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(영문) 서울행정법원 2020.10.28 2019구단66203
요양급여부지급처분취소
Text

1. The Defendant’s disposition of granting medical care benefits to the Plaintiff on November 22, 2018 is revoked.

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

Reasons

1. Details of the disposition;

A. On February 2, 1987, the Plaintiff entered the partnership B, and was promoted from March 1, 2010 to the C Union (hereinafter “instant place of business”) from March 1, 2010, to the “commercial affairs,” and was in charge of overall management of the portion of the economic business.

On January 24, 2015, the Plaintiff attended a family meeting of 19:00, and then singing at around 21:00, but singing at the singing room. However, the Plaintiff was diagnosed as “cerebrovascular blood” (hereinafter “the instant injury”) on the day after she was transferred to the hospital due to abnormal symptoms, such as her head is unable to walk.

B. On May 29, 2015, the Plaintiff filed an application for medical care benefits with the Defendant. However, on December 10, 2015, the Defendant rendered a decision to grant medical care benefits for the Plaintiff on the ground that “the instant injury and disease is deemed to have occurred due to the natural aggravation of existing diseases.”

C. As of January 1, 2018, the Defendant notified the Plaintiff that the matters necessary for determining whether to recognize the occupational disease of cerebrovascular disease or heart disease or cardioscular disease (Notice of the Ministry of Employment and Labor No. 2017-117) was subject to the claim for medical care benefits, which was amended by the Ministry of Employment and Labor.

Accordingly, on October 4, 2018, the Plaintiff again filed an application for medical care benefits to the Defendant.

However, on November 22, 2018, the Defendant: (a) performed the Plaintiff’s work with respect to “the Plaintiff,” and thus, was under heavy stress due to the Plaintiff’s failure to recover rice sales proceeds; (b) this constitutes an increase in work burden, which is a major mental tension; (c) however, there is no sudden and difficult occurrence of a case related to the Plaintiff’s work within 24 hours prior to the outbreak or sudden change in the work environment; (d) there is no increase in the daily work hours by at least 30% compared to the daily work hours prior to the outbreak; and (e) the daily average work hours per week during 12 weeks prior to the outbreak does not fall short of the chronic path (60 hours) set forth in the Ministry of Employment and Labor’s notification; and (e) the Plaintiff did not take appropriate measures to the effect that there was an individual disease,

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