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(영문) 대법원 2018. 12. 27. 선고 2018두46377 판결

[요양불승인처분취소][공2019상,406]

Main Issues

[1] The method of recognizing the existence of a disease claimed by an employee under the premise of recognizing an occupational accident under Article 5 subparag. 1 of the Industrial Accident Compensation Insurance Act

[2] In a case where Gap who worked as a mining source in a mining center, etc. claimed that "the Rano-Madon Radon who is not accompanied by the Radon Madon Madon Madon Madon Madon Madon Madon Madon Madon Madon Madon Madon Madon Madon Madon Madon Madon Madon Madon Madon Madon Madon Madon Madon Madon Madon Madon Mad on 21 year, applied for medical care benefits, but the Korea Labor Welfare Corporation did not recognize the injury or disease, the case holding

Summary of Judgment

[1] In order to recognize the existence of a disease claimed by an employee under Article 5 subparag. 1 of the Industrial Accident Compensation Insurance Act as a premise for the recognition of an occupational accident, the symptoms of workers verified by objective and reasonable methods, such as the appraisal result, should conform to generally accepted medical knowledge or diagnosis standards in relation to the diagnosis of the disease. Unless otherwise, barring any special circumstance, it is difficult to recognize the existence of the disease itself.

[2] In a case where Gap who worked as a mining source in the mining center, etc. claimed that "the Radar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madder for about 21 years, and applied for medical care benefits, but the Korea Labor Welfare Corporation did not recognize the injury or disease, the case holding that Gap's Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Madar Mad Madar Madar Madar Madar Madar Ma, etc.

[Reference Provisions]

[1] Article 5 subparag. 1 of the Industrial Accident Compensation Insurance Act / [2] Article 5 subparag. 1, Article 37(1)2 and (5) of the Industrial Accident Compensation Insurance Act, Article 34 of the Enforcement Decree of the Industrial Accident Compensation Insurance Act

Plaintiff-Appellee

Plaintiff

Defendant-Appellant

Korea Labor Welfare Corporation

Judgment of the lower court

Seoul High Court Decision 2018Nu30411 decided May 10, 2018

Text

The judgment below is reversed and the case is remanded to Seoul High Court.

Reasons

The grounds of appeal are examined.

1. In order to recognize the existence of a disease claimed by an employee as a premise for the recognition of occupational accidents under Article 5 subparag. 1 of the Industrial Accident Compensation Insurance Act (hereinafter “Industrial Accident Insurance Act”), the symptoms of workers verified by objective and reasonable methods, such as the result of appraisal, should conform to the generally accepted medical knowledge or diagnosis standards in connection with the diagnosis of the disease. Unless otherwise, barring any special circumstance, it is difficult to recognize the existence of the disease itself.

2. A. The lower court acknowledged the following facts based on the evidence duly admitted:

1) From December 12, 1981 to December 7, 1994, the Plaintiff worked as a luminous source in ○○ Mining Center, △△△△△, △△△△ Incorporated Company, etc.

2) On March 29, 2016, the Plaintiff was diagnosed by Rano-Madon-gun (hereinafter “the instant injury and disease”). Based on this, the Plaintiff asserted to the Defendant that “the instant injury and disease occurred by performing long-term work involving vibration, such as driving a crypus, etc. while working as a luminous source for about 21 years in coal mines.”

3) On October 4, 2016, the Defendant rendered a disposition not to grant medical care to the Plaintiff on the ground that “the instant injury and disease is not recognized, and there is no proximate causal relation between the Plaintiff’s practice and the instant injury and disease after a considerable period of time has elapsed since the Defendant’s installation of the vibration exposure work.”

4) The first instance court entrusted the Plaintiff’s physical appraisal to Do○○○○ Hospital head, and the appraisal commission was presented to the effect that “the Plaintiff had no verified opinion on the confession in the cooling House inspection,” and “the Plaintiff appears to have symptoms, such as: (a) the Plaintiff appears to have caused fluoral changes in the color of fingers and heavy depreciation, and such symptoms were caused by the use of the vibration tools during the past 20 years; (b) however, the Plaintiff’s present situation is deemed to be the degree that the Defendant’s medical treatment was not required, and there is no serious need for treatment or disability to be considered to be the degree that there is a problem in the labor ability.”

B. The court below found that the Plaintiff’s major doctor, based on the Plaintiff’s opinion of the doctor in charge of the hospital affiliated with △△ University, and the result of the first instance court’s appraisal commission, etc., found that there exist symptoms that may result in the Plaintiff’s reduction of the end of the hand-on, and that the Plaintiff’s symptoms constitute a occupational disease as provided by Article 37(1)2(a) of the Industrial Accident Insurance Act, which is the “rain phenomenon that occurs on the part exposed to vibration” as provided by Article 34(1) and (3) [Attachment Table 3] 12(d) of the Enforcement Decree of the Industrial Accident Insurance Act.

3. However, we cannot agree with the judgment of the court below that the plaintiff suffered from an occupational accident for the following reasons.

According to the records, (1) The Plaintiff’s main doctor conducted X-ray shooting, rano cans inspection, and diagnosis for the reduction of self-exempt disease, and diagnosed the Plaintiff as Rano Norma-gun; and (2) The Plaintiff’s symptoms are acknowledged that the Plaintiff caused the Plaintiff’s sensa-gun to be impreged, and the Plaintiff’s rasa-gun was not verified as to the result of the Rano-Man-gun’s diagnosis, which is the representative symptoms of the Rano-Masa-gun group. Meanwhile, according to the result of the first instance court’s appraisal commission, it is not clear whether it is possible to diagnose the Plaintiff as Rano-Masa-gun solely on the symptoms shown on the part of the Plaintiff, even in cases where it is not confirmed as a result of the rano-Masa-Masa test.

As such, if the result of the diagnosis of the Plaintiff may vary according to the method of the examination, the lower court should have first determined the medical knowledge or diagnosis standards generally used in relation to the diagnosis of the Malaysia, and further should have deliberated on whether the Plaintiff can be diagnosed with the Malaysia.

Nevertheless, the lower court, without examining and determining whether the Plaintiff’s above symptoms can be diagnosed as Rano-Ba, in light of the generally accepted medical knowledge and diagnosis standards, concluded that the injury and disease of this case is recognized solely on the basis of the result of appraisal commission, etc. that the Plaintiff was found to have a heavy sense of the end of the loss and that the symptoms are found to have been found. In so doing, the lower court erred by misapprehending the legal doctrine on occupational accidents under the Industrial Accident Insurance Act, thereby failing to exhaust all necessary deliberations, thereby adversely affecting the conclusion of the judgment. The allegation contained in

4. Therefore, the lower judgment is reversed, and the case is remanded to the lower court for further proceedings consistent with this Opinion. It is so decided as per Disposition by the assent of all participating Justices on the bench.

Justices Park Sang-ok (Presiding Justice)