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(영문) 서울고등법원 2015.07.10 2014누64454
요양급여불승인처분취소
Text

1. Revocation of a judgment of the first instance;

2. The Defendant’s disposition of granting medical care benefits to the Plaintiff on October 25, 2013.

Reasons

1. Details of the disposition;

A. From August 6, 1987, the Plaintiff joined B Co., Ltd. (hereinafter “instant company”) and worked in the old and previous factory of this case from that time.

On June 4, 2013, at around 21:20, the Plaintiff was used in the vicinity of the transmitting engine while performing work at the steel in the outer and outer organs inside the workplace, and was diagnosed as “cerebrovascular (hereinafter “the instant injury”).

B. On August 7, 2013, the Plaintiff filed an application for medical care benefits with the Defendant that the instant injury was caused by overwork and stress.

On October 25, 2013, the Defendant rendered a decision not to approve the Plaintiff’s application (hereinafter “instant disposition”) on the ground that “The Plaintiff did not objectively verify the occurrence of a sudden and difficult incident related to the Plaintiff’s work and the rapid change in the work environment within 24 hours prior to the outbreak, and the amount of work, the intensity of work, the responsibility and the change in the work environment, etc. within one week from the outbreak, and the occupational factors likely to deem that there was an excessive physical and mental burden for three months or longer, etc. are not objectively confirmed, and there is no proximate causal relation between the work and the applicant’s disease.”

C. The Plaintiff brought the instant lawsuit against the instant disposition without going through the previous trial procedure.

【Ground of recognition】 An without any dispute, entry of Gap evidence 1-1, 2, 2, and 3, and the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The Plaintiff asserted that the Plaintiff had been working for the first three classes, and due to the rapid increase in the ordered volume, the Plaintiff had worked as two classes from May 4, 2013 in order to set the delivery date, resulting in a sudden increase in work capacity and a change in rhythm of life. As a result, the Plaintiff’s mental and physical division accumulated and led to the instant injury and disease.

The Plaintiff’s blood pressure, blood transfusion, etc.

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