추가상병불승인처분취소
1. On August 8, 2019, the Defendant’s disposition of non-approval of an additional injury or disease against the Plaintiff is revoked.
2. The costs of the lawsuit are assessed against the defendant.
1. Details of the disposition;
A. On November 6, 2017, the Plaintiff (B) received medical care approval from the Defendant regarding “the escape certificate of protruding signboards No. 3-4-5,” and received medical care until December 31, 2018.
B. The Plaintiff was diagnosed on May 3, 2019, and applied for an additional injury and disease to the Defendant. However, on August 8, 2019, the Defendant applied for additional injury and disease to the Defendant on the ground that “the confirmation of injury and disease is confirmed as image data, but it is difficult to prove the causal relationship with the disaster” against the Plaintiff.
[The facts that there is no dispute over the basis for recognition, the entries in Gap evidence 1 and 2, and the purport of the whole pleadings.]
2. Whether the instant disposition is lawful
A. The major processes of coaling operations conducted by the Plaintiff are mostly kneeeing, kneneeing, kneeing, and kneeing, because most of the processes of coaling operations conducted by the Plaintiff are repeated.
Since such knee-sharing work resulted in the occurrence of the instant wound, or the rapid aggravation of it at a speed above nature and level, there is a proximate causal relation between the Plaintiff’s business and the instant wound, and the disposition taken on a different premise is unlawful.
B. Article 49 of the Industrial Accident Compensation Insurance Act provides that an employee receiving medical care due to an occupational accident may apply for medical care benefits for an additional injury or disease if medical care is necessary due to a new disease caused by the injury or disease caused by the occupational accident. As such, proximate causal relation should be acknowledged between the additional occupational accident and the occupational accident.
With respect to the causal relationship, it is not necessarily required to be proved by the assertion side, or it is not necessarily required to be proved by medical, natural and scientificly, but to be clearly.