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(영문) 서울행정법원 2013.12.19 2012구단22839
요양급여불승인처분취소
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. Details of disposition;

A. On June 3, 201, the Plaintiff was diagnosed on the part of B of the Seoul Southern-gu Urban Management Corporation, as an accident that took place along with bicycles in the process of managing the facilities of public parking lots in Samsan Park (hereinafter “instant accident”). On December 20, 201, the Plaintiff claimed occupational accidents and filed an application for medical care benefits with the Defendant on December 20, 201.

B. On February 8, 2012, the Defendant took a non-approval disposition on the ground that the instant injury was deemed to be a chronic disease, and that it cannot be seen as an occupational accident. The Plaintiff appealed against the request for examination, but was dismissed on June 26, 2012.

【Ground of recognition】 The fact that there is no dispute, Gap 5, 7, 9, the purport of the whole pleading

2. Whether the disposition is lawful;

A. The plaintiff asserted that the plaintiff exceeded 2003 and was judged at the medical care approval and disability grade No. 4-5 in the 2003 post, and had symptoms of minor scam escape symptoms at the same time. However, since the symptoms of the accident of this case worse and led to the diagnosis of the disease of this case, the defendant's disposition that deemed that the accident was merely a chronic disease is unlawful.

B. (1) Determination of the "occupational accident" under the Industrial Accident Compensation Insurance Act refers to the injury, disease, disability or death of an employee due to an occupational reason, and in order to be recognized as a occupational accident, the accident is caused by the occupational accident, and there is a proximate causal relation between the business and the accident. In this case, the causal relation between the worker's accident and the business should be proved by the claimant.

The existence of a causal relationship shall be determined on the basis of the health and physical conditions of the worker concerned, not the average person, and the degree of proof of a causal relationship must be proved clearly in medical or natural science.

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