How Amazon’s In-House First Aid Clinics Push Injured Employees to Keep Working

Interviews with OMRs who worked at other facilities suggest that the practice of sending injured employees back to work isn’t limited to the Albany warehouse. Eight OMRs who spoke to WIRED say they faced direct pressure from managers to keep the number of workers they sent to doctors low, despite Amazon protocol requiring them to offer injured employees the option of being referred to outside medical care. Several former OMRs say that when an injured worker requested to see a doctor, they had to wait for a senior manager to interview the worker first, although Amazon says this is not part of its protocol. An OMR who worked in Maryland says that if their managers saw in the messaging system that they sent workers to the doctor on the day they were injured, “they’d be hauling ass to our office to ream us one.”

Peter Torres, who worked at AmCare in a facility in California’s Central Valley, says managers would bring up their high “day one” numbers in meetings, a count of employees sent to the doctor the same day they were injured. “It was making us look bad,” he says managers told the AmCare staff. “We needed to try to find a way to improve those numbers, which was a big shock to me.” Torres says that he had to seek permission from senior management to send employees to a doctor, and that sometimes they would try to talk workers out of going. Three other OMRs say that they heard from either managers or employees that the managers had talked workers out of seeing a doctor.

Once, a manager asked Torres to try to convince an injured employee to be treated in-house. A colleague had already decided to refer the worker to a doctor, and Torres was asked to talk the worker out of going. “Where I come from, in the emergency medical services world, that’s a big no-no. You never step on somebody else’s patient,” he says.

In the spring of 2022, a fulfillment center in Salt Lake City, Utah, was sending five to six employees to workers’ comp doctors every week, amongst the highest rates for Amazon facilities in the region, says former OMR Jed Martinez. He says that senior operations managers told staff that they needed to reduce that number to one or two per week. Managers encouraged OMRs to tell employees that there was nothing a doctor would offer that AmCare couldn’t provide, he says.

Vogel of Amazon says the managers’ behavior described by Torres, Martinez, and other OMRs violates company policy and that the company tracks “day one” numbers only to ensure its staff are providing high-quality first aid.

Many of the clinic staffers who spoke to WIRED said they tried to do their best to help employees under the limitations Amazon placed on them, and that some employees did appear to improve. But others deteriorated—especially those with repetitive stress injuries, says a former Colorado-based EMT. Amazon policy states that employees who aren’t improving should be immediately referred to an outside provider, but she saw some workers get stuck in an injury loop. “We really struggled to get those people better because they were still going out there and doing the same repetitive movement that injured them in the first place.”

Delayed Care

Amazon is fighting a growing throng of regulators, law enforcement, and politicians trying to force it to meaningfully address warehouse safety. OSHA currently has investigations open at 18 Amazon warehouses and has already issued six citations across eight facilities in 2023, including the one in April for medical mismanagement and one last month for ergonomic hazards at a New Jersey facility. It was accompanied by a warning letter alleging that AmCare employees at the warehouse failed to ensure that injured employees received proper medical care, including several employees with head injuries.

In Washington state, a trial began on July 24 after the state’s occupational safety regulator said that at three Amazon warehouses the ergonomics and pace of work, combined with the company’s discipline system, elevated the risk of developing musculoskeletal disorders. The agency ordered Amazon to change its processes, but it claims to have made improvements and is pushing back on the allegations. Meanwhile, the US Department of Justice is investigating whether the company deliberately underreported injuries, and Bernie Sanders recently launched a Senate investigation into the company’s safety record. The various probes could force Amazon to revamp its processes, or haul executives before Congress.