진폐보험급여부지급처분취소
1. The plaintiff's claim is dismissed.
2. The costs of lawsuit shall be borne by the Plaintiff.
1. Details of the disposition;
A. The Plaintiff, who was engaged in dusty work at the Korea Coal Corporation, applied for medical care for pneumoconiosis to the Defendant.
B. From February 3, 2015 to February 5, 2015, the Defendant issued a disposition to pay pneumoconiosis insurance benefits installment (hereinafter “instant disposition”) to the Plaintiff on April 14, 2015 on the ground that the Plaintiff’s pneumoconiosis type falls under normal conditions (0/0) and cardiopulmonary function (F0), following the review by the Pneumoconiosis Review Board.
[Ground of recognition] Facts without dispute, entry of Gap evidence 1, purport of whole pleadings
2. Whether the disposition is lawful;
A. The Plaintiff’s pneumoconiosis type of the Plaintiff’s assertion falls under Type 1 (1/1), and thus, the instant disposition based on a different premise is unlawful.
B. According to Article 83-2(1) [Attachment 11-2] of the Enforcement Decree of the Industrial Accident Compensation Insurance Act, in order to be eligible for pneumoconiosis insurance benefits, the pneumoconiosis type should be more than Type 1; whether the pneumoconiosis type has been affected by pneumoconiosis and the progress of pneumoconiosis is determined by reading chest simple radiation; and the classification of pneumoconiosis type should be in accordance with the complete classification as prescribed by the International Classification of Pneumoconiosis (ILO) of the International Labor Organization (ILO).
In this case, it is not sufficient to recognize that the Plaintiff’s pneumoconiosis disease type constituted Type 1 solely with the statement of health room and evidence No. 2, and rather, in light of the result of the request for wiretapping of medical records to the head of the Seoul Hospital of the relevant court, it is reasonable to deem that the Plaintiff’s pneumoconiosis type constitutes a medical evidence
Therefore, the defendant's disposition of this case, which was made on the same premise, is legitimate.
3. Conclusion, the plaintiff's claim is dismissed as it is without merit.