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(영문) 부산지방법원 2020.04.22 2019구단21010
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 November 15, 2016, the Plaintiff was used as a machine pipeline system under the control of B, and received medical treatment for a cerebral cerebral cerebral cerebral cerebral cerebral cerebral Spona (hereinafter “the instant injury”).

B. On July 2, 2019, the Plaintiff claimed for medical care expenses equivalent to class 2 of the nursing class for the period from June 5, 2019 to June 30, 2019 on the ground that “a person who is unable to engage in any action necessary for daily life by having her mental disorder caused a malute or a disturbance due to brain damage,” and the Plaintiff claimed to the Defendant for medical care expenses equivalent to class 2 of the nursing class.

C. On July 26, 2019, the Defendant determined the Plaintiff as a nursing class 3 according to the advisory doctor’s opinion, and paid nursing fees applying the determination as medical care expenses.

[2] The court below's determination of grade 3 of nursing care and part of the site price for medical care expenses (liver medical care expenses) 【Disposition of this case'

2. Whether the instant disposition is lawful

A. The Plaintiff’s assertion is not possible to communicate with the Plaintiff, and the physical strength of the Plaintiff has decreased considerably to its right-hand end, making it difficult to change his body or make his actions necessary for daily life so that it can not be forceed by his own, and thus, constitutes 1 to 2-class nursing as it is always or considerably necessary to assist others.

On a different premise, the instant disposition is unlawful.

(b) as shown in the attached Form of the relevant statutes.

C. 1) Article 11(1) and (2) of the Enforcement Rule of the Industrial Accident Compensation Insurance Act provides that the nursing fees shall be part of the medical care benefits. Article 11(2) of the Enforcement Rule of the same Act separates depending on the state of injury or disease of a worker under medical care, the degree of need for nursing, and “a person who has considerable difficulty in medical treatment, such as being unable to communicate with any psychosis or mental disorder,” (Article 2(4) and 2(5).

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