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(영문) 서울행정법원 2013.06.19 2012구단16636

요양불승인처분취소

Text

1. The Defendant’s disposition of refusal to grant medical care to the Plaintiff on June 16, 2011 is revoked.

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

Reasons

1. Details of the disposition;

가. 원고는 1991. 6. 24. 기아자동차 주식회사(이하 ‘회사’라 한다)에 입사하여 위 회사의 B공장에서 자동차조립업무를 담당해왔는데, 2011. 3. 23. 회사 내의 배드민턴 경기장에서 점심시간을 이용하여 사내클럽활동으로 배드민턴 경기를 하던 중 왼쪽 무릎을 바닥에 찧으며 앞으로 한바퀴 구르는 재해(이하 ‘이 사건 재해’라 한다)를 당하여 ‘좌측 슬관절 내측 반월상연골판 파열, 좌측 슬관절 외측 반월상연골판 파열, 우측 슬관절 염좌’의 진단을 받은 후 피고에게 요양승인신청을 하였던바, 피고는 이 중 ‘우측 슬관절 염좌’는 요양승인을 하였으나 ‘좌측 슬관절 내측 반월상연골판 파열, 좌측 슬관절 외측 반월상연골판 파열’(이하 ‘이 사건 상병’이라 한다)은 퇴행성 증상으로 보인다며 2011. 6. 16. 이에 대하여 요양불승인 결정(이하 ‘이 사건 처분’이라 한다)을 하였다.

B. The Plaintiff filed a request for review with the Defendant on November 201, but was dismissed on the ground that the Plaintiff filed a request for review with the Industrial Accident Compensation Insurance Review Committee, but was dismissed on March 23, 2012.

[Judgment of the court below] The ground for recognition is without merit, entry of Gap evidence 1 through 3, and the purport of whole pleadings

2. The assertion and judgment

A. The gist of the Plaintiff’s assertion was that the Plaintiff had not received treatment due to symptoms related to the instant wound, and the instant disposition that did not recognize it was unlawful in the absence of any other cause than the instant accident, even though it did not have to find out any other cause of the injury, and even if there was a change in the Plaintiff’s response to some of the Plaintiff’s slots, it was working for the company for more than 20 years.

Since the repeated work of the occurrence of the outbreak leads to a sudden change in the state of happiness, there is a proximate causal relation between the plaintiff's work and the injury and disease of this case.