Amazon, one of the world’s largest employers, has for years faced scrutiny over its safety record. When Billy Foister, a 48-year-old worker, died after a heart attack inside one of the tech giant’s warehouses in September 2019, managers were accused of telling staff to “get back to work”.

When another worker died this month at a distribution center in Troutdale, Oregon, an Amazon spokesperson claimed they had collapsed from an “existing medical issue”. They denied a report that a nearby employee was told: “Please get back to work.”

As Donald Trump’s administration continues to overhaul federal government oversight of workplace safety, workers inside Amazon and labor advocates say the company’s injury rates, and how it treats injured workers, remain a problem.

While the company insists that “nothing is more important” than its employees’ safety, it continues to face questions about how it handles, and reports, workplace injuries.

A training PowerPoint document obtained by the Guardian on “best practices” inside its AmCare in-house first aid unit, included slides on how to “maximize AMCARE Utilization”, which it defined as the percentage of employees who pass through without the need to see a workers’ compensation doctor.

The presentation covers how to “prevent day 1 send outs”, where workers bypass the service and go to a doctor first. AmCare “CAN NOT send any one home or excuse time”, it said. If a worker is injured, it said, “do not recommend they take time to rest it away”, adding: “report to amcare and receive treatment early.”

Amazon disputed the document, dated August 2022. “We have over a million employees who sometimes create documents that are never used,” Sam Stephenson, a company spokesperson, said. “This document is several years old, doesn’t reflect the priorities or policies of our Global Medical Health team, and was never approved for use.”

Juan Loera-Gomez, 46, was working at LGB5, an Amazon sortation center in San Bernardino, California, in October 2024, when he was assigned to work alone in an area he typically did not work in, according to a lawsuit filed in March. The area normally had at least three workers, per the filing.

After several hours unjamming, pushing and pulling boxes that each weighed more than 50 pounds, Loera-Gomez claims that he sustained a “life-altering workplace injury to his back and shoulders”.

He reported his injury to his manager, according to the lawsuit, only to be told to keep working. In November 2024, he was seen at a medical center and given work restrictions, and Amazon placed him on light duty. Over the next six months, Loera-Gomez was diagnosed with several strains, sprains and a lumbosacral disc disease while receiving care.

‘Fired by a single email’

As he recovered, Loera-Gomez participated in organizing efforts with other workers, calling on Amazon to make improvements to safety and working conditions in the warehouse and urging the company not to take alleged disciplinary action for “time off task” spent using the bathroom.

Loera-Gomez alleges that something strange happened in May 2025. He was told by a safety manager he would need to find a new place to work, according to the lawsuit, because the company could no longer accommodate his work restrictions. He started receiving notifications that he had exceeded 180 days of working under accommodations. The following month, Loera-Gomez was told he could no longer come to work, the lawsuit said.

Amazon placed Loera Gomez on unpaid leave. He protested, until his employment was terminated in January, according to the lawsuit.

“They accommodated my work restrictions after my injury at first, but then suddenly forced me out on unpaid leave, even though I was still able to work. I was later fired by a single email,” said Loera-Gomez in a statement. “What Amazon did was very hard on my family. We depended on my job to pay for our house, food and monthly expenses for my children.”

Stephenson, the Amazon spokesperson, said “many of these claims appear to be false or misrepresent Amazon policies”, and expressed confidence that this “will be proven through the legal process”.

A colleague of Loera-Gomez at LGB5, who remains employed by Amazon and requested to remain anonymous for fear of retaliation, said that if workers are hurt on the job, they are sent to AmCare – which they compared to the equivalent of a school nurse.

“They only give you an ice pack or water,” the worker said. “You can’t get adequate help at AmCare. My experience at AmCare, they’ll try to keep you there for the longest time because they want you to go back to work, they will do everything in their power to not let you go home.”

AmCare won’t log reports, they claimed, until it’s completely apparent a worker cannot return to work. “Amazon really, really likes it when their injury rate looks low, so they will do their best and not have injuries logged,” the worker said.

Amazon denied the worker’s allegations. “This is false,” Stephenson said. “Ensuring our employees have access to onsite first-aid and to their care of choice is incredibly important to us because the safety of our team and our partners is our top priority.”

“This isn’t an isolated incident,” said Lauren Teukolsky, the attorney representing Loera-Gomez. “It looks to me there’s a pretty clear pattern of this occurring in Amazon warehouses.”

The lawsuit is one of several recent cases related to Amazon’s injury rates.

Lashone Brown, who lives in Las Vegas, Nevada, filed a lawsuit in February alleging that he was fired while recuperating at home from surgery for two work-related hernias he suffered at Amazon. The firm has also disputed this lawsuit, and its allegations.

In California, a trial began in January 2026 over a lawsuit filed by several former Amazon workers over heat conditions across its warehouses. Amazon did not comment on the specific allegations, but Stephenson said: “The health and safety of our employees and partners is our highest priority, and our heat prevention and mitigation policies and practices exceed state and federal guidance.”

Earth’s safest place to work?

For years, elected officials, state and federal government agencies, workers and labor groups have looked closely at Amazon’s injury rates, and how injured workers are treated. The company has repeatedly denied and dismissed criticism.

It claimed in 2016 that improved record keeping resulted in injury rate increases. It claimed in 2018 that injury rates were high because the company was aggressive about recording injuries, and conservative in allowing injured workers to return to work.

In 2019, Amazon’s serious injury rate reported to the Occupational Safety and Health Administration (Osha) hit 7.7 per 100 employees, nearly double the industry average – and the company now uses that year as a benchmark to tout their safety progress, and declining rates. Amazon said in an email that it does this “because 2019 – unlike 2020 – was a year of normal operations”.

Amazon’s injury rates declined in 2020, before increasing again in 2021, then decreasing in subsequent years. They remain above warehouse industry averages.

In 2021, the company’s founder, Jeff Bezos, pledged in a letter to shareholders to become Earth’s safest place to work. The company set a goal to cut its injury rates in half in 2025.

Even by Amazon’s own numbers, it seems to have fallen short. In 2021, the company reported a US recordable incident rate (RIR) of 7.6 per 100 employees. In 2025, it reported a rate of 5.

In 2024, Amazon employed 39% of US warehouse workers but accounted for 56% of all serious injuries in the industry, according to the Strategic Organizing Center.

Amazon has disputed the reports by such groups, and questioned their methodology, while these reports have in turn criticized Amazon’s own reports and methodology.

When a December 2024 Senate report found that Amazon “manipulates its workplace injury data to portray its warehouses as safer than they actually are”, Amazon disputed the report and its methodology.

Stephenson, the Amazon spokesperson, said: “The reality is that nothing’s more important than the safety of our employees, we’ve invested more than $2.5bn in safety programs over the past six years, and we’ve seen the results: including a 43% reduction in our global recordable incident rate since 2019, which includes any work-related injury that requires more than basic first-aid.”

Workplace safety under Trump

Osha, as the federal government agency on workplace safety, launched its first multisite investigation in more than a decade amid concern over the conditions inside Amazon’s warehouse.

But in December 2024, in the final weeks of the Biden administration following Trump’s election victory, Osha and Amazon reached a settlement to resolve multiple hazardous working conditions cases. It covered Amazon sites nationwide and included ongoing meetings and assessments of the company’s progress.

Among the factors that prompted the agency to reach a settlement was Bezos’s decision to block the Washington Post, his newspaper, from endorsing Kamala Harris for the presidency, a former Osha official in the Biden administration said. Times were changing. “It was a consideration,” they said.

The settlement was announced as part of a drive “to help better protect employees from hazardous working conditions leading to serious lower back and other musculoskeletal disorders”. Amazon’s acknowledgment of this problem had varied over time, and the company had been very sensitive to the issue, the former Osha official said. “The settlement acknowledges a much longer-term process of fixing things that is not going to happen overnight.”

A spokesperson for the Department of Labor said Osha and Amazon had held “biannual meetings” to discuss the settlement “and additional topics such as the status of pilot projects and controls intended to address ergonomic risks”, but did not provide further information on Amazon’s progress.

The settlement did not affect an investigation by the southern district of New York at the US Department of Justice that began under the Biden administration. The justice department did not respond to multiple requests to confirm whether the investigation continues under Trump. The recently fired US attorney general, Pam Bondi, was registered as a lobbyist for Amazon in 2020 and 2021.

Osha conducted 20% fewer inspections from April to September 2025, compared with the same period in 2024. Workplace health and safety penalties have dropped 45% under the Trump administration.

Amazon donated $1m to Trump’s inaugural fund before Trump’s return to office, compared with $58,000 it gave to Trump’s inauguration in 2017, and $276,509 it gave to Biden’s inaugural fund in 2021. It also faced questions over its acquisition of a documentary on Melania Trump, the first lady. “We’ve been a company across five administrations and we always try to have a collaborative relationship with each administration and policymakers of all levels of government,” said Stephenson, the Amazon spokesperson.