재요양 및 추가상병불승인처분취소
1. On January 23, 2019, the Defendant’s disposition of additional medical care and non-approval of additional injury or disease rendered to the Plaintiff is revoked.
2...
1. Details of the disposition;
A. On July 31, 2017, while working as an employee of the Incorporated Foundation C, the Plaintiff (B) suffered from an accident causing serious pains in the process of transporting camping spons to the stairs under the subway station (hereinafter “instant accident”) and filed an application for medical care benefits to the Defendant, subject to the diagnosis of the Mari-ri, the “Mari-si (No. 4-5),” which was the first application for medical care benefits.
Accordingly, on January 18, 2018, the Defendant rendered a decision not to grant the first application to the Plaintiff according to the medical opinion that “The first application for medical care is deemed to have occurred as a part of natural progress, and there is no objective opinion to determine that the first application for medical care has occurred due to the instant accident, and it is reasonable to change it to the 'Meatum Madum' (hereinafter referred to as the "Meat Madum Madum').” The Defendant changed the first application for medical care to the existing approval disease.
B. On February 23, 2018, the Plaintiff provided medical care to an injury or disease with the previous approval, and thereafter, on December 22, 2018, the Defendant filed an additional medical care and additional injury or disease application with the Defendant by providing “the escape certificate of a conical signboard (Article 4-5)” (hereinafter “instant injury or disease”).
C. However, on January 23, 2019, the Defendant rendered a decision on the Plaintiff’s failure to approve the Plaintiff’s additional medical care and additional medical care (hereinafter “instant disposition”) in accordance with the result of the deliberation by the Defendant advisory society, that “The instant injury and disease is similar to the first injury and disease for which the approval was not granted, and the MRI from the RoI to the 4-5 prosecution section is more severe than the other sections, and the circumstance of the instant accident cannot be deemed as the circumstance to presume that the injury and disease occurred, and it is difficult to recognize causation.”
[Reasons for Recognition] Facts without dispute, Gap evidence Nos. 1, 3, and 5 (including each number; hereinafter the same shall apply), the purport of the whole pleadings
2. Whether the instant disposition is lawful
A. The plaintiff.