최초요양급여 불승인처분취소
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 September 2, 2014, the Plaintiff worked as an employee of B (hereinafter “company”) from September 2, 2014, and, around 17:00 on June 14, 2015, after gas delivery to the transaction partner and returned to the company, the Plaintiff was a traffic accident that meets the instant traffic accident (hereinafter “instant traffic accident”).
On June 15, 2015, the Plaintiff did not work at the Plaintiff’s home on June 15, 2015, and the Plaintiff visited the Plaintiff’s home, and sent the Plaintiff to D Hospital because it was hicking and leaving a good condition. The Plaintiff was diagnosed as “the Plaintiff’s home-to-bed-bed-bed-to-bed-bed-be from the electric transport connection (hereinafter “instant wound”).
B. The Plaintiff asserted that the instant injury and disease had a causal relationship with his/her duties, and on July 7, 2015, the Defendant applied for medical care benefits to the Defendant. However, on September 24, 2015, the Defendant rendered a disposition of non-approval for medical care on the ground that the correlation with the duties of the instant injury and disease is not recognized.
C. On June 14, 2018, the Plaintiff applied for medical care benefits again to the Defendant. However, on April 4, 2019, the Defendant rendered a re-examination to the Industrial Accident Compensation Insurance Review Committee for the purport of seeking revocation of the instant disposition on April 26, 2019, following deliberation by the Occupational Disease Determination Committee (hereinafter “instant disposition”). D. The Plaintiff filed a request for reexamination with the Industrial Accident Compensation Insurance Review Committee for the purport of seeking revocation of the instant disposition on April 26, 2019, and the said claim was dismissed on July 19, 2019.
2. Whether the instant disposition is lawful
A. The plaintiff's assertion that the traffic accident of this case occurred with an external trauma, so it is clear that there is a proximate causal relation with the business.
The plaintiff suffered a significant injury due to the traffic accident of this case, and there was a tension, interest, blank, play, etc. to the extent that it was unexpectedly difficult to predict. The average working hours per week during 12 weeks prior to the occurrence of the plaintiff.