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(영문) 부산지방법원 2015.05.27 2013구단1649
요양급여불승인처분취소
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. While the Plaintiff was engaged in pressing operations at the site of the installation of a machine frame in the Gandong Co., Ltd., the Plaintiff received medical care from the Defendant with the approval of the medical care for the head, arms, and bridge (hereinafter “the instant accident”) as the Plaintiff was faced with the incident involving the head, arms, and legs (hereinafter “the instant accident”) due to the decline of the bridge at around 10:0 on October 28, 2005, the Plaintiff was under way at the site of the installation of the machine frame in the Gandong Co., Ltd. (hereinafter “the instant accident”).

B. On November 5, 2005, the Plaintiff started medical care from November 5, 2005, and completed medical care on January 31, 2010, and was judged by the Defendant as Grade 8 (Grade 9 on the mental function disorder and Grade 12 on the right shouldering function).

C. After that, on June 23, 201, the Plaintiff was approved of additional medical care by the Defendant on the grounds that it is necessary to conduct satisfying satisfy between the 3 balance of the right side and the 3 balance of the raw materials, and applied for additional medical care during the period of additional medical care, and was approved of additional injury and disease on November 28, 201, and is currently under medical care for this reason.

On the other hand, on December 6, 2011, the Plaintiff was diagnosed additionally, and filed an application for additional medical care with the Defendant. However, on March 8, 2012, the Defendant rendered a disposition not to approve the Plaintiff’s condition on the ground that “the Plaintiff’s condition was worse than at the time of the completion of medical care, and no evidence exists that can be seen as a qualitative mental disorder.” On the other hand, on March 20, 2013, the Plaintiff filed an administrative litigation seeking the revocation of the disposition under the Busan District Court Decision 2013Gudan677, Busan District Court Decision 2013, but the lawsuit was withdrawn upon confirmation.

E. After that, the Plaintiff asserts that the instant additional injury occurred due to the accident in the instant case, and thereafter, to the Defendant.

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