When Diane* was diagnosed with severe carpal tunnel syndrome, her doctor was clear about what caused the condition – her work at the poultry processing plant.
It was news her employer didn’t want her to hear. In fact, Diane knew she could be fired if her employer learned she had sought treatment from her own doctor instead of the company doctor or nurse.
Her boss had made it clear how she should deal with her pain.
“My supervisor let me know that if my hands hurt and I go see the nurse, I should tell her that the pain comes from something that happened at home,” the 38-year-old African-American woman said. “I shouldn’t say it’s work-related. If I say my pain comes from something I did at work, then I will be laid off without pay and three days later get fired. So, when I go to the nurse I tell her that I hurt my hands at home.”
But Diane knew the treatment recommended by the nurse – taking a Tylenol and soaking her hands in water – wouldn’t be enough to address a serious injury.
So, she secretly saw a doctor and was diagnosed with carpal tunnel syndrome.
Diane’s story is not unique. Company policies requiring workers to see plant nurses first, even threatening discipline if workers initially seek outside treatment, are prevalent throughout the industry.
Company doctors and nurses often deter workers from seeking their own treatment or workers’ compensation.
Yet, if these workers see the company nurse too often, they’re fired. Workers in this survey told of at least two plants with unwritten but rigid practices that result in the termination of any worker believed to have sought medical attention from the plant nurse too often.
Given these working conditions, it’s not surprising that 66 percent of survey respondents believe their co-workers were scared or reluctant to report injuries. Seventy-eight percent of those respondents attributed it to fear of being fired.
Plant employees are often worked until they can bear no more and then tossed aside. Because workers know they are essentially disposable, it is difficult – if not impossible – for them to take a stand to improve their safety.
Roberta,* a young Latina in South Alabama, went to her plant nurse’s office three times to seek relief from the aches in her hands and wrists. After the third visit, she was told that she had gone to the nurse too many times. She was fired.
Kendrick, a young African-American man, developed carpal tunnel syndrome as he worked the deboning line at a plant. When he asked the nurse for a lighter work assignment, she let him know there were consequences for such a request.
“Do you want your job?” she asked him.
Samantha,* a 24-year-old African-American woman, was fired because she supposedly visited the plant nurse one too many times about the pain and swelling in her wrists.
“They shouldn’t have a nurse’s office at all if they don’t want you to go to it,” she said.
Three years after being fired, Samantha’s hands still swell and become so numb that she cannot move them.
In total, this survey found that about 40 percent of injuries went unreported to the company. About one-fourth (24 percent) of all injuries discussed in the interviews went unreported because of the worker’s fear of being fired or disciplined for reporting the injury, missing work to heal, or seeking medical treatment.
This fear is well-founded. Almost one-tenth (9 percent) of workers who reported an injury were fired or otherwise disciplined for being injured, missing work or seeing a doctor.
Many workers who did report their injuries noted serious problems with access to medical care and recovery time. Of the workers who reported any injury to the company:
• 33 percent described the medical treatment received from company nurses as inadequate (only 22 percent of reported injuries were met with adequate in-plant medical treatment);
• 45 percent were sent right back to their same job without access to treatment or time to recover when they tried to get medical care from the company;
• 14 percent were given time off from work to heal;
• 82 percent noted they were never sent to a doctor; and
• 50 percent of the time workers saw a doctor, they said that the decision of when they returned to work was made by the poultry corporation rather than the treating doctor or injured worker.
When workers manage to visit the plant nurse, they often described the nurse providing temporary remedies such as a Band-Aid, a warm-water hand wash, or instructions to buy pain medication from a vending machine in the employee break room. Workers are then, routinely, sent back to their assignment without rest or relief. The nurses, enforcing company policies, discourage workers from seeking their own treatment.
One survey participant recalled a nurse who quit working at a poultry plant because of the company’s disregard for worker health. According to the worker, she said, “These people are going to make me lose my license because of the way they make me treat people.”
Juan,* a Latino father of three living in Alabama since 1999, worked for six years in a poultry plant. He worked primarily in stacking jobs that required him to lift, carry and stack two 80-pound boxes of chicken a minute. While lifting a box of chicken, he became dizzy, slipped, and fell to the floor. He was told to go right back to working despite being in great pain.
Juan’s back pain worsened and the swelling became constant. He was unable to sleep. When he was finally able to get X-rays, they revealed that he had two lumbar vertebrae fractures from the fall. He was eventually fired. Juan has yet to recover. His employer never paid for any medical treatments. Another worker, Fernanda,* described losing her breath from the pace of the line where she deboned chicken carcasses. She told her supervisors that she felt that she was going to faint. They would not allow her to take a break or slow the line. She fainted. Co-workers caught Fernanda before she hit the floor. She was unconscious for several minutes. After she was revived, Fernanda was given less than 30 minutes to rest before being ordered back to the line.
Even if a company doesn’t create obstacles for workers seeking outside treatment, a lack of insurance can prevent them from receiving medical care. More than one-third (38 percent) of workers participating in the survey didn’t have health insurance. Only 16 percent had health insurance fully paid by their employer.
Wilfrido, who has worked in the poultry industry for a dozen years, said that in the plants where he has worked, if a worker has a doctor’s excuse assigning light duty, the company just sends the worker home without pay or even fires the worker.
Many doctors practicing near the plant appear to be aware of this situation. Some actually tell workers that they would like to give them a note recommending light duty, but that they think they should not do so because it could lead to the worker’s firing.
Most poultry workers eventually give up on reporting injuries and seeking treatment from company nurses. They give up after witnessing workers lose their jobs. And they give up after receiving treatments from company nurses that leave them wondering why they should even bother. These workers often realize they only have one option – working through the pain.
Points system costs workers their health, jobs
Even without these obstacles, a worker seeking outside medical treatment must take time off from work to do so. This can be another hurdle, partly because of a points system that penalizes them for such absences.
Virtually all Alabama poultry plants rely on this system to enforce attendance policies.16 The system varies slightly among companies, but the general premise is that for each absence – even late arrivals or early departures – the employee receives a point or a half point. The reason for the absence or tardiness usually doesn’t matter.17
When an employee reaches a certain number of points, that person is fired. Depending on the company’s policy, it can take as few as six points for an employee to be fired. At some plants, it can take a year for the employee to work off a single point.
Even workers who have a doctor’s appointment or a chronic illness can get a point for taking time off to seek treatment. In an industry notorious for its high rate of long-lasting injuries, this type of policy can force employees to choose between their health and their employment. It also means injured or ill workers will almost certainly be fired – enabling the company to quickly dispose of workers who have endured harsh working conditions as they’ve helped the company turn a profit.
This points system cost LaTonya, a young African-American woman, her job at a poultry plant in North Alabama where she cut chicken legs and thighs. She has asthma, which occasionally flared up and forced her to leave work. Sometimes her supervisors or the plant nurse ordered her to leave work to recuperate, an uncommon occurrence in an industry where injured and ill workers are often coerced into working even when ill or injured.
But even on the days LaTonya was told to leave the plant, she received a point under the points system. Her employer even denied her request to work in areas that did not aggravate her condition. Instead, she was forced to work in rooms that both she and her supervisors knew made it difficult for her to remain at work.
LaTonya received her final point when she needed emergency medical care.
On that day, her supervisors attempted to force her to stay at work. When she insisted that she needed medical treatment a plant nurse couldn’t provide, her supervisor told her that if she left, she would “point out.”
In other words, she would be fired.
LaTonya feared for her health. She made the difficult decision to go to the hospital, even though it meant losing her job.
EEOC case offers hope
A recent lawsuit brought by the Equal Employment Opportunity Commission (EEOC) highlights a legal problem with points systems. In EEOC v. Verizon Wireless,18 the EEOC alleged that no-fault attendance policies – such as the points system frequently used by poultry plants – violate the Americans with Disabilities Act.19
The EEOC argued that Verizon Wireless was required to provide reasonable accommodations to disabled employees that would allow them to continue working. Such reasonable accommodations include not receiving points for absences caused by their disability and its symptoms.
The EEOC’s argument in this case, which was settled out of court, recognizes that points systems discriminate against workers with disabilities.20 These workers could continue working if the company permitted them to take the time to seek medical treatment and recover as needed. Refusing to do so while forcing employees to engage in such demanding and dangerous jobs is unjust and illegal.
Until the poultry industry ends these policies, its workers will continue to discover what workers before them have learned about the industry.
“It’s a house of pain in there,” Kendrick said.
* Not his/her real name
 Among workers asked about attendance policies, 97 percent reported the existence of some type of points system in their plant.
 Eighty-one percent of interview participants asked about attendance policies reported that their plants assess points for any absence, even absences for personal medical or family health reasons.
 EEOC v. Verizon Wireless, CV-018320-SKG (N.D. Md. filed July 5, 2011).
 Americans with Disabilities Act, as amended, 42 U.S.C. § 12101 et seq. (2011).
 This case recently settled for $20 million. See Press Release, EEOC, Verizon to Pay $20 Million to Settle Nationwide EEOC Disability Suit (July 6, 2011).