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(영문) 울산지방법원 2013.5.16.선고 2011구합1171 판결

요양불승인처분취소

Cases

2011Guhap1171 Revocation of Disposition of Non-approval for Medical Care

Plaintiff

A person shall be appointed.

Law Firm Hayn, Counsel for the defendant-appellant

[Defendant-Appellant]

Defendant

Korea Labor Welfare Corporation

Conclusion of Pleadings

April 18, 2013

Imposition of Judgment

May 16, 2013

Text

1. On October 14, 2010, the Defendant revoked the Plaintiff’s disposition of non-approval for medical care granted.

2. The costs of lawsuit are assessed against the defendant.

Purport of claim

The order is as set forth in the text.

Reasons

1. Details of the disposition;

A. On February 13, 1995, the Plaintiff joined the Ulsan Factory B (hereinafter referred to as "B") and served as a body assistance.

B. On July 21, 2010, the Plaintiff filed an application for medical care to the Plaintiff on October 14, 2010, on the following grounds: (a) there was a pain on Huuri (hereinafter referred to as “the instant disaster”); (b) on the ground that the Plaintiff had received diagnosis, and the No. 4-5 protruding escape certificate (hereinafter referred to as “the instant accident”); and (c) on the ground that on October 14, 2010, the Defendant approved the Plaintiff to receive medical care in relation to the relevant protruding base, and (d) on the ground that the Defendant did not recognize the causal relationship between the instant accident and the instant accident (hereinafter referred to as “the instant medical treatment”).

[Ground of recognition] Facts without dispute, entry of Eul's evidence Nos. 1 to 4, purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The plaintiff's assertion

The plaintiff was employed in B for 15 years repeatedly and repeatedly engaged in unstable daily work with heavy weight of 21 km, and the occurrence of the injury or disease of this case occurred due to such work force or the disaster of this case. Thus, there is no causation between the plaintiff's work and the injury or disease of this case.

The defendant's disposition of this case, which was taken by him, should be revoked because it is illegal.

B. Facts of recognition

1) Plaintiff’s business

The plaintiff joined B on February 13, 1995 and was in charge of assembly of the body body body, which moves to B on August 8, 2010, by inserting one bridge and deducting materials equivalent to 21kg in front of the buckbucks. < Amended by Presidential Decree No. 22020, Aug. 8, 2010>

2) Progress details

○ From August 16, 2007 to August 18, 2007, and from 18 October 8, 2008, the Korea National Assembly members received a total of four times of medical treatment from 1900 to 1900.

○ On July 22, 2010, an in-house medical institution provides medical treatment on July 22, 2010.

○ From July 23, 2010 to July 27, 2010, 4 days from the D Unauthorized to the D Unauthorized to the D Unauthorized to the D Unauthorized to the D Unauthorized to the D Unauthorized to the D Unauthorized to the 27th day of July 2010, referring to the treatment for 4 days from the D Unauthorized to the

○ On July 30, 2010, E Hospital was diagnosed as the escape from the clatum 4 - 5 of the clatum base and the clatum 4-5, and was administered on August 10, 2010.

3) Medical opinions

A) Plaintiff Mean (E Hospital)

- Sick name: Hypool base, 4-5 Spare signboards escape certificates

- On July 21, 2010, as a person who was within the hospital as a result of the symptoms, such as the cathoe cat, the catum cat, the radioactive cat, the radioactive cathers not on the right side, and the radioactive cathers, etc. which occurred after the water, to diagnose the above cata in the eologic examination

- Medical treatment is conducted on August 10, 2010. It is confirmed that the escape of a conical signboard from the Round MRI test to the upper end is pressured due to the movement of the escape of a conical signboard from the Round MRI test to the upper end.

B) A medical certificate of F Hospital;

- Dolle, vertebrates, and other congrative signboards accompanied by disease identification cards;

- The view of the escape from the RoI from the RoI to the 4-5th century, which was implemented by another hospital on July 30, 2010, seems to be the opinion of the escape from the acute signboards that were transferred to the upper end, which is judged to be consistent with the Plaintiff’s clinical symptoms, and the disease caused by the disaster and work in this case.

C) Defendant’s advice

1. ① 1 1. Consultation 1. The 4-5 pages of the Round MRI is difficult to occur from an original high-priced disaster, which is the general center of escape. It is springed as an existing opinion on the sediment disease. It is difficult to generate the vegetable base.

② Advice 2: On July 30, 2010, from the MRI to 4-5 in the Johnan MRI on July 30, 2010, to observe the king of the conical signboards, such as the expansion of their decline and the clibing of the postline, but the opinion of acute escape is not visible, the escape certificate of the conical signboard No. 4-5 in the condition that it is not visible to the opinion of acute escape, and the approval of the conical base is reasonable.

(3) Advice 3: MRI's identification card No. 4 - 5 of MRI's identification card shall be increased. It is reasonable to increase the galle base.

(d) consulting with the Industrial Accident Compensation Insurance Reexamination Committee;

From No. 4-5 of the MaRI on the Hastst MRI, conical signboards are observed by the number of side signboards, the number of side signboards, the number of side signboards, the reduction of side effects, the expansion of alley, the formation of a runway, the structural gun light, the labing, the labing, and the yellow labing. This is due to a change in the individual's laveness, and there is no causal relationship between the disaster and the work force.

E) Results of this Court’s commission of physical examination of G Hospital

- It is not visible from a simple chronic examination;

- As a result of MRI, the whole e.g., the e., the e.g., the e., the e.g. back to the drilling No. 4 in the e.g., the e., the e.g.

- The Plaintiff’s statement that the nucles remain after the surgery but they were crypted. The Plaintiff’s crypted with the overall symptoms and the progress of illness, which occurred to the Plaintiff, is also highly likely to be salted.

- The probability that this disaster has contributed to the escape from hydro-nuclear injury is determined to the extent of 20% on the basis of the medical judgment of compensation and compensation. However, the degree of contributions to hydro-nuclear escape can not be known.

F) Results of this court’s entrustment of appraisal of medical records to H hospitals

- Without regard to MRI, it is not possible to determine whether the escape from a acute signboard can be seen, but in the case of the plaintiff, it is thought that the symptoms were treated.

- It is very difficult to measure the part that has vocational ability due to the ebrate change and the occurrence of spine disease. Ultimately, it is necessary to evaluate the individual status of the patient separately.

- In the case of the plaintiff, it is recognized that the data submitted for a long period of time imposes a burden on the patient's symptoms, and it is reasonable to regard the degree of contribution to the patient's symptoms as 50% by integrating the case where the symptoms have occurred as prompt re-re-re-re-consigning the 15-year work force and the 21km parts, and the relevant degree of contribution is considered to be 25%, respectively.

- vertebrate diseases may occur in the course of natural aging, and in this case, the burden of long-term blurgism may cause aggravation of progress. In other words, in the case of the plaintiff, work force or disaster may cause aggravation of injury and disease, and the relevant degree is considered to be 50%.

[Ground of recognition] The non-contentious facts, Gap evidence Nos. 1 through 11, Eul evidence Nos. 1 through 8, the result of the commission of physical examination to G hospital by the source of this Act, the determination of the entrustment of medical examination to H hospital by this court, and the purport of the whole pleadings

C. Determination

1) The term "occupational accidents" under the Industrial Accident Compensation Insurance Act means that an employee's injury, disease, physical disability, or death resulting from his/her duties while performing his/her duties requires causation between the employee's injury, physical disability, or death, which is caused by his/her duties, and must be proved by his/her assertion of such causation. The method and degree of proof does not necessarily have to be clearly proved by direct evidence, but it is sufficient if it is proved to the extent that proximate causal relation between his/her duties and the accident is estimated by indirect facts, such as the health conditions at the time of employment based on the health and physical conditions of the employee in question, existence of existing diseases, nature of his/her duties, and working environment, and whether another employee's work has transferred to the same kind of disease (see Supreme Court Decision 98Du4740, May 22, 1998, etc.).

2) In the instant case, in full view of the following circumstances revealed in the facts acknowledged earlier, it is presumed that the instant injury or disease was caused by the Plaintiff’s business or the instant accident, or the Plaintiff’s existing disease aggravated at a naturally occurring speed, and thus, there is a proximate causal relation between the instant accident or the Plaintiff’s business and the instant injury or disease.

A) The Plaintiff’s work seems to be a duty to put one bridge on the working stand at the height of buckbucks and assemble several parts 21 km toward the front of bucks with repeated entry of parts equivalent to 21 km.

B) Even if the Plaintiff received four times medical treatment before the occurrence of the instant accident, it cannot be deemed that there was an existing chronic disease, and even if there was an existing chronic disease, such treatment was performed as much as it was impossible to perform his/her duties. Such treatment was performed while the Plaintiff entered the Plaintiff in B and had been engaged in the said business for more than ten years.

C) As the result of the RoI taken on July 30, 2010 by the Plaintiff, the F Hospital considers it as an acute signboard escape certificate, and it is judged that this is consistent with the Plaintiff’s clinical symptoms, and there is a medical opinion that it is judged that the disease caused by the disaster and work in this case is a disease.

D) As a result of the court’s entrustment of physical examination of G Hospital and the court’s entrustment of medical examination of H hospital records, there is a medical opinion that the degree of contribution of the instant accident and the Plaintiff’s duties to the escape from the nuclear escape is about 50% or 20%.

E) According to the Defendant’s advisory opinions and the advice of the Reexamination Committee on Industrial Accident Compensation Insurance, the disease of this case is close to the happiness, but the above opinion alone does not deny that the Plaintiff’s existing disease of this case has deteriorated due to the Plaintiff’s occupational failure and the disaster of this case. According to the above opinion, even if the Plaintiff had a bruptive disease prior to the disaster of this case, the Plaintiff did not have received medical treatment related to the bruptal failure between 1 and 9 months prior to the disaster of this case, and it is difficult to view that the degree of the existing disease was excessive if the Plaintiff continued to perform the bruptive work prior to the disaster of this case.

3) Therefore, the Defendant’s disposition in this case, which deemed that there is no proximate causal relation between the Plaintiff’s business or the instant disaster and the instant injury and disease, should be revoked as it is unlawful.

3. Conclusion

The plaintiff's claim is reasonable, and it is so decided as per Disposition.

Judges

Judges Kim Jong-dae

Judge Senior Professor

Judges Min Il-young