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(영문) 부산고등법원(창원) 2017.08.23 2016누10643
요양불승인처분취소
Text

1. The plaintiff's appeal is dismissed.

2. The costs of appeal shall be borne by the Plaintiff.

Purport of claim and appeal

The first instance court.

Reasons

1. The reasoning for the acceptance of the judgment of the court of first instance is as stated in the reasoning of the judgment of the court of first instance, except for the addition of the following contents, and thus, it is acceptable in accordance with Article 8(2) of the Administrative Litigation Act and Article 420 of the Civil Procedure Act

[추가하는 부분] 원고는 ‘2014. 9. 18. B 주식회사의 의장1공장에서 고속열차 차량의 공정검사를 위하여 하부덮개 해체 및 전장커넥터 분리 작업을 하다가 우측 어깨 부위의 통증을 느낀 후 C병원에서 2014. 10. 24. 이 사건 상병으로 진단되어 수술을 받았다’고 주장하면서, 한국표준질병사인분류(KCD7) 기준 ‘ⅩⅨ. 손상, 중독 및 외인에 의한 특정 기타 결과, 어깨 및 위팔의 손상(S40-S49), S46 어깨 및 위팔 부위의 근육 및 힘줄의 손상, S46.0 어깨의 회전근개의 근육 및 그 힘줄의 손상’ 중 ‘우측 견관절 전방관절와순 부분 손상 및 우측 견과절 회전근개 부분 손상‘을 상병으로 하여 이 사건 요양급여신청을 하였다.

However, in full view of the evidence in the first instance trial and the fact-finding results of this court's fact-finding with respect to the head of the High University Uniform Hospital, it can be acknowledged that the Plaintiff did not observe the above Korean Standard Disease Disease Death Classification (KS7) in the right shoulder section S46.0 of the Injury Code, and the damage to the right shoulder section of the upper right shoulder section, and contrary to this, it is difficult to believe that the results of the fact-finding with respect to the head of the hospital in this court and the head of the C Hospital are the same.

As such, the instant disposition is legitimate unless the applicant’s injury or disease is recognized. Although the instant disposition is deemed legitimate, even if the Plaintiff’s injury or disease is recognized as a shoulder corresponding to the Korean Standard Disease Disease Classification (KM7) and the combined organization’s disease, M60-M79 (M60-M79), and other annual organization failure (M70-M79), it is a type of disease separate from the upper branch of the instant application, and thus the instant disposition is legitimate.

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