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(영문) 서울행정법원 2014.05.29 2013구단51964
요양불승인처분취소
Text

1. The Defendant’s disposition of refusal to grant medical care to the Plaintiff on May 13, 2013 is revoked.

2. The costs of the lawsuit are assessed against the defendant.

Reasons

1. On March 7, 2013, the Plaintiff was an employee engaged in the business of digging and collecting coal for 17 years in the Korea Coal Corporation B, etc., and applied for medical care for pneumoconiosis. On May 13, 2013, the Defendant issued a non-approval disposition (hereinafter “instant disposition”) on the ground that the Plaintiff’s precise diagnosis of pneumoconiosis against the Plaintiff constitutes “the conditions of pneumoconiosis disease (0/0) and the conditions of cardiopulmonary function (F0)” as a result of the precise diagnosis of pneumoconiosis against the Plaintiff on May 13, 2013, the fact that the Plaintiff did not dispute between the parties or is recognized

2. Whether the disposition is lawful;

A. " Pneumoconiosis" under the Industrial Accident Compensation Insurance Act refers to a disease, the main symptoms of which are a bruplic change caused by the inhaled dust, and the pneumoconiosis review committee as to the result of a health examination is required for the diagnosis of pneumoconiosis. In the above review process, determination of the type of pneumoconiosis, complication, type, degree of cardiopulmonary function, etc. of the relevant worker shall determine whether to pay medical care benefits, etc.

The Enforcement Decree determines the criteria for the determination of pneumoconiosis and the determination of insurance benefits, and the progress of pneumoconiosis shall be determined by reading a chest simple radiation image, and it shall be determined by both chests, where the noise level in its original or influent form is high, and there is no large fluence, and where it is deemed that there is no large fluence, it shall be determined that it falls under the pneumoconiosis disability grade of class 13 without cardiopulmonary function disorder as the type 1 of pneumoconiosis type, and where it is more than the type 1 of pneumoconiosis type and the engine expansion, etc. is confirmed due to a merger of pneumoconiosis, it shall be recognized as the subject of medical care.

B. Prior to the determination of the aforementioned evidence, the following circumstances are acknowledged by adding up the descriptions of Gap evidence Nos. 2-1, 2, and Eul evidence Nos. 1 through 3 and the results of the medical record appraisal commission and fact-finding inquiry with respect to the head of the Seoul Hospital Hospital of the Republic of Korea in this Court, namely, the result of the precise diagnosis of pneumoconiosis conducted five times from February 24, 2006 to March 7, 2013.

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