On Nov. 25, 2016, applicant Ricardo Lezama, 32, a roofer for Apex Fumigation Inc., was working on a home’s roof when he fell off and landed on a concrete surface. He claimed to his head, pelvis, back and hands. Lezama filed a workers’ compensation claim against Apex Fumigation Inc., which was insured by State Compensation Insurance Fund. He brought a claim in an attempt to collect workers’ compensation benefits., Lezama sustained a fracture of the skull vault, an open subarachnoid hemorrhage, a subdural/extradural bleed, a traumatic intracranial subdural hematoma, a closed cerebral contusion, and pulmonary contusions resulting in acute hypoxemic respiratory failure. He claimed he lost consciousness after the fall, and he was emergently transported to the nearest hospital, where a percutaneous endoscopic gastrostomy tube (a flexible feeding tube) was placed. While receiving emergency care, Lezama regained consciousness. However, he suffered from pulmonary issues and contracted a urinary tract infection, which both had to be treated at the hospital. As a result, Lezama remained hospitalized in the intensive-care unit for 28 days. Following his hospital stay, Lezama was admitted to a rehabilitation institute for further care before being discharged home in January 2017. Lezama was later admitted to a neuro-rehabilitation facility, where he receives neuro-rehabilitation treatment, as needed, and comprehensive interdisciplinary treatment, which includes occupational therapy, speech therapy, physical therapy and neuropsychological counseling. Upon his admission, Lezama was diagnosed with a traumatic brain injury, post-concussive syndrome, left-sided hemiparesis, post-traumatic vision syndrome, vestibular dysfunction with decreased balance, a history of a neurogenic bladder and urethral strictures. Lezama claimed that he continues to struggle with ongoing symptomology consistent with his traumatic brain injury, including suffering somnolence. He claimed that his condition causes him to struggle with activities of daily living. Lezama’s counsel asserted that, based on the medical findings, Lezama should be considered 100 percent totally and permanently disabled. Counsel also asserted that as a result, Lezama requires long-term neuro-rehabilitation care with 24-hour supervision for the foreseeable future. The respondent’s counsel disputed the nature and extent of Lezama’s residual , and asserted that Lezama does not require long-term care with 24-hour supervision for the foreseeable future.