진료계획서불승인처분취소
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 October 22, 2008, the Plaintiff was diagnosed on the left-hand chain of ionion due to an occupational accident, and received medical care until February 25, 2009 and re-medical care from January 16, 2012 to October 31, 2013.
B. On October 11, 2013, B hospital treated the Plaintiff, submitted to the Defendant a medical treatment plan extending the medical treatment period for the following nine weeks (from October 27, 2013 to December 27, 2013) for physical therapy and rehabilitation treatment for the instant injury and disease.
C. On October 28, 2013, the Defendant reduced the treatment period from October 27, 2013 to October 31, 2013, on the ground that the symptoms have been fixed due to the Plaintiff’s lack of further surgery or rehabilitation treatment, and issued a disposition not to approve the remaining treatment plan.
[Ground of recognition] Facts without dispute, Gap evidence 1 (including branch numbers for those with branch numbers; hereinafter the same shall apply), Eul evidence 1 to 4, the purport of the whole pleadings
2. Whether the instant disposition is lawful
A. The Plaintiff’s assertion was conducted five times after the Plaintiff suffered from a disaster on October 22, 2008, and even until now, the Plaintiff continued to receive treatment as the pains of the operation department continued. As such, the Plaintiff’s assertion cannot be deemed to have fixed the symptoms of the instant injury and disease at the time of the instant disposition, the instant disposition based on the premise that the Plaintiff’s symptoms were fixed is unlawful.
B. Article 5 subparag. 4 of the Industrial Accident Compensation Insurance Act provides that the term “cure” refers to the completion of an injury or disease, the effect of which is no longer expected, and the symptoms thereof are fixed. Article 47 of the same Act and Article 41 of the Enforcement Decree of the same Act provide that where an industrial accident insurance-related medical institution submits a medical treatment plan that requires the extension of the period of medical care, the Defendant may take necessary measures, such as ordering the completion of the treatment or the reduction of the scheduled period of medical treatment after examining
On the other hand, Industrial Accident Compensation Insurance Act.