Abstract: On March 15, 2007, Employee #1 was assigned to his usual and customary occupation as a Collection System Worker. At the time of his injury Employee #1 was exiting from the passenger side of the cab of a Hydro-Vac sewer cleaning truck. To descend to the ground from the cab of the truck, the driver and the passenger must climb down three metal steps, situated in the form of a ladder, on either side of the cab. The first step is 10-in. below the floor of the cab, the second step is 16-in. below the first step, and ground level is 16-in. below the second step. Each step is 1.5-in. thick. Employee #1 said he and the driver had worked beyond the noon meal period and stopped on the way back to the company yard to buy carryout food. Employee #1 stated when the truck stopped in the yard he (Employee #1) removed his seatbelt and opened the passenger side door with his right hand. Employee #1 said he then moved the bag of food from the dashboard to the seat with his right hand, while extending his right foot out onto the first step. As Employee #1 twisted his body to grab the hand rail at the rear of the cab with his left hand, his right foot slipped off the step and he fell to the ground. The impact of his body striking the ground after a 35-in. fall caused a comminuted fracture of his right elbow and contusions on his face. Employee #1 was hospitalized.