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(영문) 서울행정법원 2018.09.06 2018구단52573
진폐요양급여부지급결정처분취소
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. The Plaintiff filed an application for medical care benefits for pneumoconiosis with the Defendant, who was exposed to the final and conclusive free acid in the course of collecting stone, blasting, etc.

B. From March 6, 2017 to March 8, 2017, the Plaintiff was diagnosed with pneumoconiosis in C Hospital, and as a result, was given the opinion of pneumoconiosis type 1 (1/1) in the chest video examination.

C. On May 19, 2017, the Defendant rendered a disposition on the payment of the Pneumoconiosis Medical Care Benefit Board (hereinafter “instant disposition”) to the Plaintiff on the following grounds: (a) as a result of the review by the Pneumoconiosis Review Board on the diagnosis of pneumoconiosis, the Defendant determined that “the conditions of the pneumoconiosis type, the light disorder of cardiopulmonary function (F1), and the non-activity-pulmonary tuberculosis (tb).”

[Ground of recognition] Unsatisfy, Gap evidence Nos. 1 and 2, the purport of the whole pleadings

2. Determination on the legitimacy of the disposition

A. Although the Plaintiff’s assertion falls under the type 1 or more of pneumoconiosis, the Defendant’s disposition of this case made on a different premise is unlawful.

B. Article 83-2(1) [Attachment Table 11-2] of the Enforcement Decree of the Industrial Accident Compensation Insurance Act, which provides for the criteria necessary for the determination of pneumoconiosis pursuant to the delegation of the latter part of Article 91-8(1) of the same Act, provides that “The criteria for determining the degree of pneumoconiosis and cardiopulmonary function, criteria for determining pneumoconiosis disability grade and criteria for recognition of eligibility for medical care” shall be determined by the reading of chest simple radiation image and the progress of pneumoconiosis, and the classification of pneumoconiosis caused by chest simple radiation image shall be in accordance with the complete classification as prescribed by the International Labor Organization (ILO) Act on the Promotion of Pneumoconiosis Videos (ILO 200).

According to the above provisions, in order to be granted a pneumoconiosis disability grade, at least the type of pneumoconiosis shall fall under the type 1, and in order to be recognized as a beneficiary of medical care due to complication, etc., it should fall under cases where active pulmonary tuberculosis is combined with pneumoconiosis symptoms.

In light of the above provisions, this Court's President of the Korean Cinematographic Medical Institute.

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