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(영문) 서울행정법원 2016.05.11 2014구단17138
추가상병및재요양급여불승인처분취소
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 June 9, 2012, the Plaintiff was an employee of the known technology company, who was employed in the field of construction work for the prevention of abortion in the Taecheon-si Public Health Center (hereinafter “the first injury and disease”), and entered into the upper and lower mouth of the river (hereinafter “the first injury and disease”) and received medical care from the Defendant on June 28, 2012, and received medical care from the industrial accident compensation insurance medical institution from around that time until August 31, 2013.

B. On April 15, 2014, the Plaintiff filed an application with the Defendant for approval of additional medical care on the grounds that the trineal disorder and the trine aftermathosis (hereinafter collectively referred to as “each of the instant injury”) occurred due to the first injury.

However, on July 7, 2014, each of the instant injury and disease actually occurred.

The non-approval decision was made on the ground that it is difficult to expect the treatment effect due to additional medical care.

(hereinafter “instant disposition”). C.

On July 14, 2014, the Plaintiff appealed and filed a request for review on July 14, 2014, but the Defendant dismissed the request on October 6, 2014.

[Ground of recognition] Facts without dispute, Gap evidence Nos. 2, 7, 8, 9, 10, 11, 5-2, 3, Eul evidence Nos. 1, 2 and 3 (including all kinds of numbers if there are several numbers among those not separately indicated,), Gap evidence Nos. 1 and 3, and the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. Since the Plaintiff’s first injury or disease caused each of the instant injury or disease, the instant disposition was unlawful.

B. It is as stated in the relevant laws and regulations attached thereto.

C. The burden of proof 1 additional medical care benefits is an additional discovery of an injury or disease caused by an occupational accident, or a new disease caused by an injury or disease caused by an occupational accident, and thus requires medical care, the person who received the medical care benefits has become the subject of medical care after recovery.

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