최초요양불승인처분취소
1. On April 18, 2017, the Defendant’s revocation of the first approval of medical care granted to the Plaintiff.
The complaint is written.
1. Details of the disposition;
A. On July 12, 2016, the Plaintiff, as an employee of Nonparty KSA Co., Ltd. (hereinafter “Nonindicted Company”), was diagnosed by the Madern Hospital affiliated with the Escopian University (hereinafter “Escopic Hospital”), after being sent to the emergency room of the Escopic Hospital affiliated with the Escopic University (hereinafter “Escopic Hospital”), with an 119 ambulances due to symptoms difficult to breathea while performing the duties of promoting and selling frozen food at the Escopa (hereinafter “Escopic disease”).
B. On September 22, 2016, the Plaintiff filed an initial medical care benefit application with the Defendant, but the Defendant, on April 18, 2017, issued a non-approval of the Plaintiff’s initial medical care benefit application (hereinafter “instant disposition”) on the ground that “The instant injury and disease is verified, but this is determined as a natural transitional outbreak by an individual person, and there is no proximate causal relation between the work and the instant injury and disease.”
C. The Plaintiff filed a request for examination against the Plaintiff, but the request for examination was dismissed on September 27, 2017.
[Reasons for Recognition] Facts without dispute, Gap evidence 1, 4, Gap evidence 2-1, the purport of the whole pleadings
2. Whether the instant disposition is lawful
A. The summary of the Plaintiff’s assertion was due to the characteristics of the Plaintiff’s duty to serve in a long hours, and the instant injury and disease generated from blood transfusion on the Plaintiff’s bridge, and the instant injury and disease occurred from preventing the Plaintiff’s waste and so, proximate causal relation is acknowledged between the Plaintiff’s duty and the instant injury and disease.
Therefore, the defendant's disposition of this case which rejected the plaintiff's initial medical care benefit application on different premise is unlawful.
B. Facts of recognition 1) The Plaintiff’s labor relationship and the date on which the Plaintiff’s job was hired by Nonparty Company: The average working hours and rest hours on September 1, 201: Work hours (13:00~22:00), rest hours (15:0 to 16:00 work days: Free food sales and promotion.