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(영문) 서울행정법원 2020.05.22 2019구단71748
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 August 14, 2019, the Plaintiff, as an employee of the Plaintiff Company B, was subject to an accident of falling off 1m height from the work site board at a height of 1m while engaged in painting work in guest rooms and households at the site of the hotel building in Gwangjin-gu Seoul Special Metropolitan City (hereinafter “instant accident”).

B. On September 24, 2019, the Plaintiff filed an application for medical care benefits with the Defendant for the instant accident alleging that the injury or disease occurred in the “Semando 5-6 pressure frame, 1, 2, and 3 of Maternal typosis, chlostal typosis, chlostal base, chlostal base, chlostal base, and chlostal typosis.”

C. On October 4, 2019, the Defendant issued to the Plaintiff a medical care non-approval disposition (hereinafter “instant medical care non-approval disposition”) on the ground that the Plaintiff’s injury or disease at the pressure frame No. 5-6 (hereinafter “the instant injury or disease”) was “assumed with a clear pressure frame,” on the ground that the instant injury or disease at the pressure frame No. 5-6 (hereinafter “the instant injury or disease”) was subject to the medical care non-approval disposition (hereinafter “instant disposition”).

[Ground of recognition] Facts without dispute, Gap evidence 1, 4, Eul evidence 3, the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The plaintiff asserted that the plaintiff was diagnosed of the injury or disease of this case after the accident of this case. The disposition of this case on the premise that the injury or disease of this case is not recognized is unlawful.

B. 1) The term “occupational accident” under Article 5 subparag. 1 of the Industrial Accident Compensation Insurance Act refers to an accident caused by an employee’s occupational accident while performing his/her duties, and there is a proximate causal relation between his/her duties and the accident. In this case, the existence of the accident, the causal relation between the employee’s duties and the accident must be proved by the party asserting it. 2) The instant case is about the health unit, Eul’s statement in subparagraph 1, and the hospital of this court.

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