요양불승인처분취소
1. On December 7, 2018, the Defendant’s disposition of non-approval for medical care rendered to the Plaintiff is revoked.
2. The costs of the lawsuit are assessed against the defendant.
1. Details of the disposition;
A. From January 2, 2018, the Plaintiff served in the Ansan-si Welfare Center for the Aged, and filed an application for medical care benefits with the Defendant on November 26, 2018, on the ground that, around October 18, 2018, the Plaintiff was diagnosed with the 쇠 pipes (hereinafter “instant accident”) during which he was killed in a box at around 07:50 on October 18, 2018.
B. On December 7, 2018, the Defendant rendered a disposition not to grant medical care (hereinafter “instant disposition”) against the Plaintiff on the ground that “the instant injury and disease is not deemed to have a proximate causal relation with the instant accident according to the medical opinion of the advisory society based on the medical opinion of the advisory society that the instant injury and disease are confirmed without any damage to the acute personality,” and on the ground that “the instant injury and disease is not recognized.”
C. The Plaintiff filed a request for examination against the Defendant, but the Defendant dismissed the request for examination on March 11, 2019.
[Ground of recognition] Facts without dispute, Gap evidence Nos. 1 and 2 (including branch numbers; hereinafter the same shall apply), Eul evidence No. 1, the purport of the whole pleadings
2. Whether the instant disposition is lawful
A. The Plaintiff’s assertion had never received any medical treatment on the left-hand side of the instant accident, and had been performing the duties required by the Welfare Center for the Aged in Ansan-si without undue difficulties. After the instant accident, the Plaintiff received surgery on the left-hand side of the instant accident at the hospital, and eventually retired from the Welfare Center for the Aged in Ansan-si.
Therefore, even though the injury or disease of this case occurred due to the accident of this case or becomes worse due to nature, the defendant's disposition of this case on different premise should be revoked as unlawful.
B. The "occupational accident" under the Industrial Accident Compensation Insurance Act refers to an accident caused by an employee's occupational failure in the course of performing his/her duties. As such, there is a proximate causal relation between the occupational accident and the accident, and in this case, between the employee's occupational accident and the accident.