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(영문) 서울행정법원 2019.11.28 2018구단14304
상병보상연금 및 간병료 지급청구 거부 처분취소
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 was enrolled in B on February 24, 2004 and engaged in painting duties, was diagnosed as “TDI’s vocational transplant” on May 2005, and obtained the Defendant’s medical care approval from the Defendant. The medical care is during the period from May 31, 2005 to the present.

B. On November 20, 2017, the Plaintiff filed a claim against the Defendant for injury-disease compensation annuities and nursing fees equivalent to the period from October 12, 2017 to November 10, 2017.

C. On December 6, 2017, the Defendant issued an injury-disease compensation annuity payment disposition against the Plaintiff on the ground that the Plaintiff’s claim for nursing fees (hereinafter “instant nursing fee payment disposition”) was “under the circumstance that the Plaintiff’s nursing service is able to be performed in a condition that it is able to receive medical treatment,” and on December 7, 2017, the Defendant issued an injury-disease compensation annuity payment disposition (hereinafter “instant disability compensation annuity payment disposition”) on the ground that the Plaintiff’s claim for nursing fees falls short of the payment standard for nursing fees in a condition that it is possible to receive medical treatment, and it is confirmed that the Plaintiff did not perform the recent closure function inspection but falls short of the invalidity grade standard according to a medical opinion that his/her labor is limited to a person whose labor is limited to a considerable degree due to the prolonged malfunction of the

The Plaintiff filed a request for each review on the instant nursing charge payment disposition and the injury-disease compensation annuity payment disposition, but the Defendant dismissed all the Plaintiff’s request for review.

[Ground of recognition] Facts without dispute, Gap evidence Nos. 1, 2, 20, 26, Eul evidence No. 10, the purport of the whole pleadings

2. Whether each of the dispositions of this case is legitimate

A. The Plaintiff’s assertion as to the disposition of nursing fees is justifiable. The Plaintiff’s assertion as to the disposition of nursing fees is in a state of need of nursing in order to carry out measures necessary for daily life due to the condition of serious symptoms and hospitalization, and the spouse is currently being accompanied at all times at the time of outpatient treatment. Accordingly, the instant disposition of refusing the Plaintiff’s nursing fees is unlawful. 2) The instant disposition of paying injury-disease-disease compensation annuities is unlawful.

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