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(영문) 서울행정법원 2020.04.22 2018구단13851
요양비일부부지급처분취소
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 October 22, 2008, the Plaintiff obtained the approval for medical care for the injury and disease of the “stolley-stolley-stoke-s to the left side” due to occupational accidents, and provided medical care until December 10, 2014.

B. On June 3, 2015, the Plaintiff filed an additional injury and disease with the Defendant on the part of the side of the region, the left-hand slot, and the Defendant’s application for the additional injury and disease on the “infection of the inner side of the region” but, after non-approval on June 22, 2015, obtained the approval of the additional injury and disease from the Defendant only on October 13, 2017, pursuant to the recommendation for mediation in the relevant administrative litigation (Seoul Administrative Court No. 2016Gudan12366, hereinafter “related litigation”).

C. On March 28, 2018, the Plaintiff claimed for medical care expenses for the period from October 29, 2013 to March 22, 2018 with respect to the instant injury and disease to the Defendant.

On April 10, 2018, the Defendant issued a partial partial installment payment disposition (hereinafter “instant disposition”) against the Plaintiff on the ground that “The period from the diagnosis of the infection on June 3, 2015 to June 22, 2016, to the six months from the date of operation due to the infection, shall be determined as the period of medical care, and the subsequent period shall be deemed as symptoms, and it is reasonable to recognize the period thereafter.”

According to the instant disposition, the Defendant paid the Plaintiff medical care expenses for the period from June 3, 2015, which was six months after the date of the instant medical examination to December 22, 2016, which was six months from the date of the surgery.

【Ground of recognition】 The fact that there has been no dispute, Gap evidence 1, Eul evidence 1 and 3, and the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The Plaintiff’s assertion is an unlawful disposition that rendered a decision on the installment payment of medical care expenses for a certain period, on the premise that the Plaintiff was in need of continuous medical treatment as to the instant injury and disease from October 29, 2013 to March 22, 2018, and the symptoms are not fixed.

B. 1) Industrial Accident Compensation Insurance Act (hereinafter referred to as “Industrial Accident Compensation Insurance Act”).

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