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(영문) 서울행정법원 2018.09.19 2017구단68359
요양급여부지급처분취소
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 February 26, 2016, the Plaintiff was a person working in a mining office, such as B, etc., and was diagnosed as “Madsung Closed Disease” (hereinafter “the instant injury”), and applied for medical care benefits to the Defendant.

B. However, on December 27, 2016, the Defendant rendered a disposition to grant medical care non-approval (hereinafter “instant disposition”) to the Plaintiff on the ground that “the instant injury and disease cannot be recognized as an occupational disease” was determined by the Seoul Occupational Disease Determination Committee.

C. The Plaintiff filed a request for review against this objection, but was dismissed.

[Ground of recognition] Unsatisfy, Gap evidence Nos. 4 and 16, the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The plaintiff alleged that the plaintiff had been exposed to dust while working in a mining center for about 30 years, and the disease of this case occurred. However, the defendant's disposition of this case on different premise is unlawful.

B. Determination 1) Since an occupational accident under the Industrial Accident Compensation Insurance Act refers to a disease caused by an employee’s occupational accident during his/her work, there must be a causal relationship between the occupational and the disease. The causal relationship must be proved by the party asserting it. The causal relationship must not be explicitly proved in medical and natural science, even if it is not necessarily necessary to establish it, a proximate causal relationship between the occupational and the disease can be inferred (see, e.g., Supreme Court Decision 2001Du7725, Feb. 5, 2002). However, in light of the following circumstances, evidence submitted by the Plaintiff alone is insufficient to induce the Plaintiff’s occupational accident.

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