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(영문) 서울행정법원 2015.03.26 2014구단57822
진폐보험급여부지급처분취소
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. The Plaintiff (1941 students) filed an application for medical care benefits for pneumoconiosis with the Defendant, who had been engaged in approximately eight years in the luminous mining center, etc.

B. From July 14, 2014 to July 15, 2014, the Defendant conducted a precise diagnosis of pneumoconiosis with respect to the Plaintiff at the KaTol University Seoul Go Hospital.

C. On October 20, 2014, the Defendant issued a disposition on the additional payment of pneumoconiosis insurance benefits against the Plaintiff (hereinafter “instant disposition”) on the ground that the Plaintiff’s pneumoconiosis disease type (0/1) was suspected, following a review by the Pneumoconiosis Review Board.

【Unsatisfied Facts, Gap 1, 3 evidence, Eul 1's each entry

2. Whether the instant disposition is lawful

A. On May 22, 2014, the Plaintiff’s assertion that a simple chest radiation testing conducted with the Plaintiff at the Katol University Seoul Escar Hospital was made by the medical specialist in charge of the Plaintiff’s disease type No. 1 (1/0). As such, the Defendant should determine the Plaintiff’s pneumoconiosis type No. 1 (1/0) and pay the Plaintiff the pneumoconiosis medical care benefits.

(b) The attached Form of relevant statutes is as follows.

C. (1) According to Article 83-2(1) [Attachment Table 11-2] of the Enforcement Decree of the Industrial Accident Compensation Insurance Act, in order to fall under the subject of pneumoconiosis insurance benefits (health benefits for pneumoconiosis compensation annuities, complications, etc.), the type of pneumoconiosis must be at least one type. The determination of whether pneumoconiosis has occurred and the progress of pneumoconiosis has occurred shall be made by reading a chest simple radiation image, and the classification of pneumoconiosis type C shall be based on the complete classification as prescribed by the International Labor Organization (ILO) Act (ILO).

(2) According to the result of the court’s request for the examination of medical records, it can be recognized that the examination of the department of visual image of the Ansan Hospital at Korea University was conducted on May 22, 2014 and July 15, 2014 by comprehensively taking into account the Plaintiff’s chestless radiation images taken on July 15, 2014, and that the Plaintiff’s form of pneumoconiosis falls under p/q, (0/1), and (4zone.

The degree of suffering from pneumoconiosis and the progress of pneumoconiosis is the chest simple radiation.

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