The Reason Pandemic-Era Injury Rates At Amazon Warehouses Are Soaring

The company is trying to keep up with rising demand driven by the pandemic. As a result it is pushing employees harder than ever.

In addition, the company uses robots as the standard against which workers are compared, meaning humans cannot keep up without getting hurt. JL

Will Evans reports in Reveal:

Amazon’s injury rates have gone up each of the past four years,. Amazon fulfillment centers recorded 14,000 serious injuries. The rate of 7.7 serious injuries per 100 employees was 33% higher than in 2016 and double the most recent industry standard. Safety professionals say the company has used the robots to ratchet up production quotas to the point that humans can’t keep up without hurting themselves. For each of the past four years, injury rates have been significantly higher at Amazon’s robotic warehouses than at its traditional sites.

Clark proudly unveiled the company’s new warehouse of the future in Tracy, California.  Behind him, tall yellow racks packed with vitamins, toy rockets and paintball gear zipped across the floor, lugged by the powerful, squat orange robots that would help catapult the company toward world domination. In a checked shirt and with neatly parted hair, Clark looked more the part of a high school teacher than a corporate executive, as he cheerfully called himself “head elf of Santa’s workshop around the world.”

Of Amazon’s transformation, he said, “It’s better for everybody.” Workers no longer would have to walk massive warehouse floors to find the right power drill – instead, robots would bring the drill directly to them. The hour or more it took to process a package had been shaved down to as little as 15 minutes. More Amazon customers could now get products delivered to their door the same day they clicked “Buy.”

The following July, Amazon rolled out another innovation: Prime Day. The holiday-shopping season was already an intense pressure cooker of warehouse activity known as “peak” inside Amazon. Now the company had just manufactured a second peak in the middle of the year: a brand-new holiday that would become pivotal to the company’s growth.

Indeed, in the six years since Clark stood in that cavernous warehouse and saw the future, the company’s value has leaped from less than $150 billion to more than $1 trillion, and CEO Jeff Bezos has become the richest person in the world. The company’s top leaders have fashioned a mythology around its growth, casting Amazon as a force for good. Its obsession with delighting customers fuels a “virtuous cycle,” they say, that ends up benefiting everyone – even Amazon’s more than 250,000 warehouse workers.

In fact, as senators have fired off letters to the company and workers have led walkouts over health and safety, Amazon has engaged in an unapologetic public relations campaign. Robots, Amazon insists, are good for workers. “They make the job safer,” Jeff Wilke, one of two CEOs under Bezos, told PBS FRONTLINE last September. And Prime Day and the holiday rush are so well orchestrated, Amazon has claimed, that injury rates stay flat or even go down during these buying frenzies. Thanks to “diligent record-keeping,” Amazon told Business Insider, “we know for a fact that recordable incidents do not increase during peak.”

But a new cache of company records obtained by Reveal from The Center for Investigative Reporting – including internal safety reports and weekly injury numbers from its nationwide network of fulfillment centers – shows that company officials have profoundly misled the public and lawmakers about its record on worker safety. They reveal a mounting injury crisis at Amazon warehouses, one that is especially acute at robotic facilities and during Prime week and the holiday peak – and one that Amazon has gone to great lengths to conceal. With weekly data from 2016 through 2019 from more than 150 Amazon warehouses, the records definitively expose the brutal cost to workers of Amazon’s vast shipping empire – and the bald misrepresentations the company has deployed to hide its growing safety crisis.

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Amazon warehouse injury rates

Look up injury rates at the Amazon warehouse that ships your package, along with more than 150 other warehouses across the country.

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The internal reports cheer incremental progress in a specific month or region; call out problem warehouses with the worst injury numbers; and detail safety initiatives, action items and pilot projects. While the reports show a committed drive to improve processes with technology or design changes, they don’t propose reducing the intense workload for Amazon’s warehouse employees, which is what helps drive Amazon’s speed.

Amazon often points to the tens of millions of dollars it has invested to enhance safety practices. Yet Amazon’s injury rates have gone up each of the past four years, the internal data shows. In 2019, Amazon fulfillment centers recorded 14,000 serious injuries – those requiring days off or job restrictions. The overall rate of 7.7 serious injuries per 100 employees was 33% higher than in 2016 and nearly double the most recent industry standard.

Serious injury rates at Amazon fulfillment centers

Note: Serious injuries are work-related injuries and illnesses that require days away from work or a job restriction. The most recent data available from the Bureau of Labor Statistics for general warehousing and storage industry averages is 2018.

Sources: Reveal analysis of internal Amazon data; U.S. Labor Department

Credit: Soo Oh/Reveal

The data back up the accounts of Amazon warehouse workers and former safety professionals who say the company has used the robots to ratchet up production quotas to the point that humans can’t keep up without hurting themselves. For each of the past four years, injury rates have been significantly higher at Amazon’s robotic warehouses than at its traditional sites.

And for years, the internal data show, injury rates have spiked during the weeks of Prime Day and Cyber Monday, contrary to Amazon’s public claims. Those two weeks had the highest rate of serious injuries for all of 2019.

Monthly bulletins from Amazon’s environment, health and safety team show that the famously data-obsessed company is well aware of its safety problems. Each month, company officials sent out detailed updates – marked “Privileged & Confidential” – to warehouse safety managers across the country with data, charts and FAQs. They set safety goals and monitor progress closely. But the internal documents show that the company has failed to hit these targets. In 2018, Amazon aimed to lower its injury rate by 20%. Instead, injury rates went up. The next year, the goal was more modest: a 5% decrease. But the rate rose again.

In May, Bezos told shareholders that he welcomed scrutiny of the company’s operations. “It’s good for us,” he said. “Nothing is more important,” he added, “than the health and well-being of our employees.”

Amazon declined Reveal’s interview request and did not respond to detailed questions about the accuracy of its public statements. Instead, a company spokesperson provided a general statement about its warehouse safety initiatives.

“Nothing is more important than the health and safety of our teams. So far in 2020, we have committed over $1B in new investments in operations safety measures, ranging from technology investments in safety to masks, gloves, and the enhanced cleaning and sanitization required to protect employees from the spread of Covid-19,” spokesperson Rachael Lighty said in the email.

She said the company has seen improvements through an array of programs inside its warehouses, such as installing guardrails to separate forklifts from pedestrians, increasing safety staffing and offering wellness exercises. “Our investments in safety training and education programs, in technology and new safety infrastructure are working,” Lighty said.

Yet her email didn’t say how the company justifies its claim that these initiatives are working, while injury rates have continued, year after year, to rise.

About an hour south on Interstate 5 from Amazon’s Seattle headquarters is DuPont, Washington, and a company warehouse called BFI3. Last year, its workers experienced the highest injury rates of any Amazon fulfillment center in the country: 22 serious injuries for every 100 workers. That’s a rate more than five times higher than the most recent industry average.

Serious injury rates at Amazon’s DuPont warehouse

Note: Serious injuries are work-related injuries and illnesses that require days away from work or a job restriction.

Sources: Reveal analysis of internal Amazon data; U.S. Labor Department

Credit: Soo Oh/Reveal

Cecilia Hoyos has been at the company for nine years. She lives just a block away from BFI3, and her $17.90 hourly wage supports two children and a 1½-year-old granddaughter. Earlier this month, she spent her 56th birthday at work in the warehouse. She often talks about how much she loves her job – she likes being around people and keeping busy. “It’s just that it’s hurting me and they’re not listening to what my body’s telling me,” Hoyos said.

Since the warehouse opened in 2014, Hoyos has seen the production quotas go higher and higher. Managers would closely monitor a computer system that tracks how many items an employee scans every hour and write up workers who weren’t hitting targets. Workers who fell too far behind could be fired.

Those quotas changed dramatically when the robots arrived at Amazon. Company officials promised they’d save workers such as Hoyos from the fatigue of walking miles a day to find customer orders. All they would have to do is stand in place and grab things.

“We thought it was so cool,” she said. But she soon wished she were back to walking all day. Instead of greeting colleagues as she moved through the facility, she was isolated at a workstation, and standing 10 hours a day doing repetitive motions proved to be much harder on her body, Hoyos said.

The robots were too efficient. They could bring items so quickly that the productivity expectations for workers more than doubled, according to a former senior operations manager who saw the transformation. And they kept climbing. At the most common kind of warehouse, workers called pickers – who previously had to grab and scan about 100 items an hour – were expected to hit rates of up to 400 an hour at robotic fulfillment centers.

According to Kathleen Fagan, a physician who inspected Amazon warehouses in her capacity as a medical officer for the federal Occupational Safety and Health Administration, or OSHA, studies have shown that production rates have a direct impact on injuries.

“If you’ve got robots that are moving product faster and workers have to then lift or move those products faster, there’ll be increased injuries,” she said. Doing the same motion over and over again, quickly and without a break, doesn’t allow muscles to rest. Increased physical and mental stress leads to distraction and exhaustion, which also increase injuries, studies show.

Amazon’s robots, which help fill orders by bringing shelves of merchandise to workers, navigate a fulfillment center in DuPont, Wash., in February 2015. In 2019, the DuPont warehouse had 22 serious injuries for every 100 workers. (Stephen Brashear/Getty Images)

A former senior Amazon safety manager said that within a year or two of introducing the robots, the unintended consequences had become clear to Amazon’s safety team. “We vastly underestimated the effects it was going to have on our associates,” said the former safety manager, whom we agreed not to name because he left on good terms with the company and, overall, has a positive impression of how Amazon otherwise handled safety. “We realized early on there was an issue. It was just – you’re already moving that way at light speed, so how do you take a step back and readjust?”

As far back as December 2015, just over a year after Amazon debuted its fleet of robots, OSHA issued a hazard alert letter against an Amazon robotic warehouse in New Jersey. OSHA called out Amazon for conditions that resulted from the robotics innovation: “The company exposed employees to ergonomic risk factors including stress from repeated bending at the waist and repeated exertions, and standing during entire shifts up to 10 hours, four days a week and sometimes including mandatory overtime shifts.”

The federal agency recommended measures – such as an extra rest break and rotating employees to different jobs throughout the day – that Amazon has yet to implement across its warehouse network. And Amazon’s data show that by the end of 2016, its robotic warehouses had significantly higher injury rates than its traditional facilities.

Yet in May 2019, Wilke, Amazon’s co-CEO, said in a tweet, “What some folks may not know is that the robots make those jobs better and safer.” He also said robots allow “people to take advantage of their innate human creativity instead of doing rote things over and over again.”

Amazon’s robotic fulfillment centers have higher serious injury rates

Injuries at Amazon’s sortable warehouses

Note: Serious injuries are work-related injuries and illnesses that require days away from work or a job restriction. Sortable warehouses, which ship small- and medium-sized items, are the most common type of Amazon fulfillment center. The data for 2019 includes 46 robotic and 13 nonrobotic sortable warehouses.

Sources: Reveal analysis of internal Amazon data; U.S. Labor Department

Credit: Soo Oh/Reveal

Amazon’s data – available at the time in widely circulated internal reports – shows otherwise. At the most common type of Amazon fulfillment center, those that ship small- and medium-sized items, the rate of serious injuries from 2016 to 2019 was more than 50% higher at warehouses with robots than ones without.

Amazon did not respond to the finding that its robotic facilities have higher injury rates, instead reiterating its claim that “the use of robotics, automation and technology in our fulfillment centers is enhancing our workplace, making jobs safer and more efficient.”

Prime Day is one of Amazon’s two most crucial sales periods. Amazon Prime members get access to more than a million deals over what is now two days; workers get mandatory overtime, with shifts extended from 10 to 12 hours or extra shifts added to an already grueling job.

Prime Day 2019 was the biggest shopping event in the company’s history. It was also the year’s most dangerous week for injuries at Amazon fulfillment centers, with nearly 400 serious injuries recorded across the country. Reveal calculated those numbers from Amazon’s internal data. Yet Amazon officials have publicly denied that rates spike during these days.

Last November, a Reveal investigation showed that the company’s obsession with speed had turned its warehouses into injury mills. When asked about injuries during Prime Day and the holidays for that story, an Amazon spokesperson told Reveal that “the rate of injury – an average rate of injury per person – has historically decreased or been stable during these two times.” In a safety report from that same month, a line graph illustrates Amazon’s injury rates for 2019. The tallest spike is right in the middle of the year, during the week of Prime Day.

Just five months earlier, in June 2019, the monthly report from the Amazon safety director in charge of robotic warehouses across the country was frank about the risks. Warehouses in the region that encompasses New Jersey, New York, Maryland and Connecticut were “expecting an increase in injuries across all sites during Prime Week.” Injuries already had increased in the ramp-up to Prime Day, a trend the report attributed to mandatory overtime and bringing in 1,200 to 2,000 seasonal employees to each robotic site in that region. Both the overtime and the influx of new workers were labeled “high-risk situations.”

Injuries spike the weeks of Prime Day, Cyber Monday

Note: Serious injuries are work-related injuries and illnesses that require days away from work or a job restriction. Amazon’s fiscal year corresponds to the calendar year.

Source: Reveal analysis of internal Amazon data

Credit: Soo Oh/Reveal

At the time, Amazon had several safety initiatives in the works. A pilot project to do what OSHA had recommended years before – rotate workers to different jobs to alleviate repetitive stress – had shown promise in reducing injuries.

But sales came first. “Despite the considerable benefits, half of the pilot sites decided to turn off sort rotation during Prime Week,” Amazon’s safety team reported in August 2019. A November report said that while the job rotation had driven down injury rates in robotic warehouses, “adherence is declining.”

Another pilot project, outlined in a May 2019 report, sought to lower injuries by blocking off the highest and lowest shelves on warehouse racks, “optimizing work allocation to an associate’s power zone,” so workers wouldn’t have to bend as low or reach as high. According to the report, ergonomic issues such as excessive repetition and bending down led to 74% of injuries among the workers who stowed away and picked out customer orders in robotic warehouses in 2018.

That pilot project, however, was designed for use only “during non-Peak.” And out of six warehouses testing the pilot, five put it on hold for the runup to Prime Day. The report warned there was “risk of complete termination of (the) project.” Amazon declined to provide an update on the program’s current status.

Amazon has maintained that the company properly staffs its warehouses with safety officials. An Amazon spokesperson told me last November, “We ensure we have adequate leadership and safety staff on hand during these peak times.”

Yet an August 2019 report described safety staffing at robotic warehouses as being “critically low.” That October, another report again warned of staffing problems at robotic warehouses, including safety-team attrition in the region that covers New Jersey, New York, Maryland and Connecticut that “will put several sites understaffed going into Peak.”

As last year’s holiday-shopping season approached, Amazon’s safety managers received talking points to pass along to workers fatigued from 12-hour shifts and 60-hour weeks. “Mandatory Extra Time,” it said, “requires us to give a little extra to stay customer obsessed.”

“Take the time away from work to recharge your internal battery,” the list of tips suggests. “Smile and laugh with the people in your life that bring you joy. Sleep in on your day off. Binge your favorite shows.”

Austin Wendt left his job as an EMT for a private ambulance company in 2016 to take a higher-paying role running the first aid clinic at Amazon’s warehouse BFI3 in DuPont.

Eventually, he became the only person responsible for safety at the warehouse during his shifts. A safety specialist had quit and wasn’t replaced. His manager, he said, was rarely on-site. Overworked and overwhelmed, Wendt was being asked to do things he wasn’t trained to do, he said, such as ergonomic assessments of workstations.

“I never had support from my boss or senior leadership, to do my job effectively or enforce safety,” he said. “There’s so much to do and you’re so far behind, and there’s so many injuries that you could just never get caught up.”

He’d watch workers heave heavy bags of dog food and cat litter all night – tens of thousands of pounds in some cases, he estimated. And the workers had to do it quick. Under constant pressure to hit ever-increasing production rates, they took shortcuts, he said.

Instead of climbing a ladder to grab a heavy item off a top shelf, workers would get on their tiptoes and reach. Or they’d bend over, instead of squatting, to grab a bag, then twist to put it down quickly. They’d grab a heavy tote off a conveyor belt with one hand while pressing a button on a computer screen with the other. The extra hours, fatigue and stress of peak times compounded the problem.

An associate hands merchandise to a fellow worker at the Amazon fulfillment center in DuPont, Wash., in February 2015. In 2018, 36% of the site’s workers gave an “unfavorable” response to the staff survey question: “Does the safety training match the real world expectations of your job?” (Stephen Brashear/Getty Images)

“I’d have managers sitting there watching these people work very improperly” he said, “and they don’t say anything. Because it’s about rate and productivity.”

In 2018, Amazon safety officials did what they called a “deep dive” analysis into why so many workers at the DuPont warehouse gave negative feedback in a routine safety survey. To the question, “Does the safety training match the real world expectations of your job?” 36% of the site’s workers gave an “unfavorable” response. For months, that was the safety question with the worst response, and it wasn’t budging even with retraining.

Trying to figure out why, Amazon got a common explanation from workers, according to the report: The work “requires me to move too quickly, so I am forced to either cut corners or not make rate.”

The report said BFI3 leadership was seeking “to improve processes and ensure that they can be performed safely at rate.”

Yet not one of the dozens of safety initiatives described in the 2018 and 2019 internal safety reports obtained by Reveal suggests slowing down production quotas to reduce injuries.

“In the end, I don’t think it’s that hard of an issue,” Wendt said; the answer is to “lower the rate.” But, he added, “I don’t think that was ever an option in their head or even thought of as a route to take.”

Wendt left Amazon for a fire department job in early 2019. That year, the warehouse’s injury problem got even worse.

Cecilia Hoyos accounted for two of the injuries on the warehouse logs that year. For one, in July 2019, the heavy lifting and repetition caught up with her. After an entire shift spent unloading a trailer – grabbing heavy boxes and putting them on a conveyor belt – she had a hard time walking to her front door. Trying not to complain, she returned to unloading trailers the next day.

“It was killing me, but OK, that’s my job,” she said.

After a break, Hoyos found she couldn’t walk back to her workstation. She ended up with a hip injury that put her off work for months, according to Amazon’s injury logs. That and other work injuries have left her in constant pain, she said, leaving her feeling like her 80-year-old mother when she climbs stairs.

Hoyos said Amazon should have workers rotate jobs to lessen the repetitive strain. But managers don’t listen, she said. “They say no because they only think about the rates.”

Warehouse leaders would, however, offer pizza parties as a reward for a streak of injury-free shifts, Wendt said – so some workers would push through the pain rather than be the person who cost their co-workers free pizza. Managers were effectively “offering rewards for not reporting injuries,” Wendt said.

In February, a group of 15 U.S. senators, led by Sherrod Brown, Bernie Sanders and Tammy Baldwin, demanded that Bezos make a long list of changes in Amazon’s warehouses after Reveal’s initial investigation.

“These reports make clear that by placing such a priority on speed and quota fulfillment, your company requires employees to risk their safety and health to perform and keep their jobs,” the letter reads. The senators also demanded a response from the company.

Brian Huseman, Amazon’s vice president of public policy, pushed back on the idea that the company had a worker injury problem, telling the senators that other companies underreport their injuries. “In 2016, we decided to change our approach to recordkeeping and design a system that reported all injuries – no matter the severity,” he wrote in response to the senators.

But the 2015 OSHA investigation of the fulfillment center in New Jersey found that Amazon had failed to record more than two dozen injuries as required, leading to a $7,000 fine. And several former Amazon safety professionals told me that the company used to systematically hide injuries by having safety staff write up “justifications” for not recording injuries that should have been counted by federal regulations.

Days after the senators sent their letter, Jay Carney, Amazon’s senior vice president for global corporate affairs, went on CNBC to talk about the company having raised its minimum wage to $15 an hour. When asked about the letter, he echoed the argument that the company’s injury rates are so high today only because it initiated a policy of zealous compliance.

“Across the country, injuries are woefully underreported,” he said. “That was true at Amazon a number of years ago, and then we changed the way we report injuries. That spiked the numbers for us. We report well above what’s required by OSHA.”

Fagan helped lead that 2015 inspection as a medical officer for OSHA. She found Amazon’s on-site clinics would send injured workers back to work instead of referring them to another clinic for proper medical attention. “What we learned was really surprising, actually shocking,” she said.

Kathleen Fagan, a physician who inspected Amazon warehouses as a medical officer for OSHA, found the company did not provide proper medical attention to injured workers. (Thaad Sabolboro for Reveal)

Fagan went on to investigate Amazon warehouses in New Jersey again and found the same problems with medical care. Workers were still being discouraged from reporting injuries in 2017 and from seeking outside medical attention in 2019, Fagan found. In another hazard alert letter, OSHA criticized Amazon for explicitly allowing AmCare, Amazon’s system of on-site medical clinics, to delay sending workers to a doctor for up to 21 days. The result was that workers’ injuries got worse while they waited for proper medical care, she said. “The company did not improve,” Fagan, who has since retired, told me.

“I mean, that’s shameful,” she said. “This is a company that makes enormous profits.”

Amazon also has selectively released flattering numbers to inquiring Congress members, even when the big picture is far grimmer. Last November, after Reveal reported that the 2018 injury rates at a warehouse in Fall River, Massachusetts, were nearly triple the industry average, Massachusetts Sens. Elizabeth Warren and Ed Markey and Rep. Joe Kennedy III wrote to Bezos “seeking answers about why so many Massachusetts workers are getting seriously injured at Amazon fulfillment centers.”

Huseman responded, “The injury data by itself does not tell the full story.” He declined to provide the 2019 annual injury numbers the lawmakers had requested, but cited one data point: The 2019 holiday peak produced a lower rate of injuries requiring time off work compared with 2018, a change he attributed to “the continuous improvement initiatives executed locally and companywide.”

Serious injury rates at Amazon’s Fall River warehouse

Note: Serious injuries are work-related injuries and illnesses that require days away from work or a job restriction.

Sources: Reveal analysis of internal Amazon data; U.S. Labor Department

Credit: Soo Oh/Reveal

Lost-time injuries did dip in that time period. But Amazon’s internal numbers for 2019 as a whole were significantly worse. The Fall River warehouse’s rate of lost-time injuries, for example, was more than 50% higher in 2019 compared with 2018 and six times the industry average.

Just like Carney, Huseman insisted that Amazon doesn’t play games with the numbers.

“We differ from companies who take aggressive measures to avoid recording a lost time injury, such as requiring employees to come back to work immediately after injury,” he wrote. “We do not create ‘light duty’ work, even if this means that we record a lost time injury as a result.”

The internal safety reports show that Amazon did exactly that in some of its warehouses.

Amazon’s safety team last year rolled out an initiative to “drastically reduce” its rate of lost-time injuries – those considered more serious because they require days off work. But the initiative didn’t involve preventing injuries – it just prevented them from being recorded as lost time. The initiative’s name: “temporary light duty.”

Many injured workers, hurt to the point that they were unable to perform their warehouse jobs, were reassigned. Some were sent to tag photos on a computer to help train Amazon’s machine learning algorithms. Others were loaned to nonprofit organizations with which the company partners. The strategy, articulated in an August 2019 email from Marla Corson, Amazon’s safety director for robotic warehouses, could be used for workers whose injuries meant they had the use of only one hand or could do only sit-down work. Rolled out across the fulfillment center network, she said, it had “the potential to reduce Lost Time Injuries and workers compensation costs by 70%.”

Amazon’s rate of lost-time injuries did go down in 2019. This can be better for workers because they keep their regular pay, instead of being out on workers’ comp.

But the injuries hadn’t gone away. The rate of injuries needing a job restriction or accommodation went up by just as much. Combine those categories, as OSHA often does in calculating serious injuries, and there was no improvement at all.

U.S. Rep. Pramila Jayapal, whose district includes Amazon’s Seattle headquarters, said she’s troubled by Amazon’s lack of honesty. “I don’t know that the information I’m getting from Amazon is accurate, because mostly Amazon denies that anything is happening and says that there is a vast network of people who are simply reporting on things to make them look bad,” she said. “I just don’t believe that.”

Amazon’s safety team knew there was a problem at its fulfillment center in Thornton, Colorado. Internal reports sent to Amazon safety managers across the country in early 2019 repeatedly flagged the warehouse for having especially high injury rates. One item in the FAQ section asked why that warehouse and six others had a rate of lost-time injuries “more than twice” the internal goal for January.

The answer didn’t attribute the injury rate to unsafe working conditions. Instead, the report cited an increase in work restrictions ordered by medical providers. Workers typically get first aid at AmCare, Amazon’s on-site health centers, and may be referred to outside medical clinics – usually on contract with Amazon – if they need further medical attention. What happens at those clinics has a decisive impact on the company’s official injury records.

Employers must log for OSHA any work-related injuries that require medical care beyond first aid, time off work to heal or a change to a worker’s job. These “recordable” injuries make up a company’s injury rate.

Keeping injuries off that log has benefits for a company. High recorded injury rates can make a company more of a target for OSHA inspectors. Keeping workers from getting medical care can also lower a company’s workers’ compensation insurance. Plus, too many injuries can lead to bad press.

The report said Thornton safety staff were meeting with the facility’s most frequently used medical clinic to “discuss the impact” of the care it was giving workers.

Amazon employee Viri Barrera (left) helps Thornton, Colo., Mayor Heidi Williams pack a product during a tour at Amazon’s Thornton fulfillment center in August 2019. (Andy Cross/The Denver Post)

When things didn’t improve, the next month’s report, in March 2019, documented a more drastic solution: “To address the flat recordable rate, the site has … terminated the use of an occupational clinic with poor performance.”

The warehouse, the report said, also would ensure “strong” use of the on-site AmCare first aid and “reduce the probability of associates transitioning to external clinic care.”

The next month, in April 2019, Amazon contracted with a new clinic for its injured Colorado workers: Advanced Urgent Care & Occupational Medicine, a local operation that promoted itself online as “OSHA-Sensitive.”

According to the Advanced website, Julie Parsons, then its occupational medicine medical director, believed in “treating injuries such that they are not OSHA recordable, if possible.”

Serious injuries at Amazon’s Thornton warehouse

Recorded injuries began to decline after Amazon contracted with an “OSHA-Sensitive” clinic.

Note: Serious injuries are work-related injuries and illnesses that require days away from work or a job restriction.

Sources: Reveal analysis of internal Amazon data

Credit: Soo Oh/Reveal

Three medical providers who worked for Advanced told me that clinic directors instructed them to avoid giving any treatment to Amazon workers that would make their injuries recordable. Normally, these providers could prescribe medications, days of rest, physical therapy or workplace restrictions, such as guidance to avoid climbing stairs or lifting anything above a certain weight. But clinic directors pressured medical staff to send injured Amazon employees back to work without any of those remedies, said the providers, who asked that their names not be used for fear of harming their careers.

A nurse practitioner who worked at the clinic said she dreaded seeing Amazon patients because she didn’t think she would be able to treat them appropriately. She said she remembers an Amazon worker who came to the clinic in a lot of pain from a wrist injury, crying and asking, “Can’t you do something?”

“I’m really sorry,” the nurse practitioner recalled telling her. “There’s really not a whole lot I can offer you right now.”

In a July 2019 email, Parsons instructed medical staff to contact her or the clinic owner before they “think about giving restrictions or making it recordable” for Amazon patients.

When they did contact the directors to recommend restrictions, the providers said they were usually told to not make them recordable.

“That was made very clear – that there was pressure from Amazon and it seemed like it was very explicit that you should try to avoid recordables at all costs,” said an Advanced provider who left last year. “When I felt like our policies were impacting my ability to make proper medical decisions, that made me very uncomfortable.”

Parsons did not respond to requests for comment. Tony Euser, who owns Advanced Urgent Care, said in an interview that his clinic tries to balance the needs of employers and patients and looks for “common-sense alternatives” to treatment that would make an injury recordable. Many employers seek to limit recordable injuries and lean on workers’ compensation doctors to help them out, he said.

“I wouldn’t put Amazon at the far end of it,” he said, “but I wouldn’t put them on the soft end of it, either.”

Early on in the contract, he said, Amazon representatives would call his clinic out of concern about how certain cases were handled. “Now they don’t call us as much,” he said, “whether they trust us more or whether they just determined that we are trying to do the best we can.”

Euser denied personally pressuring his providers to avoid giving Amazon workers treatment that would make their injuries recordable. He also said he had decided to stop providing occupational medical care for companies, including Amazon, at the end of this year. He said it was too much to balance the needs of employers and their employees.

“It’s not worth it,” Euser said. “We’ve made the decision that we don’t want to be dealing with this anymore. And we don’t want to have to play these games. And I say games, and not – they’re not games. But it’s this back-and-forth, constant thing.”

In Amazon’s statement to Reveal, Lighty reiterated the company’s talking point that while workplace injuries are underreported in general, Amazon is different.

“At Amazon, we are focused on improving the safety of our workplace and seek to accurately report across all sites and all incident types, which means recording all injuries or illnesses that meet or likely meet the OSHA criteria for recordkeeping, and ensuring that we learn from these incidents and improve each day,” she said.

Amazon did not respond to questions about why it changed medical clinics for the Thornton warehouse and how medical professionals say they were pressured to keep injuries off the books.

Jeff Bezos’ 14 leadership principles are famous inside and outside Amazon for vividly articulating what is expected of the company’s leaders. The first is customer obsession. “Leaders start with the customer and work backwards,” it reads.

Tim Bray, a former Amazon executive, told me that principle is so baked into the company’s culture that it can be blinding. “It’s so absorbing, it’s hard to see outside it. It’s possible that a lot of the leaders are simply so absorbed with obsessing about customers that they just haven’t found the bandwidth to pay attention to some of the side effects.”

Bray also cited another line from the principles that might help explain Amazon: “We accept that we may be misunderstood for long periods of time.”

“If you’re in one of those leadership roles, you’re used to being right,” Bray said. “Unfortunately, this can lead to an almost impossible level of arrogance.”

In early May, Bray resigned as vice president of Amazon Web Services. As U.S. customers drove up sales while they sheltered in place, hundreds of Amazon warehouse workers got sick from COVID-19 and several died. Amazon ultimately invested $800 million on COVID-19 safety measures in the first half of the year. But workers said the company was slow to protect them and offered inadequate sick leave, leaving workers who may have been exposed to the coronavirus with the choice of going to work or not getting paid. They signed petitions calling on Amazon to shut down worksites for deep cleaning and, in a few cases, walked off the job in protest.

Amazon responded by firing a worker who helped organize a walkout at its Staten Island, New York, fulfillment center. It then fired two employees from the tech side who spoke up in support. That was the last straw for Bray, whose resignation post went viral.

Still, the company was – is – growing relentlessly. Its stock is up by more than 50% this year. The growth of Bezos’ personal wealth has exploded by about $60 billion so far in 2020.

At Amazon’s annual shareholders meeting in May, Bezos was confronted with an uncomfortable question: “As Amazon gets bigger, it’s getting a lot more scrutiny. Do you think that scrutiny could hurt your reputation with customers?”

He paused, then gave his answer: “No.”