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(영문) 서울고등법원 2016.05.12 2015누45573
진료계획서불승인처분취소
Text

1. The plaintiff's appeal is dismissed.

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

Purport of claim and appeal

The first instance court.

Reasons

1. Details of the disposition;

A. On October 22, 2008, the Plaintiff was diagnosed as the left-hand sloping fever (hereinafter “instant injury”) due to an occupational accident, and was approved by the Defendant from around that time to August 26, 2009 as the medical care was provided from January 16, 2012 to October 26, 2013.

B. On October 11, 2013, B hospital that treated the Plaintiff during the period of the above additional medical care submitted to the Defendant a medical treatment plan stating that the period of the medical care should be extended by nine weeks (from October 27, 2013 to December 27, 2013) for physical therapy and rehabilitation treatment for the instant injury and disease.

C. On October 28, 2013, the Defendant rendered a disposition to reduce the treatment period from October 27, 2013 to October 31, 2013 and to deny the remaining treatment plan (hereinafter “instant disposition”).

[Ground of recognition] Facts without dispute, Gap evidence 1, Eul evidence 1 through 4 (including each number in the case of provisional evidence) and the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The plaintiff asserted that the disposition of this case, which was issued on the premise that the plaintiff's symptoms have been fixed, was unlawful since five times since the disaster occurred on October 22, 2008, because the plaintiff had undergone an operation for the disease of this case, and even until now, the symptoms of the disease of this case cannot be deemed to have been fixed at the time of the disposition of this case as the pain of the operation department continued to require continuous treatment.

B. Article 5 subparag. 4 of the Industrial Accident Compensation Insurance Act provides that the term “cure” means that an injury or disease completely recovers or the effect of treatment is no longer expected and the symptoms thereof are fixed, and Article 47 of the same Act and Article 41 of the Enforcement Decree thereof submit a medical treatment plan where an industrial accident insurance-related medical institution needs to extend the period of medical treatment.

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