all times for consultations. Consultations were usually held in the doctors' private homes. On a case-by-case basis, treatment coordination could be provided.
Social security obligation
In a status determination procedure, the German pension insurance/DRV classified the physician as a dependent employee. The provider of the consulting hotline (the insurance company) and the doctors themselves assumed that they were self-employed. As an argument for this, the parties involved argued that they could conduct their telephone calls anywhere and that the intensity of the consultations was freely configurable.
Ruling-LSG
The Lower Saxony-Bremen Regional Social Court/LSG took a different view. As a result, the court confirmed the legal opinion of the DRV. The consultation of physicians for a consultation hotline fulfills the characteristics of dependent employment relationships even if the physicians perform the on-call services in their own homes. According to the LSG, the fact that physicians are responsible for their own medical treatment does not necessarily mean that they are self-employed. Also, the performance of an activity at home and the fact that the physician was not subject to any instructions regarding the place of work is no longer a suitable delimitation criterion in view of the general possibility of home office activity (LSG judgment of Feb. 20, 2023, L 2/12 BA 17/20).
Status: May 29, 2023
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