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(영문) 서울행정법원 2021.01.28 2020구합50072
미지급보험급여부지급처분취소
Text

1. On November 4, 2019, the Defendant’s disposition on disability benefits and disability benefits rendered to the Plaintiffs is revoked.

2...

Reasons

Details of the disposition

C (D) From March 25, 1975 to July 1, 1981, and from September 21, 1989 to December 13, 1991, E Co., Ltd. worked as mining source.

C under the diagnosis of pneumoconiosis on May 11, 1992, and on January 29, 1999, C was determined to be the grade 5 of pneumoconiosis disability due to “the 4 type of pneumoconiosis disease and the light of cardiopulmonary function (F1).” On May 25, 2005, C was approved as “the 4 type of pneumoconiosis disease, the 4 type of complication, and the light of cardiopulmonary function (F1),” and died on February 24, 2015 during the medical care.

The Plaintiffs are children of C (hereinafter referred to as “the Deceased”).

The Plaintiffs, “The cardiopulmonary function of the Deceased was aggravated by disability (F2) through high-level disability (F3) before the death.

The Court claimed that the amount of disability benefits and disability benefits should be calculated in consideration thereof, and claimed a difference between the amount determined in the calculation on the premise of the light of the cardiopulmonary function (F1).

On November 4, 2019, the Defendant is difficult to trust the Plaintiffs’ “The mandatory records of the deceased, the inspection records, etc. submitted by the Plaintiffs.”

The deceased maintained the existing result that the cardiopulmonary function of the deceased constitutes a light disability (F1) and thus, the disability grade was subject to a disposition of the difference between disability benefits and disability (hereinafter “instant disposition”). [The grounds for recognition] The fact that there is no dispute, Gap’s evidence Nos. 1, 2, and 3, and Eul’s evidence No. 3, and the purport of the entire pleadings are as shown in the attached Form of relevant statutes.

In full view of the evidence, Gap's evidence, evidence Nos. 4, 5, 6, 10, 11, Eul evidence Nos. 1 and 2, Eul evidence Nos. 1 and 2 (including the number of branches), and the result of requesting the examination of the medical records to Seoul National University Hospital, which was recognized or known by the overall purport of the pleadings, prior to the legitimacy of the instant disposition, the deceased's cardiopulmonary closing function of the deceased person aggravated to f2).

It is reasonable to view that the Plaintiff’s assertion constitutes a serious obstacle to the cardiopulmonary function (F3) among the Plaintiff’s assertion, and it is not acceptable to accept the part that constitutes a serious obstacle to the cardiopulmonary function (F1) at the time of approval of the medical care in 2005.

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