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(영문) 서울고등법원 2016.01.14 2014누8379
요양불승인처분취소
Text

1. Revocation of a judgment of the first instance;

2. The plaintiff's claim is dismissed.

3. All costs of the lawsuit shall be borne by the Plaintiff.

Reasons

1. Details of the disposition;

A. On March 2, 2009, the Plaintiff (D) joined a local self-employed company (hereinafter “local self-employed company”) and took charge of the collection of household wastes (food, plant, fluence, etc.) and recyclables.

나. 원고는 2011. 11. 25. 재활용품 자루를 들어 올리다 허리를 삐끗하는 바람에 “제4-5 요추간 및 제5요추-1천추간 추간판탈출증”(이하 ‘이 사건 상병’이라 한다)이 발병하였다고 주장하면서 2012. 1. 25. 피고에게 요양급여를 신청하였다.

C. On this basis, the Defendant approved the medical care for the instant injury disease only on February 7, 2012 according to the deliberation by the Occupational Disease Determination Committee (hereinafter “instant disposition”), while approving the medical care for the instant injury to the disease (hereinafter “the instant disposition”). In light of the following: “The instant injury was determined as an existing disease, and its work-related relationship is not recognized; however, it is recognized that the likelihood of the outbreak of the relevant injury caused by considering the circumstances leading up to the occurrence of the accident and the progress of medical treatment after the occurrence of the accident, etc.” (hereinafter “the instant disposition”).

Accordingly, the plaintiff filed a request for reexamination with the Industrial Accident Compensation Insurance Reexamination Committee, but was dismissed on May 4, 2015.

[Ground of recognition] Facts without dispute, Gap evidence 1-1, 2, Gap evidence 2, 3, and 4, the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The Plaintiff’s assertion did not have any particular number of problems at the time of the Plaintiff’s entry into a native unemployment. Since the instant injury and disease occurred, or the existing disease has deteriorated beyond natural progress, it is deemed that there was a proximate causal relation between the Plaintiff’s duties and the instant injury and the instant injury and disease. However, the instant disposition based on a different premise is unlawful.

(b)a recognition;

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