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(영문) 광주고등법원 2017.2.9. 선고 2016누3511 판결

재요양불승인처분취소

Cases

2016Nu3511 Revocation of revocation of approval for non-additional medical care

Plaintiff Appellant

A

Defendant Elives

Korea Labor Welfare Corporation

The first instance judgment

Gwangju District Court Decision 2015Gudan335 Decided April 7, 2016

Conclusion of Pleadings

January 12, 2017

Imposition of Judgment

February 9, 2017

Text

1. The plaintiff's appeal is dismissed.

2. The costs of appeal shall be borne by the Plaintiff.

Purport of claim and appeal

The judgment of the first instance shall be revoked. The defendant's disposition of non-approval for additional medical care rendered on February 12, 2015 shall be revoked.

Reasons

1. Details of the instant disposition

A. At around 14:00 on September 18, 201, the Plaintiff suffered from an accident of 's scarf, scarfe base salt, and scarfe (hereinafter referred to as 'first injury’) due to the scarf, scarfe, scarf, etc. of the non-scarf (hereinafter referred to as 'first accident') while performing the dismantling work at the construction site of the International University International University of B University, Inc., and was treated until June 4, 2012 after the review by the Industrial Accident Compensation Insurance Review Committee.

B. On June 22, 2012, the Plaintiff asserted that he/she suffered from injury or disease in the column No. 2-3, No. 5-cheon 1, and No. 3-7, due to the initial accident, and applied for medical care on July 5, 2012, but was not approved on July 5, 2012. While the Plaintiff filed a lawsuit against the Defendant for the revocation of the disposition for the revocation of the additional injury or disease approval, the Plaintiff was sentenced to the judgment against the Defendant on August 29, 2013, which became final and conclusive at that time due to the Plaintiff’s failure to file an appeal.

C. On January 1, 2015, the Plaintiff alleged that he had suffered from 's border, scopical salt base, 5-6, 1, 2-3, 5-3, 1, and 5-3, 201 (hereinafter referred to as "the injury and disease in this case") due to the first accident, and applied for approval of additional medical care. However, on February 12, 2015, the Defendant issued a disposition to approve non-approval of the Plaintiff's application for additional medical care (hereinafter referred to as "disposition in this case") on the ground that the injury and disease in 1, 2015 was in treatment and the causal relationship between the first accident and the first accident in this case is not recognized.

[Ground of recognition] Facts without dispute, Gap evidence Nos. 4 through 6, Eul evidence No. 3, the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The plaintiff's assertion

On December 21, 2011, the Plaintiff was diagnosed by C Hospital on vertebrate escape certificate, etc., and continuously received treatment for the instant injury and expressed that there was a causal link between the first accident and the injury and disease of this case. As such, there is a proximate causal link between the first accident and the injury and the injury and disease of this case. Furthermore, since from around 1995, the Plaintiff is bound to be a person who was at an inappropriate level to bear the burden on working environment and work characteristics, etc. due to the first accident. Thus, the Plaintiff continued to receive treatment, such as cryplate, which was accompanied by verteum, spath, spathr, brithr, and nephal ppuri, etc., before the first accident. In light of these circumstances, given that the injury and disease of this case has further aggravated the Plaintiff’s existing disease due to the first accident or caused the symptoms thereof, there is a proximate causal causal link between the first accident and the injury and the injury and disease of this case.

B. Determination

1) Circumstances consistent with the Plaintiff’s assertion

According to Gap evidence Nos. 1, 3, 7, 12, 13, 26 through 28, and 30, medical doctors who treated or treated the plaintiff can be acknowledged as having prepared a medical certificate, a written request for medical treatment, etc., with the following contents consistent with the plaintiff's above assertion.

① On December 21, 2011, the C Hospital’s written request for medical examination and treatment written by the C Hospital doctor on December 21, 201, state that “the medical examination of a university hospital is required under the name of the injury or disease with the 'brupt, pleine and spathal inverte, the disc escape from spine part, and the left-hand flag.’

② The diagnosis for the assessment of the work content on December 26, 201 of the FIC G Preparation in the FIG G on December 26, 201, contains the following: the name of the disease: the 'pathic disease accompanied by the nephal ppuri disease certificate', the 'cirical and other conical signboards', the content of the assessment, and the future treatment plan.

③ On December 17, 2014, the C Hospital’s written request for medical examination and treatment, as of December 17, 2014, indicates that the Plaintiff’s request for a close inspection to the university hospital that shows her pains, hye, hye and hye and hye and hye at the time of the Plaintiff’s request for a close inspection was found, and that hye and hye were found. As a result of the C Hospital’s nuclear image examination taken on May 11, 2012, there were minor hye and hye that are found on the left side of the earth, 4, 5 hye and hye in Seoul Asan Hospital’s nuclear image examination and treatment. It appears that there is a causal link with the initial accident. The university hospital requires a close examination and treatment at the university hospital.

④ The written opinion dated January 7, 2015, prepared by the doctor E of B University Hospital according to the request of the director of the regional headquarters of Gwangju District Office to which the Defendant belongs, stated that “the injury and disease of this case in the process of MRI examination requires continuous outpatient treatment and observation of progress.”

⑤ On March 20, 2015, the medical examination document prepared by the doctor E of B University Hospital stated that the name of the injury and disease of this case is the same as the name of the injury and disease of this case, and that the Plaintiff, “the Plaintiff, as a result of the first accident, was treated on December 31, 2014, because it did not show symptoms to the left-hand side and the treatment of the local hospital was conducted on the part of the Republic of Korea. However, the said name was observed and treated on December 31, 2014, but the first accident is not accompanied by symptoms, and there is a causal relation with the outbreak and aggravation of the disease, and thus continuous treatment is required.”

6. The C Hospital’s medical records and diagnosis report of October 10, 2016, stated that it is deemed that there is a causal link with the initial accident, such as chest catum fatum and satum, fatum, and catum escape, etc., taken on May 11, 2012.

7) On October 10, 2016, the medical examination report prepared by the H Hospital physician prepared on the medical examination report prepared by October 10, 2016, stating that the name of the hospital is "the name of the hospital is "the chromatic base, the chromatic base, the chromatic base, and the cromatic disc escape certificate" to be "the patient who was within the hospital after the first accident and considered the results of the examination conducted by the university hospital, it is deemed that the first accident was related to the first accident, and the condition where the symptoms continue to exist notwithstanding the current medical treatment, such as drug treatment

8) On October 19, 2016, the medical examination of B University Hospital E prepared on the medical examination of October 19, 2016, stating that the name of sick was "the disease was continuously treated with the above medical examination of MRI, but the symptoms were not shown, and the accident was caused by the first medical examination of MRI conducted on December 31, 2014, and it is necessary to continuously treat the disease as it was related to the occurrence and aggravation of the disease, and it is necessary to continuously treat the disease as the first medical examination of MRI conducted on December 31, 2014."

2) Circumstances alleged by the Plaintiff and opposed thereto

However, in light of the following circumstances acknowledged by comprehensively taking account of the descriptions of No. 1-5 and No. 1-2-5 and No. 2-5 of Eul and the overall purport of the pleadings as a result of the request for the appraisal of records of the records of the examination of the records on the President of Mine University Hospital at the court of first instance, the disease of this case cannot be deemed to have occurred due to the first accident, as it was caused by a sediative disease. Furthermore, the evidence and circumstances presented by the Plaintiff alone are insufficient to recognize that the Plaintiff’s existing disease of this case aggravated due to the first accident beyond the natural progress, and there is no evidence to acknowledge otherwise, the Defendant’s disposition that rejected the Plaintiff’s request for additional medical care on the same premise is legitimate.

(1) Results of appraisal of medical records in related cases (No. 2013-Gu District Court Decision 2013Gudan379)

In the medical record appraisal of the plaintiff's injury or disease conducted in the above related case, it is the opinion suggesting less expansion of the scarcity between the 3-7 square and the 2-3 square and the 5th square and the 1000 square and the 1000 square. However, the escape of the protruding is not observed, and the sacrific change is observed through the drilling and the overall sacrific change is observed, the expansion opinion of the proton of the protruding signboard is considered as a sking, and the opinion that the above injury or disease was caused by the RoI is not observed.

2. Medical opinions of the Defendant adviser

The defendant's advisory opinions on February 1, 2015 presented the following medical opinions on the injury and disease of this case.

- Hexical pressure opinions on the part applied in GRI by GRI are not well known. Hexical pathology, which does not recognize causal relationship with the disaster, as hexical pathology.

- The escape certificate of light or conical signboards shall be the disease that occurred during the escape process and unrelated to the disaster.

- The injury or disease of this case has no causal relationship with the first accident.

- The name of the injury or disease diagnosed by a special reason (e.g., the escape card of the warning or conical signboard) is not related to the first accident, and thus non-approval is not required for additional medical care.

- MRI disks is not an external trauma, and there has been no career of working in lusoral fluoral fluoral fluoral fluor during the recent years

(3) Results from entrustment of appraisal of medical records to the head of the original university or hospital of the first instance court.

-Crick: Pool, the climatic base, the chest base, the climatic climatic climatic signboard escape card, the climatic base five climatics and the climatic base escape card.

-The cause: The base accident and the cause of the salt farm, and the forecast escape certificate are the first accident and the sedentary disease, which are judged to be the plaintiff's king.

- The time of occurrence: The time of occurrence of a horse escape certificate of the background and the climatics cannot be known. At present, symptoms cannot be deemed to be due to the first accident. The symptoms caused by salt can be deemed to be beyond 2 to 3 years after the first accident. The plaintiff's symptoms are determined to be due to the climatic and the climatic escape symptoms.

- The plaintiff's king evidence cannot be accurately known. However, the plaintiff's sking change and the sking escape certificate in the sking and the sking shall be deemed to be a sking, and the degree of the sking escape certificate after the first accident does not have deteriorated, and if the degree of the sking escape certificate after the first accident and the direct sloping pressure symptoms after the first accident occurred immediately after the first accident, the first accident aggravated the plaintiff's existing disease. However, since the plaintiff is not such a case, the sloping escape certificate does not have a relation to the first accident.

- Existence of causation: The plaintiff's symptoms began from the first accident, but there is no causation.

3. Conclusion

Therefore, the plaintiff's claim of this case is dismissed as it is without merit, and the judgment of the court of first instance is just and it is so dismissed as it is so decided as per Disposition.

Judges

Judge Lee Chang-chul

Judges Kim Ho-ho

Judges Kim Sung-sung