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(영문) 서울행정법원 2019.02.08 2018구단68288
요양불승인처분취소
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, who worked in the mining stations operated by B, etc., was diagnosed with pneumoconiosis at C Hospital from February 20, 2018 to February 21, 2018.

B. On May 14, 2018, the Defendant rendered a disposition to pay pneumoconiosis insurance benefits installment against the Plaintiff on the ground that both the Plaintiff’s pneumoconiosis type and cardiopulmonary function were normal through a review by the Pneumoconiosis Review Committee as to the result of the diagnosis conducted by the above C Hospital.

(hereinafter “Disposition in this case”). 【No dispute over the grounds for recognition”, Gap’s evidence Nos. 1, 2, and 3, Eul’s evidence Nos. 1 and 2, and the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. A physician in charge of pneumoconiosis belonging to C hospital, who is a health examination institution of the Plaintiff, presented his opinion that the Plaintiff’s pneumoconiosis type constitutes Type 1 (1/0). In light of this, the Plaintiff’s pneumoconiosis grade falls under Grade 13.

Therefore, the instant disposition, which was based on a different premise, should be revoked as it is unlawful.

(b) The details of the relevant statutes are as shown in the attached statutes.

C. According to Articles 91-6(1) and 91-8(1) and (2) of the Industrial Accident Compensation Insurance Act, the Defendant shall determine the type of pneumoconiosis of the relevant worker, whether there exists a merger certificate and type, and the degree of cardiopulmonary function of the relevant worker after undergoing deliberation by the Pneumoconiosis Deliberation Committee as to the result of the precise diagnosis conducted by a health examination institution, and shall determine whether to pay medical care benefits

According to Article 83-2(1) [Attachment 11-2] of the Enforcement Decree of the same Act, in order to be eligible for pneumoconiosis compensation annuities, the pneumoconiosis type shall be higher than the type 1, whether the pneumoconiosis type has occurred and the progress of pneumoconiosis is determined by reading chest simple radiation image, and the classification of pneumoconiosis type shall follow the complete classification prescribed by the International Classification of Pneumoconiosis Videos (ILO) of the International Labor Organization (ILO).

The case is returned to the case and entered in the Certificate No. 2, and to the Director of the D Hospital of this Court.

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