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(영문) 서울행정법원 2016.06.10 2016구단7975
간병급여지급비대상결정처분취소
Text

1. The instant lawsuit shall be dismissed.

2. The costs of lawsuit shall be borne by the Plaintiff.

Reasons

1. Whether the lawsuit of this case is legitimate

A. On October 8, 2002, the Plaintiff received medical care due to occupational accidents, and completed medical treatment on January 31, 2008, and received class 2 Subparag. 5 of the disability grade. 2) The Plaintiff received nursing benefits for the nursing period from February 1, 2008 to June 30, 2013. On September 18, 2015, the Plaintiff filed a claim for nursing benefits with the Defendant for the nursing period from July 1, 2013 to June 30, 2015.

The claim for nursing benefits which had been submitted with a thickness was processed, but since January 20, 2016, the status of Nign's disease did not meet the criteria for the recognition of occasional nursing benefits under the Industrial Accident Compensation Insurance Act.

In addition, according to the above decision, A shall be informed that the period of claiming nursing benefits from July 1, 2015 to January 19, 2016 may be additionally claimed by submitting a written claim and documentary evidence of nursing.

3) On February 19, 2016, the Defendant decided to pay all the nursing benefits claimed by the Plaintiff on February 19, 2016, and provided guidance to the effect that the Plaintiff is ineligible for nursing benefits after January 20, 2016 as follows (hereinafter “instant guidance”).

(4) After that, on March 25, 2016, the Plaintiff filed a claim for nursing benefits for the nursing period from July 1, 2015 to November 30, 2015, and received nursing benefits for the said nursing period.

[Ground of recognition] Facts without dispute, Gap evidence Nos. 1, Eul evidence Nos. 1 to 5, the purport of the whole pleadings

B. On September 18, 2015, the Defendant decided to pay all of the Plaintiff’s claims for nursing benefits (from July 1, 2013 to June 30, 2015, the period of nursing benefits). However, since the Defendant provided de facto guidance that the amount of nursing benefits may not be paid if it is claimed after January 20, 2016, the instant guidance cannot be deemed an administrative disposition subject to appeal litigation.

(c) any act of the judgment administration.

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