Larry Alexander v. Avera St. Luke's Hospital, 768 F.3d 756

Dr. Larry Alexander was a pathologist who contracted with Avera St. Luke’s under successive Pathology Services Agreements (most recently 2008) that expressly characterized him as an independent contractor and stated Avera would not control the manner of his services.
The contracts required performance consistent with hospital bylaws, allowed Alexander to hire substitutes/assistants at his own expense (which he did), provided 35 days of leave per year with substitute coverage responsibilities, and allocated compensation via Form 1099; Alexander reported income on Schedule C and paid self-employment taxes.
Avera provided hospital facilities, equipment, non-medical staff, and billed patients; it paid Alexander monthly but did not withhold taxes or provide benefits or malpractice insurance (unlike later physician employees Buttolph and Fritz, who received W-2s and benefits).
In August 2011 Avera terminated Alexander’s 2008 contract with 90 days’ notice; Alexander sued under the ADA, ADEA, FMLA, and the South Dakota Human Relations Act (SDHRA), alleging discriminatory discharge and other statutory violations.
The district court granted summary judgment for Avera, finding Alexander was an independent contractor, and the Eighth Circuit affirmed on de novo review.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether Alexander was an "employee" under the ADA/ADEA	Alexander contended his hospital relationship made him an employee subject to statutes	Avera argued the contract and practical indicia show an independent-contractor relationship	Court held Alexander was an independent contractor under Darden/common-law agency; ADA/ADEA claims fail
Whether Alexander was an "employee" under the FMLA (economic-reality)	Alexander urged the FMLA should use an economic-realities test that would cover him	Avera argued the hybrid/common-law test applies and he was not an employee	Court applied the hybrid/common-law test (including economic realities) and held Alexander was not an employee; FMLA claim fails
Whether the SDHRA covers Alexander	Alexander argued he was an "employee" under SDHRA §20-13-1(6) and thus protected	Avera argued SDHRA should be construed like federal statutes and does not cover independent contractors	Court predicted South Dakota would apply Darden-like test; found no reasonable jury could find Alexander an employee; SDHRA claim fails
Appropriateness of summary judgment on employee-status question	Alexander argued disputed facts should preclude summary judgment	Avera argued undisputed contractual and economic facts warranted judgment as a matter of law	Court held employee-status may often be decided on summary judgment and affirmed dismissal as no reasonable jury could find he was an employee

Nationwide Mut. Ins. Co. v. Darden, 503 U.S. 318 (Sup. Ct. 1992) (common-law agency test for "employee")
Ernster v. Luxco, Inc., 596 F.3d 1000 (8th Cir. 2010) (application of Darden factors)
Lerohl v. Friends of Minn. Sinfonia, 322 F.3d 486 (8th Cir. 2003) (employee/contractor factors and summary judgment)
Wojewski v. Rapid City Reg'l Hosp., Inc., 450 F.3d 338 (8th Cir. 2006) (physician independent-contractor analysis)
Glascock v. Linn Cnty. Emergency Med., PC, 698 F.3d 695 (8th Cir. 2012) (control factor in medical-context employment cases)
Bartels v. Birmingham, 332 U.S. 126 (Sup. Ct. 1947) (economic-dependence/"economic realities" concept)
Wilde v. Cnty. of Kandiyohi, 15 F.3d 103 (8th Cir. 1994) (hybrid test blending common-law and economic realities)
Tsosie v. United States, 452 F.3d 1161 (10th Cir. 2006) (use of hospital facilities and equipment not dispositive of employee status)