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(영문) 서울행정법원 2013.10.30 2012구단14760

추가상병및재요양불승인처분취소

Text

1. The Defendant’s additional injury and additional medical care granted to the Plaintiff on April 2, 2012.

Reasons

1. Details of the disposition;

A. On October 28, 2002, the Plaintiff received medical care with the Defendant’s approval until April 30, 2006, as an occupational fall accident, from the upper disease of “the alleys in the left, the scopical base, the scopical base, the scopical base, the right-hand scopical base, and the conical signboard escape certificate between the 5-6 trend.”

B. On March 28, 2012, the Plaintiff filed an application for additional injury and additional medical care to the Defendant for the Radical injury and injury to the Radical injury and injury to the Defendant (hereinafter “the instant injury and injury and injury”). However, the Defendant rejected the application on April 2, 2012 on the ground that there was no proximate causal relation with the business and that the approved injury and injury and injury were not repeated or malicious.

(hereinafter referred to as “instant disposition”). [Grounds for recognition] A without dispute, Gap 1, 3, 4-2, 4-4, the purport of the entire pleadings

2. Whether the instant disposition is lawful

(a) Where a worker receiving medical care due to an occupational accident under Article 49 (Application for Medical Care Benefits for Additional Injury or Disease) of the Industrial Accident Compensation Insurance Act, falls under any of the following subparagraphs, he/she may apply for medical care benefits for an injury or disease (hereinafter referred to as "additional injury or disease"):

1. Where medical care is necessary as an injury or a disease which has already occurred due to the occupational accident is additionally discovered;

2. Where a new disease occurs as a result of the occurrence of an injury or disease caused by the relevant occupational accident and requires medical care. (1) If there exists a medical opinion that a person who has received medical care benefits under Article 40 suffers from a recurrence of an occupational injury or disease that was the object of medical care after the cure, or that active treatment of such occupational injury or disease is needed as his/her state becomes worse than the time of cure, he/she may again receive medical care benefits under Article 40 (hereinafter referred to as "additional

(2) Necessary matters concerning the requirements, procedures, etc. for additional medical care shall be prescribed by Presidential Decree.

B. According to the results of the request for the examination of medical records and the overall purport of the arguments with respect to the head of Sincheon-do University Seoul Hospital, the instant injury and disease in question are either occupational fall accident itself or occupational fall.