휴업급여부지급처분취소
1. The instant lawsuit shall be dismissed.
2. The costs of lawsuit shall be borne by the Plaintiff.
1. Details of the disposition;
가. 원고는 “2016. 10. 16. 19:00경 아파트 시수 개폐 작업을 하던 중 왼쪽 어깨에서 툭 하는 소리가 발생하는 재해로 인하여 ‘좌측 회전근개 부분파열, 좌측 관절낭 파열’(이하 ‘이 사건 상병’이라 한다)을 입게 되었다”고 주장하며 피고에게 요양승인 신청을 하였다.
B. On November 7, 2016, the Defendant rendered a disposition to non-approval of the Plaintiff’s application for medical care (hereinafter “instant disposition”) on the ground that “the pertinent injury and disease cannot be recognized as having a relation to his/her duties due to the soariness.”
C. The Plaintiff dissatisfied with the instant disposition and filed a request for examination with the Defendant. The Defendant dismissed the Plaintiff’s request for examination on January 2, 2017, and the Plaintiff was served with the written request for examination on January 5, 2017.
[Reasons for Recognition] Facts without dispute, entry B in the evidence of subparagraphs 1 through 5, the purport of the whole pleadings
2. Determination on the defense prior to the merits
A. Although the Plaintiff filed the instant lawsuit against the instant disposition upon a request for examination, it is unlawful that the instant lawsuit was filed after the lapse of 90 days from the date of receipt of the decision to dismiss the request for examination.
B. In full view of the relevant provisions such as Article 103(1), main text of Article 106(1), Article 106(3) and Article 111(2) of the Industrial Accident Compensation Insurance Act, a person dissatisfied with the decision on insurance benefits, including medical care benefits, may immediately file a lawsuit for cancellation, without filing a request for examination or reexamination under the Industrial Accident Compensation Insurance Act, and (2) a lawsuit for cancellation may be instituted on voluntary basis after receiving such decision; and (3) a lawsuit for cancellation may be instituted only after filing a request for examination or reexamination (see, e.g., Supreme Court Decision 2002Du6811, Nov. 26, 2002). A lawsuit for cancellation against an administrative agency’s disposition becomes aware of the pertinent disposition.