EE WAS REMOVING RETAINING BOLTS & UPPER RAIL PADFROM UNDERSIDE OF THE HOUSE (REVOLVING FRAME) OFA 295B SHOVEL. HE STATED THE WRENCH SLIPPED OFF THE BOLT. HE FELL 41"" OFF THE FIRST RUNG OF A 6' STEP LADDER HE WAS USING & LANDED ON THE GROUND.HE STRUCK HIS HEAD AGAINST THE MATT BOARDS BEINGUSED AS A PLATFORM TO HOLD UP THE BOOM FOOT AREAHE WAS TAKEN TO E.R. & RECEIVED SUTURES TO HEAD