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 November 20, 2010, while working in B Co., Ltd. (hereinafter “instant workplace”) from January 20, 2010, the Plaintiff was transferred to C Hospital with symptoms of abnormal senscence in the senscence of the arms, which occurred after getting out of the kitchen around 20:30 on November 19, 2017.
B. On December 23, 2017, the Plaintiff filed an application for medical care benefits with the Defendant. On March 26, 2018, the Defendant rendered a disposition to grant medical care benefits non-approval (hereinafter “instant disposition”) to the Plaintiff on the ground that “(i) the duty performed by the Plaintiff prior to the occurrence of the instant injury is not verified to the extent that the Plaintiff may cause cardio-cerebrovascular diseases, such as short-term, chronic, etc. from the duty performed before the instant injury, and (ii) the time of the investigation is too excessive to the extent that the instant injury is likely to cause the instant injury.” In light of the above, the instant injury is deemed to have been caused by the natural aggravation of the existing individual disease, and it is the result of deliberation by the Occupational Disease Determination Committee that the instant injury is not recognized as a occupational disease. Accordingly, the instant injury is not recognized as a proximate causal relation with the duty.”
C. The Plaintiff dissatisfied with the request for reexamination to the Industrial Accident Compensation Insurance Reexamination Committee, but the said Committee dismissed the request for reexamination on July 24, 2018.
[Ground of recognition] Facts without dispute, Gap evidence Nos. 1, 2, 5, and 6, the purport of the whole pleadings
2. Whether the instant disposition is lawful
A. On the day when the Plaintiff’s assertion of the disease occurred, in the situation where the Plaintiff was under stress due to the Plaintiff’s failure to seek staff from her part-time, even though more work was conducted on Sundays, the disease of this case was caused by the instant accident.