In Collins Building Services Inc, (WCB# G1025058, April 13, 2018), the Board reiterated its prior holdings that a finding of a permanent total disability must be made on the medical evidence alone, and while the claimant had significant problems, he is physically capable of sitting and standing, although for limited periods of time, and can drive for limited periods of time as part of work duties. Turning to the claimant’s LWEC, the 66 year old man was born in Ecuador, where he didn’t finish high school, had limited English proficiency, and didn’t know how to use a computer, all on top of his urinary incontinence.