While employee was climbing down a fixed ladder his foot slipped off the rung and he caught himself with one hand, causing pain in his left shoulder. He did not want to go to the doctor until 10/10/05 at which time the doctor put him on modified duty. EMPLOYEE STARTED LOSING TIME ON 2/21/06. MRI SHOWED TORN ROTATOR CUFF - SURGICALLY REPAIRED ON 2/21/06.