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(영문) 부산지방법원 2015.08.12 2014구단1493
산업재해보상보험요양급여불승인처분취소
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;

가. 원고는 2013. 6. 17. 10:00경 주식회사 두연건설(이하 ‘소외 회사’라 한다) 소속 일용근로자로서 밀양시 무안면 가복세천정비공사 현장에서 석축작업을 하던 중 무거운 돌을 밀어 넣다가 허리와 어깨가 삐끗하여 주저앉는 사고(이하 ‘이 사건 사고’라 한다)를 당하여 ‘좌측 회전근개 파열’(이하 ‘이 사건 상병’이라 한다)을 진단받았다며 피고에게 요양급여 신청을 하였다.

B. Accordingly, on June 9, 2014, the Defendant rendered the instant disposition rejecting the application for medical care benefits on the ground that “the proximate causal relation between the instant accident and the instant injury and disease is not recognized” against the Plaintiff.

[Ground of recognition] Facts without dispute, Gap evidence Nos. 4 and 5, the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The Plaintiff asserted that he was 10 to 70 km by the Plaintiff’s her hand.

was issued.

At least 400 stones were stockpiled a day by seeing on the left or right, and due to the nature of the work, there is a possibility that the revolving of the power is likely to occur by using excessively the shoulder boom inevitably.

Meanwhile, the Plaintiff had no pain on the left-hand shoulder before the instant accident occurred. After the instant accident, the Plaintiff was operated by seling the pass on the left-hand shoulder.

Therefore, since the injury and disease of this case is recognized as causation with the accident of this case, the disposition of this case which rejected the plaintiff's application for medical care benefits on different premise is unlawful.

B. According to the Industrial Accident Compensation Insurance Act, the "occupational accident" refers to an employee's injury, disease, disability or death caused by an occupational reason, and in order to be recognized as a disaster due to an occupational reason, the accident in question is caused by the occupational reason, and there is a proximate causal relation between the occupational accident and the accident, and in this case the worker's accident.

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