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(영문) 서울행정법원 2017.06.15 2015구단58686
신청상병 요양불승인 처분 취소
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. Details of the disposition;

A. On January 30, 2014, around 10:20, the Plaintiff filed an initial medical care benefit on July 3, 2014, under the diagnosis of “the instant accident” due to an accident (hereinafter referred to as “the instant accident”), which goes beyond the entrance door of a dormitory in the B station operated by Sejongmix Co., Ltd. (hereinafter referred to as “instant accident”).

B. On July 21, 2014, the Defendant approved the medical care for the left-hand salt field among the Plaintiff’s applicant’s disease, and issued a disposition not to grant medical care on the ground that there was no proximate causal link between the Plaintiff’s medical care and the Plaintiff’s medical care (hereinafter “instant disposition”).

C. The Plaintiff, who is dissatisfied with the instant disposition, filed a petition for review and reexamination, but was dismissed in entirety.

[Reasons for Recognition] Unsatisfy, Gap evidence 1 to 5, Eul evidence 1 and 2 (including additional number), the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. At the time of the Plaintiff’s assertion, the left part of the elbow was removed from the ground at the time of the instant accident, and the strong shock has broken down with the shoulder. The instant wound was caused by the instant accident, but the Defendant’s disposition on a different premise was unlawful.

B. 1) The "occupational accident" under the Industrial Accident Compensation Insurance Act refers to the worker's injury, disease, disability or death caused by occupational reason, and in order to be recognized as a occupational accident, there should be a proximate causal relation between the business and the accident. In this case, the causal relation between the worker's accident and the business should be proved by the claimant. 2) According to each of the evidence Nos. 4 and 6, the plaintiff's health insurance fact-finding sentence of this case prior to the accident of this case.

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