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(영문) 서울행정법원 2020.04.14 2019구단51690
요양급여신청반려처분등취소
Text

1. The Defendant’s disposition of non-approval of additional medical care rendered to the Plaintiff on December 3, 2018 is revoked.

2. The costs of the lawsuit are assessed against the defendant.

Reasons

1. Details of the disposition;

A. From August 24, 1989 to May 15, 2014, the Plaintiff served as the vegetable-line mining center in the Korea Coal Corporation (hereinafter “Mining”).

B. On June 17, 2014, the Plaintiff received a diagnosis of “the part concerning the dubs in the direction direction,” and obtained approval from an occupational disease on December 4, 2014; on December 18, 2015, “the part concerning the dubs in the direction of the left side,” and on December 8, 2016, “the part concerning the dubs in the direction of the left side, and the part concerning the dubs in the right hand tunnel” were approved as an additional injury, and completed the medical care on March 14, 2018.

(hereinafter referred to as the above injury and disease in this case) C.

On July 9, 2018, the Plaintiff submitted to the Defendant “written application for medical care benefits and temporary disability compensation benefits (the first application)” (hereinafter referred to as “the first application”) to the Defendant (hereinafter referred to as “the injury and disease in this case”), and the attached industrial accident compensation insurance statement states as follows: (a) on May 22, 2017, the date of the accident occurred; (b) on January 16, 1999; (c) the date of the first symptoms caused by the disaster; and (d) on a comprehensive check of the status of the injury and disease, the Plaintiff states as follows: (a) the Plaintiff’s submission of the written application for medical care benefits and temporary disability compensation benefits (the first application) to the Defendant.

On July 10, 2018 and July 23, 2018, the Defendant requested the Plaintiff to submit the instant injury and disease again as the instant injury and disease falls under additional medical care and additional medical care.

E. As the Plaintiff did not comply with this, the Defendant confirmed on August 7, 2018 that the Plaintiff did not have any occupational ability, which was additionally exposed to the work experience and burden factors after the Plaintiff’s retirement of the instant mining center, and the instant injury and disease is the injury and disease caused by the work of the previous mining center, and thus, should comply with the procedures for additional injury and additional medical care.

The injury or disease in this case is found in the state of not being additionally exposed to the duties, and in this case, an application for additional medical care and additional injury or disease shall be submitted to be included in the additional injury or disease.

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