On March 28, 2016, applicant Luis Castro, 41, a roofer for JG Roofing, was in the course and scope of his employment when he fell off a roof and landed on the concrete at a worksite in Bakersfield. He sustained to his head, back, shoulder, and lower extremities. Castro filed a workers’ compensation claim against his employer, JG Roofing, and the workers’ compensation insurance carrier, State Compensation Insurance Fund. Castro sought to collect workers’ compensation benefits., Castro sustained a traumatic brain injury and other serious polytrauma. Specifically, X-rays of the thoracic and lumbar spine showed compression fractures of the T11, T12 and L1 vertebrae. He also sustained a phalanges fracture of a toe on his right foot, and a rotator cuff tear. Although paramedics were summoned to the scene and Castro was examined, he was not taken to a hospital. However, after arriving at home, he became confused and disoriented. As a result, his family took him to Bakersfield Memorial Hospital, in Bakersfield, where Castro underwent a CT scan, which revealed a post-traumatic hemorrhagic contusion of the right frontal lobe. Castro was subsequently admitted to the Intensive Care Unit. He then underwent medication management for his back and legs, as no surgery was warranted. However, he ultimately underwent rotator cuff repair surgery to treat the right shoulder. Castro claimed that he suffered a traumatic brain injury, which resulted in behavioral issues, cognitive deficits, depression, anxiety, and vestibular dysfunction. His counsel argued, and the plaintiff’s medical experts opined, that Castro would require lifelong care in a structured living environment, or 24-hour in-home care and medical care by multiple specialists. Castro also claimed that he suffers from visual issues, including photosensitivity and visual spatial dysfunction, which causes difficulty in organizing visual information into meaningful patterns and understanding how they might change as they rotate and move through space, secondary to the traumatic brain injury. In addition, Castro claimed that his brain injury caused him to suffer from obstructive sleep apnea, which his counsel noted is highly prevalent in those who have sustained traumatic brain . Upon retaining counsel, and with the help of medical experts in neuropsychology and physiatry, Castro was admitted into a long-term inpatient program at Casa Colina Hospital and Centers for Rehabilitation, in Pomona. Initially, State Compensation Insurance Fund disputed the nature and extent of Castro’s , and contended that Castro was not 100 percent permanently and totally disabled. It also disputed whether Castro would require long-term inpatient care at a neurorehabilitation facility.