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(영문) 서울행정법원 2019.04.10 2018구단9654
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. On July 13, 2016, the Plaintiff was a worker in daily work at the construction site of the new medical facility in Songpa-gu Seoul, Songpa-gu, Seoul, and was subject to approximately 10km of the 13m height above that of the Plaintiff’s head and necking (hereinafter “instant accident”) and was subject to the Defendant’s disposition of approval for medical care for the head and scopical base from the Defendant on December 26, 2016.

B. Meanwhile, after the occurrence of the instant accident, the Plaintiff was diagnosed as “the brain-dead, trauma stress disorder, dystrophism, and dystrophism” (hereinafter “instant injury”). On July 21, 2017, the Plaintiff filed an application for medical care benefits with the Defendant on the ground that the instant injury was an additional injury.

C. However, on August 22, 2017, the Defendant rendered a decision not to approve the Plaintiff’s application for medical care benefits for the said additional injury (hereinafter “instant disposition”) on the ground that the symptoms and progress of the Plaintiff complained against the Plaintiff in the instant injury, and that “the blood plate decrease and the scarcity scarcity are an existing disease with no causal link with the instant accident.”

The Plaintiff dissatisfied with the instant disposition and filed a request for review on November 23, 2017, but the request for review was dismissed on February 5, 2018.

[Reasons for Recognition] Facts without dispute, Gap's statements, Gap's evidence Nos. 2, 7, 10, 13 through 16, 19, 35, and the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The gist of the Plaintiff’s assertion is the injury or disease all caused by the instant accident, which was omitted at the time of the previous medical care approval.

Therefore, the defendant's disposition of this case made on a different premise is unlawful.

B. According to the Industrial Accident Compensation Insurance Act, "occupational accident" means an injury, disease, or physical disability caused by an employee's work while performing his/her duties.

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