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(영문) 대전지방법원 2016.2.17. 선고 2014구합3459 판결

추가상병재심사청구기각결정처분취소

Cases

2014Guhap3459 The revocation of revocation of a decision to dismiss a petition for further review

Plaintiff

A

Defendant

Industrial Accident Compensation Insurance Reexamination Committee

Conclusion of Pleadings

December 23, 2015

Imposition of Judgment

February 17, 2016

Text

1. The plaintiff's claim is dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Purport of claim

On July 28, 2014, the Defendant’s decision to dismiss a petition for further review of an additional injury or disease filed against the Plaintiff (No. 745 of the Decision 2014) is revoked.

Reasons

1. Details of ruling;

A. On April 8, 2012, the Plaintiff, who was employed as a worker B, felled into the floor and felled into the floor with a gradial structure at the C construction site on April 16, 2012, and sustained medical care after obtaining approval from the Korea Workers’ Compensation and Welfare Service for occupational accidents. < Amended by Presidential Decree No. 20358, Apr. 8, 2012; Presidential Decree No. 20135, Apr. 1, 2012; Presidential Decree No. 20220, Feb. 23, 2015>

B. On April 29, 2013, the Plaintiff filed an application for additional injury to the Korea Workers' Compensation and Welfare Service, alleging that the 'Maternal M&A damage' caused by the 'Maternal M&A’ in the course of treating the said injury, and that the 'bruptary light' and the 'bruptive loss of unknown whereabouts' occurred

C. On May 20, 2013, the Korea Workers’ Compensation and Welfare Service (hereinafter “Korea Workers’ Compensation and Welfare Service”) acknowledged that the Plaintiff’s damage to the Nacheon M&C was recognized, but rendered a decision to approve additional injury only to the Nacheon M&C damage on the ground that there was no causal link with the disaster, and that there was no causation with the disaster. D. The Plaintiff appealed against this, and filed a request for re-determination with the Korea Workers’ Compensation and Welfare Service on August 20, 2013, and the Korea Workers’ Compensation and Welfare Service dismissed the Plaintiff’s request for re-determination on the same ground as the original disposition on November 20, 2013.

E. On February 17, 2014, the Plaintiff again filed a request for reexamination to the Defendant. The Defendant, on May 15, 2014, decided to hold a deliberative meeting to review and review the medical data, such as the result of the dynamic examination, and then, decided to dismiss the Plaintiff’s request for reexamination on July 18, 2014, after holding a deliberative meeting on July 18, 2014, on the following grounds (hereinafter “instant adjudication”).

As a result of a review of all relevant data, such as the Seoul National University Hospital, the Seoul National University Hospital, the Jeonnam University Hospital's Docology inspector, the main survey report, and the medical certificate submitted in relation to the case for reexamination, it is an opinion that additional disease approval can only be given to only the 'obsississis damage' in light of the opinions of the advisory society, which were examined and diagnosed by a large number of medical specialists, and the advice and consultation of the original disposition agency cannot be recognized as the 'obsississis damage' by the 'Maternsis damage' in light of the light function within the normal range. Since the protective function of the defendant's advisory opinion is within the normal range, it is difficult to recognize additional disease, considering that there is a medical opinion that it is difficult for the claimant to view that the additional disease caused by a disaster on April 8, 2012 or caused a disease or disease.

[Ground of recognition] Facts without dispute, Gap evidence Nos. 1 through 4, 15, 20, 21. 23 (including various numbers; hereinafter the same shall apply), Eul evidence Nos. 2, 5 through 7, and 9, the purport of the whole pleadings

2. Whether the lawsuit of this case is lawful

A. Defendant’s defense

A lawsuit seeking the revocation of a ruling, which is an administrative appeal, may be filed only on the ground that the ruling itself has an inherent error. Since the Plaintiff asserted the illegality of the original disposition in the lawsuit in this case, the lawsuit in this case shall be dismissed as a mistake in designating the Defendant.

B. Determination

In addition to the illegality of the original disposition of this case, the Plaintiff asserts that there are defects in the content, subject, procedure, and form of the judgment of this case itself, and this appears to have been a dispute over the inherent illegality of the judgment itself. Thus, the lawsuit of this case filed against the Defendant, who is an administrative agency which made the decision of this case, cannot be deemed unlawful. Therefore, the Defendant’s defense is without merit.

3. Whether the ruling of this case is legitimate

A. The plaintiff's assertion

The ruling of this case shall be revoked as it is illegal due to the following defects.

1) Defect in the contents of the ruling

① The original disposition of this case was unlawful since it did not confirm the Plaintiff’s maximum essential speed reduction and the degradation of the urology reduction in urology with the Plaintiff’s urgical inspection site, etc., and it did not appear that the Plaintiff’s urgical function was above the Plaintiff’s urgical function. The Defendant rejected the above illegality of the original disposition of this case and rendered the instant decision.

② The Defendant did not determine or omitted the Plaintiff’s symptoms of Maternia and Maternal Maternia.

2) Defect of the subject of the ruling

It is because the defendant's failure to state the name of the adviser who was consulted in the process of the decision in this case is due to the fact that he was consulted with an unqualified person. This is because a person who is not entitled to participate in the decision was involved in the decision, and therefore, there is a serious defect in the composition of the defendant who is the subject of the decision.

(iii) any defect in the adjudication procedure;

① On February 21, 2014, the Korea Workers’ Compensation and Welfare Service delivered the Plaintiff’s written request for reexamination to the Defendant, but the Defendant did not immediately receive and process it and received it on March 28, 2014. Pursuant to Articles 109(1) and 105(1) of the Industrial Accident Compensation Insurance Act (hereinafter “Industrial Accident Compensation Insurance Act”), the Defendant completed the deliberation and ruling within 60 days from the date of receipt of the request for reexamination, but the instant ruling was rendered at least five months after the date of receipt of the request for reexamination.

③ Although the Defendant prepared a deliberative protocol on the process of reexamination pursuant to Article 110 of the Enforcement Decree of the Industrial Accident Compensation Act, he/she did not prepare a deliberative protocol on May 15, 2014. ④ The Defendant held the second deliberative protocol on July 18, 2014 without undergoing the deliberation and resolution procedure, without undergoing the deliberation and resolution procedure.

(5) Although the chairperson’s written deliberation meeting should be signed or sealed by the chairperson pursuant to Article 110(2) of the Enforcement Decree of the Industrial Accident Compensation Act, the written deliberation meeting prepared by the defendant on July 18, 2014 does not have the signature or seal of the chairperson, and it is stated that the plaintiff’s representative was present even if he did not appear D.

6 The defendant did not legally designate advisory members, and the third person who is not a doctor but suspected of being an employee of the defendant, or the disqualified person, entered false matters, and received a reply from the adviser who was omitted from judgment on symptoms due to the decline in light of the plaintiff's optical function or sub-explosion, and made the ruling in this case as a medical opinion.

(iv) there is a defect in the form of adjudication.

① Although the Plaintiff changed an additional disease from the Mami-gun’s functional site to the Mami-Mami-Mami-Mami-Mami-Mari-Mari-Mari-Mari-Mari-Mari-Mari-Mari-Mari-Mari-Mari-Mari-Mari-Mari-Mari-Mari-Mari-Mari-Mari-Mari-Mari-Mari-Mari-Mali-ri (hereinafter “the instant judgment”), the Defendant stated his opinion on May 7, 2013

② Although the Defendant did not hold an advisory society in order to examine additional injury and disease, the Defendant stated the written adjudication in this case as “the opinion of additional medical approval only for the damage to the Nacheon M&K according to the opinion of the advisory society,” there is a serious error in the reasons stated in the written adjudication in this case.

B. Relevant provisions

It is as shown in the attached Form.

C. Determination

1) As to the defect in the contents of the ruling

A) As to the assertion of illegality of the original disposition in this case and the claim that the defendant impliedly admitted it, Article 19 of the Administrative Litigation Act provides that "a lawsuit for revocation shall be subject to a disposition, etc.: Provided, That in cases of a lawsuit for revocation of a judgment, it shall be limited to cases where the judgment itself is based on an inherent error in the judgment itself." The term "an inherent illegality" in this context refers to an illegality that is not in the original disposition nor only in the judgment (see Supreme Court Decision 96Nu14661, Sept. 12, 1997). Under the above provision, an appeal litigation against a judgment is limited to cases where there is an inherent illegality in the judgment itself, procedure, form, or content, and the reason that there is an error of law such as mistake of facts, deviation from discretionary power, or abuse, etc. is not allowed as it is inherent in the judgment itself (see Supreme Court Decision 2009Du1829, Oct. 15,

In light of the above legal principles, the assertion that the original disposition in this case was unlawful cannot be deemed to be an assertion of illegality inherent in the judgment in this case itself, and the defendant's assertion that the original disposition in this case was unlawful, such as misunderstanding of facts, deviation from discretion, abuse of discretion, etc., in the judgment in this case, cannot be deemed to be an assertion of illegality inherent in the judgment in this case, and thus, the plaintiff's assertion in this part

B) As to the assertion of omission of judgment on the Maternia and Maternal Maternia symptoms

According to the records in Gap evidence No. 1, in making the decision of this case, the defendant examined the plaintiff's opinion and diagnosis statement on the plaintiff's main body of Maternal Maternal Materne, the opinion of advisory opinion of the original body, the opinion of advisory opinion of the original body, the opinion of advisory opinion of the review body, the opinion of advisory opinion of the examination body, and the opinion of advisory opinion of the defendant. Based on the medical review on the above Maternal Materne and Maternal Materne Materne, the defendant is not entitled to medical care benefits for additional diseases, and thus, the original disposition of this case, which made the decision of non-approval of additional diseases, can be recognized as proper.

According to the above facts of recognition, the defendant determined the legitimacy of the original disposition of this case against the plaintiff's symptoms of Maternia and Maternia as the issue of the judgment of this case. Thus, this part of the plaintiff's assertion is not accepted.

2) As to the defects of the subject of the ruling

According to Article 107 of the Industrial Accident Compensation and Labor Act and Article 107 of the Enforcement Decree of the Industrial Accident Compensation and Labor Act, the defendant shall be placed in the Ministry of Employment and Labor in order to deliberate and decide on a request for reexamination which is made against the determination by the Korea Workers' Compensation and Welfare. The defendant shall be comprised of not more than 60 members, including one chairperson. The chairperson and the members shall be appointed by the President at the recommendation of the Minister of Employment and Labor from among public officials of Grade III or higher or public officials in general service belonging to the Senior Civil Service, judges, public prosecutors, attorneys-at-law, or certified labor affairs consultants for not less than 10 years. The defendant's meeting shall be comprised of nine members, including the chairperson or vice

In this case, as seen in the following Item (f), the health care team and the defendant advisory group are legally organized by the defendant and are qualified as doctors. Even if there is no legitimate qualification for advisory group, the advisory group is not a member of the defendant's meeting, which is the subject of the ruling of this case, and it cannot be deemed that there is a defect in the composition of the defendant, who is the subject of the ruling of this case. Thus, this part of the plaintiff's assertion is rejected.

3) As to the defect in the adjudication procedure

A) As to the assertion of delay in receipt

According to Gap evidence Nos. 2 and 3, the plaintiff submitted a written request for reexamination to the Gwangju Regional Headquarters of Korea Labor Welfare Corporation on February 17, 2014, and the head of the Gwangju Regional Headquarters of Korea Labor Welfare Corporation, on February 21, 2014, although he/she is deemed to have dispatched the plaintiff's written request for reexamination to the defendant on February 21, 2014, according to the whole purport of the entries and arguments in Eul evidence No. 1, the plaintiff's written request for reexamination to the defendant on March 28, 2014 and the defendant's written request for reexamination reached the defendant on March 31, 2014 and reached the defendant's electronic computer system and processed it on April 3, 2014. Thus, the defendant cannot be deemed to have delayed the receipt of the plaintiff's written request for reexamination.

B) As to the assertion of violation of the adjudication period

Article 109(1) and Article 105(1) of the Industrial Accident Compensation Act provide that a decision on a request for reexamination shall be made within 60 days from the date the defendant received a written request for reexamination, and the period may be extended only once by up to 20 days in extenuating circumstances.

In this case, the fact that the Defendant received the Plaintiff’s written request for reexamination on March 28, 2014 and rendered the instant ruling on July 28, 2014 is as seen earlier.

However, the maximum 80-day adjudication period stipulated in the Industrial Accident Compensation Act cannot be deemed to be a sufficient period for fair and appropriate rulings in all cases, regardless of the characteristics of each individual case and the actual conditions. The Industrial Accident Compensation Act does not provide for compelling compliance with the adjudication period through granting special legal effects, such as sanctions upon the expiration of the adjudication period. Thus, the above provision on the adjudication period is a decoration provision that provides guidelines for the adjudication period of a request for reexamination.

Therefore, even if the defendant dealt with the case beyond the adjudication period, it is not illegal in the adjudication procedure, so this part of the plaintiff's assertion is rejected.

C) As to the assertion that the protocol of hearing was not prepared

Article 110(1) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act requires the defendant to prepare a deliberative protocol with regard to the progress of the review, including the case number and name, date and place of the hearing, names of the members present, names of the members present, the names of the persons present, and the details of the hearing. Article 110(1) of the Enforcement Decree of the Industrial Accident Compensation Insurance Operation Rules (hereinafter referred to as the "Operation Rules") enacted pursuant to delegation of Article 107(6) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act provides that when the review meeting of the Review Committee is held

In this case, although there is no dispute that the Defendant did not prepare the protocol of the hearing of the hearing held on May 15, 2014. However, according to the overall purport of Gap evidence Nos. 4, Eul evidence Nos. 6, 7, and 9 and all arguments, the Defendant notified the Plaintiff of the postponement of the hearing date at the hearing meeting held on May 16, 2014, that the Defendant decided to review and review the Plaintiff’s petition for reexamination at the hearing meeting held on May 16, 2014. The Defendant may recognize the fact that the Defendant prepared the document “the result of the meeting of the 34th hearing committee meeting held on behalf of the Plaintiff” stating the number and name of the Plaintiff including the Plaintiff’s petition for reexamination, the date and venue of the hearing, the names of the members present, the names of the parties present, and the contents of the trial meeting, and recorded the contents of the hearing meeting in lieu of preparing the meeting minutes.

Considering that the purport of preparing a deliberative protocol is to clearly record and preserve the contents and progress of the deliberation, the contents and progress of the deliberation meeting can be confirmed through the defendant's notification to the plaintiff, the contents of the 34th meeting of the 34th meeting, and the recording of the deliberation meeting. Thus, even though the defendant did not prepare a deliberative protocol at the deliberation meeting on May 15, 2014, it is difficult to view that the adjudication of this case is unlawful. Accordingly, the plaintiff's assertion on this part is rejected.

D) Regarding the argument that the second hearing without a withholding resolution, the Defendant held the second hearing without a withholding resolution. According to the evidence No. 9, the Defendant may recognize the fact that the Defendant made a withholding resolution in order to conduct an additional investigation against the Plaintiff on May 15, 2014, and the fact that the Defendant notified the Plaintiff of the contents of the resolution on May 16, 2014 is as seen earlier, and thus, the Plaintiff’s assertion on this part is rejected.

E) According to the overall purport of evidence Nos. 6 and 7 as to the argument regarding the protocol of the hearing held by the hearing held on July 18, 2014, the Defendant prepared the protocol of the hearing held on July 18, 2014 and obtained approval from the chairperson of the Defendant, and the Plaintiff’s agent D attended the hearing held on July 18, 2014 and stated for the Plaintiff’s interest. Thus, the Plaintiff’s assertion on this part is rejected.

F) Article 50(1) of the Operating Rules provides that "The Reexamination Committee may organize and operate an expert group of experts, such as doctors, dentists, oriental medical doctors, pharmacists, nurses, attorneys-at-law, and certified labor affairs consultants, in an area related to industrial accident compensation insurance affairs, other than the members provided for in Article 107 of the Act, in order to utilize it for gathering opinions on important issues, including the issue of whether to recognize occupational diseases, in order to ensure the fairness and accurate deliberation and adjudication of the case of the request for reexamination."

According to the purport of the Plaintiff’s evidence No. 4 and the oral argument, two expert members who prepared a written advisory opinion submitted to the instant adjudication process are doctors specializing in urology, urology, etc., and who are not members of the expert group organized by the Defendant, but members of the Defendant. The above expert members present their opinions that it is difficult for the Plaintiff to compare and confirm the Plaintiff’s past history and urology, urology, and urology with normal urology and to recognize urology as additional urology.

According to the above facts, the above expert members are expert members who are legally organized by the defendant in accordance with the operational rules, and the above expert members expressed their opinion as to whether such expert members recognize the plaintiff's 'psychological protection' as additional injury and disease, and there is no defect in the procedure of the adjudication in this case, which is considered as medical opinion. Accordingly, the plaintiff's assertion on this part is rejected.

4) As to the defect in the form of adjudication

A) As to the assertion of defects regarding the determination of the opinion regarding the negotiology, Gap evidence Nos. 21 and 22 was invoked. According to the evidence Nos. 21 and 22, upon the first application for additional diseases on April 29, 2013, the plaintiff entered additional diseases into 'Tcheon MOS2', 'NOS2', and 'NOS2', but around May 16, 2013, changed to 'Tcheon M&M damage, Matern damage by M&S, Mami-S, Mami-Sa, and Mami-Sa, the advisory doctor at the process of the determination shall observe the increase of urine dose in the negotiology in the neusology test and the critical test, but it is reasonable to recognize the fact that the plaintiff is not able to recognize the additional negotiology's function, 'the additional negotiology' without any opinion any more than the basic negotiology function (hereinafter referred to as 20.).

According to the above facts, although the plaintiff's opinion was made before changing the name of additional injury, it can be seen that the plaintiff's opinion was made after reviewing the plaintiff's results of the urology test and the results of the urology test and the results of the urology test, and expressed his opinion about the function of urology, such as urology and urology. Even if the plaintiff changed the name of additional injury to the urology of urology, as long as it is a disease related to the urology of urology, this part of the plaintiff's assertion is not accepted, since the defendant stated in the written ruling of this case by citing his opinion as of May 7, 2013 or based on the plaintiff's urology test, it cannot be deemed that there was any defect in the reasons of the written ruling of this case even if it is stated in accord with the opinion of May 7, 2013.

B) As to the assertion of defect in the Defendant’s advisory society’s opinion. According to the evidence evidence No. 22, the Korea Labor Welfare Corporation may recognize the fact that it received a written opinion of deliberation on whether to recognize the Plaintiff’s additional injury and disease through a large number of advisory doctors on May 15, 2013, which was prior to the original disposition of this case, and the Defendant’s review of all relevant data in the written ruling of this case is based on the opinion of the advisory doctors’ opinion reviewed and diagnosed. It is also the opinion of the advisory doctors’ opinion. It is also the opinion of the original disposition agency’s advisory opinion and the opinion of the review agency’s advisory opinion.

According to the above facts, the defendant merely stated the opinion of the advisory society at the time of the original disposition of this case in the written ruling of this case, and it cannot be deemed that the defendant stated the opinion of the advisory society held by the defendant. Thus, this part of the plaintiff's assertion is rejected.

4. Conclusion

Therefore, the plaintiff's claim is dismissed as it is without merit. It is so decided as per Disposition.

Judges

The presiding judge, the senior judge;

Judges fixed-type

Judges, full-time maternity leave, but not stamped;

Note tin

1) 마미증후군[cauda equina syndrome, 馬尾症候群]은 척추마취 후유증의 하나로 척수마취 후 방광·직장·항문 괄약근의 마비, 회음·하지의 지각·운동부전 등의 마미신경섬유군의 이상증상을 나타내는 것으로, 척추마취 시행시의 감염, 소독액 등이 원인이 되며 척수 수막염의 형태에서 서서히 진행하는 것도 있다.

2) The NOS refers to what is not specified (Not pec).

Attached Form

A person shall be appointed.

A person shall be appointed.

A person shall be appointed.

A person shall be appointed.

A person shall be appointed.