요양급여불승인처분취소
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 1, 2012, the Plaintiff joined the Non-Party Corporation, Inc., Ltd. (hereinafter “Non-Party Company”) and served as the head of the management office of B apartment from August 1, 2012 to B (hereinafter “the apartment of this case”).
B. On December 17, 2012, the Plaintiff was diagnosed as “cerebral Color (hereinafter “instant injury”) at the Yong-Nam University Hospital on the 18th of the same month.”
C. On January 25, 2013, the Plaintiff filed an application for medical care benefits for the instant injury and disease with the Defendant, but the Defendant rendered a disposition not to grant medical care on April 10, 2013 on the ground that there is no proximate causal relation with the instant injury and disease with the duty.
(1) 【No dispute over the grounds for recognition, Party A’s entries in Gap’s Evidence Nos. 1, 2, 3, and 14, and the purport of the whole pleadings
2. Whether the instant disposition is lawful
A. The Plaintiff’s assertion was serving as the head of B apartment management office, and was under stress due to paralysis with ordinary residents, Dong representatives, and various civil petitions. From August 2012, “B night” event preparation, typhoon restoration work, and crisst installation work, etc., led to a chronic skin, such as snow removal work, senior citizens’ association, etc., even before the occurrence of the instant injury and disease.
Since the injury or disease of this case was caused by the Plaintiff’s occupational negligence and stress, the prior disposition of this case on a different premise is unlawful.
B. In order to be recognized as an occupational accident under the Industrial Accident Compensation Insurance Act, there should be a proximate causal relation between the work and the accident as well as the occupational performance in order to be recognized as an occupational accident under the Industrial Accident Compensation Insurance Act. In this case, the causal relation between the work and the accident of the worker should be proved by the assertion, and the causal relation must be medical and natural science.