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(영문) 서울행정법원 2018.08.31 2017구단81178
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 is a taxi engineer affiliated with B Co., Ltd., and around 04:00 on July 31, 2016, while driving a taxi with customers on board and driving the taxi as Seoul Olympic Games, the Plaintiff was diagnosed as “the instant accident” (hereinafter “the instant accident”), and applied for medical care benefits to the Defendant on November 2, 2016.

B. However, on November 21, 2016, the Defendant rendered a disposition not to grant medical care (hereinafter “instant disposition”) to the Plaintiff on the ground that “the proximate causal relation between the Plaintiff and the instant branch is not recognized” (hereinafter “instant disposition”).

C. The Plaintiff appealed and filed a request for review and reexamination, but all of which were dismissed.

[Ground of recognition] Unsatisfy, entry of Gap evidence 1 to 4, purport of whole pleadings

2. Whether the instant disposition is lawful

A. The Plaintiff’s assertion continued to work from around 19:20 on July 30, 2016 to around 04:40, and was in a very light of body at the time of the instant accident. The Plaintiff’s allegation was unlawful in the instant disposition on the grounds that the instant injury and disease was caused by the shock on the part of the Plaintiff, while the Plaintiff, while driving a taxi at the instant time, was at a very low level, at the time of the instant accident. The instant disposition on a different premise, is unlawful.

B. The term "occupational accident" under the Industrial Accident Compensation Insurance Act refers to an employee's injury, disease, disability, or death caused by an occupational reason. Thus, there should be a proximate causal relation between the employee's work and the injury. In this case, the causal relation between the employee's work and the injury should be proved by the party asserting it. However, the causal relation does not necessarily have to be proved by medical or natural science, and it is presumed that there is a proximate causal relation between the work and the injury in light of all circumstances.

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