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(영문) 서울행정법원 2020.09.22 2019구단62126
요양급여불승인처분취소 청구의 소
Text

The plaintiff's claim is dismissed.

Litigation costs shall be borne by the plaintiff.

Reasons

1. Details of the disposition;

A. On November 9, 2018, the Plaintiff (1956) was a worker in daily work who belongs to the Co., Ltd.B, and was faced with an accident that was brought up while taking over the concrete floor of columns at the construction site of C(P) in Gyeyang-gu Incheon, Incheon (hereinafter “the instant accident”).

On November 12, 2018, the Plaintiff was diagnosed as “heat of half-mathum in the fluoral side” (hereinafter “the instant wound”), and applied for medical care approval to the Defendant on November 30, 2018.

B. On December 10, 2018, the Defendant changed the name of the Plaintiff to “the instant accident” on the ground that “it is deemed that it is true that the instant accident is a fact, but it is deemed that the instant wound is a earthquake-surfed surf, and it is reasonable to approve the change to the right-hand surfed salt field due to the fact that it is a medical opinion of the Defendant’s advisory opinion that it is reasonable to approve the change to the right-hand surf salt in the process of the disaster” (hereinafter the instant disposition included a disposition of non-approval of the medical care for the instant injury, and that

C. The Plaintiff filed the instant lawsuit upon filing a petition for review.

[Ground of recognition] Facts without dispute, Gap evidence 1, 2, Eul evidence 1, the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. There is no dispute between the parties as to the facts at issue of the instant accident, and it is a matter of issue whether there is a proximate causal relationship between the instant accident and the instant accident.

B. (1) Determination of the Industrial Accident Compensation Insurance Act refers to the disease caused by an occupational accident under the Industrial Accident Compensation Insurance Act during the performance of the worker’s duties. As such, there should be a causal relationship between the occupational and the disease; the causal relationship must be proved by the party asserting it; and even if it is not necessarily required to prove clearly medical and natural science, proximate causal relationship between the occupational and the disease may be inferred, taking into account all the circumstances.

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