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(영문) 서울행정법원 2015.07.15 2014구단58863
진폐보험급여부지급처분취소
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 applied for medical care benefits for pneumoconiosis to the Defendant, who was engaged in dusty work in Btane, etc.

B. On October 13, 2014, the Defendant rendered a disposition not to approve the medical care for pneumoconiosis to the Plaintiff according to the result of deliberation by the Pneumoconiosis Review Board [the pneumoconiosis-type circumstances (0/0), and the altitude disorder (F3).

[Ground of recognition] Facts without dispute, Gap evidence No. 1, Eul evidence No. 3, purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The Plaintiff’s assertion reveals that, as a result of the precise diagnosis of pneumoconiosis conducted by Boansan Hospital from July 15, 2014 to July 17, 2014, the Plaintiff constitutes class 1 of pneumoconiosis disability grade since the shape/scale is q/q/1.5m to 3mm, noise level is 1/0, and the density of noise level is 1/0; at the same time, REV1 (daily volume) is 37% of normal predicted values, and thus, the Plaintiff’s assertion constitutes class 1 of pneumoconiosis grade.

Nevertheless, the instant disposition based on a different premise is unlawful.

B. In full view of the overall purport of the argument in the medical record appraisal as to the head of the Seoul Hospital of this court, the court’s appraisal of the Plaintiff’s medical record should be determined by the chest X-ray test, which is the standard prescribed by the Enforcement Decree of the Industrial Accident Compensation Insurance Act. According to the standard, the Plaintiff’s pneumoconiosis type can be acknowledged as having presented a medical opinion that the Plaintiff’s pneumoconiosis type is diagnosed as pneumoconiosis certificate (the shape/size is below 1.5mp, the noise level is below 0/1mp), and in light of this, there is insufficient evidence to acknowledge that the Plaintiff’s pneumoconiosis type is more than Type 1 solely on the basis of the written evidence No. 2 and evidence No. 2, and there is no other evidence to prove otherwise.

3. In conclusion, the plaintiff's claim of this case is dismissed as it is without merit. It is so decided as per Disposition.

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