요양불승인처분취소
1. The plaintiff's claim is dismissed.
2. The costs of lawsuit shall be borne by the Plaintiff.
1. Details of the disposition;
A. On February 5, 2016, the Plaintiff filed an application for medical care benefits with the Defendant on February 1, 2018, alleging that the Plaintiff was infected with the “defeat (hereinafter “instant injury and disease”)” from the Dong Fee C, a worker of the Dong Fee, for the medical care benefits of the Defendant on November 1, 2018.
B. On July 20, 2018, the Defendant issued a disposition of non-approval for medical care (hereinafter “instant disposition”) to the Plaintiff on the ground that “In light of the statement made by C, etc. that there was no fact of waste collection at the time, it is difficult to recognize a proximate causal relation with the duties of the instant superior branch because the route of infection of the instant superior group is not clear, and the possibility of infection was significantly low in the course of performing duties in consideration of diving, etc.” on the basis of the review by the Seoul Occupational Disease Determination Committee.
C. The Plaintiff dissatisfied with the request for reexamination to the Industrial Accident Compensation Insurance Reexamination Committee, but the said Committee dismissed the request for reexamination on November 9, 2018.
[Ground of recognition] Facts without dispute, Gap evidence 1, Eul evidence 1, Eul evidence 1, 2, and 5, the purport of the whole pleadings
2. Whether the instant disposition is lawful
A. The plaintiff's assertion was infected with the injury and disease of this case from C who had worked together while cleaning the apartment. Although the disease of this case occurred due to the plaintiff's work, the defendant's disposition of this case on a different premise should be revoked as unlawful.
B. According to the Industrial Accident Compensation Insurance Act, the term "occupational accident" refers to the injury, disease, physical disability, or death caused by a worker's occupational failure during the performance of his/her duties. As such, there should be proximate causal relation between his/her duties and the disaster, and such causal relation does not necessarily have to be proved by medical or natural science, and all the circumstances, such as indirect facts.