William John Hesbrook, known as John, died at the Royal Shrewsbury Hospital on December 20 last year from severe heart problems, with multiple injuries sustained in the November 3 fall ruled to be a contributory factor.
An inquest at Wellington yesterday heard the 72-year-old father-of-two, from Newport, had seemed to be on the mend.
It is believed Mr Hesbrook, who lived alone in Meadow View Road, had been cleaning the outside of his upstairs bedroom window and had fallen from the ladder.
But the inquest heard that no one witnessed the accident, so the reason for the fall was not known.
Mr John Ellery, coroner for Shropshire and Telford & Wrekin, concluded that Mr Hesbrook had died of natural causes "contributed to by an accident".
In a statement read out in court, neighbour Marilyn Lower, who was the first person to find Mr Hesbrook lying on the ground, described her shock.
She said: "At 4.30pm (on November 3) I went out into the back garden and I heard a strange noise, it sounded like heavy breathing. I wanted to find out what it was so I went to look into John's garden.
"I then saw John on the ground, he was on his back with his head towards our fence and his legs towards his house. His feet looked elevated slightly on a ledge or a plant pot.
"There was a ladder on the back wall under his bedroom window and I presumed he had fallen off the ladder.
"I shouted 'John'. As I went back into our house to get John's house key, my husband got home as I was running out of our front door.
"I know that John had hit his head because there was a small bit of blood on the ground."
She said the couple called an ambulance and paramedics took him to the Royal Stoke University Hospital. He was awake but not talking.
She added: "We visited John every Friday at Stoke. Each time we visited he did not speak but I think he knew we were there.
"On December 19, we heard he was moved to the Royal Shrewsbury Hospital. We went to visit him and I could not get over the change in John, he was chatting and I was so pleased to see him on the mend. I was deeply saddened when I heard of his death. I was shocked and will miss him dearly."
She added: "He was a lovely neighbour and we had been really good friends. He had a good social life and a large network of friends."