진료계획 불승인처분 취소
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 January 21, 2012, the Plaintiff, who worked as an apartment security guard, was subject to an accident that happens by leakage in the guard room (hereinafter “instant accident”).
B. The Plaintiff was under the Defendant’s approval with respect to the following: (a) detailed uncertainty of the instant accident caused by the instant accident, i.e., noise by gases, key e.g., destruction by gases, and physical extinguishment disorder; (b) adaptation disorder; and (c) damage to the external side of the front part (definite, front part) damage to the front part (definite, front part).
C. On February 20, 2017, the Plaintiff’s medical hospital B, which is an industrial accident insurance-related medical institution, submitted to the Defendant a medical treatment plan stating that “the period of medical care is extended from March 1, 2017 to May 31, 2017 for the treatment, etc. related to the above medical branch, such as adaptation disorder, etc.” (Evidence B). However, the Defendant did not approve the above medical treatment plan on March 2, 2017, on the ground that “it is difficult to expect that the symptoms the Plaintiff complained for, were transferred to mutual care through preserved treatment, etc., and it is reasonable to complete the medical treatment by February 28, 2017.”
(hereinafter “Disposition in this case”). 【No dispute over the grounds for recognition”, Gap evidence Nos. 1, 14, Eul evidence Nos. 1, 2-2, 3, and 4, and the purport of the whole pleadings
2. Whether the instant disposition is lawful
A. After the Plaintiff suffered the instant accident, the Plaintiff’s assertion continues to show abnormal symptoms, such as the heat fat, chest fat, fat, fat, memory degradation, etc., and the treatment for this is still necessary.
Therefore, the instant disposition issued on a different premise should be revoked as it is unlawful.
B. Article 5 subparag. 4 of the Industrial Accident Compensation Insurance Act defines “the recovery” as “the full recovery of injury or disease, or the effect of treatment no longer expected, and the symptoms thereof are fixed.”
Article 40 (Medical Care Benefits) and Article 51 (Additional Medical Care) of the Industrial Accident Compensation Insurance Act including this.