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(영문) 서울행정법원 2015.07.24 2015구단50347
진폐보험급여부지급처분취소
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. The Plaintiff, who had been engaged in dusting operations in the coal mine, filed a claim for pneumoconiosis insurance benefits with the Defendant. However, the Defendant conducted a precise diagnosis with the Plaintiff from August 18, 2014 to October 20, 2014, and subsequently, issued a site pay disposition (hereinafter “instant disposition”) on the ground that the Plaintiff’s symptoms constitute “mick-type: Medical certificate (0/1) and cardiopulmonary function (F0)” on October 16, 2014.

[Ground of recognition] Facts without dispute, Gap 1, the purport of the whole argument

2. Whether the disposition is lawful;

A. The Plaintiff’s pneumoconiosis type of the Plaintiff’s assertion falls under Type 1 (1/0), and the instant disposition taken on a different premise should be revoked as it is unlawful.

(b) Entry in the attached Form of relevant Acts and subordinate statutes;

C. 1) Determination 1) In order to diagnose pneumoconiosis under the Industrial Accident Compensation Insurance Act, it is necessary to examine the pneumoconiosis review committee on the result of the health examination. Determination of the type of pneumoconiosis of the relevant worker, the existence and type of annexation, and the degree of cardiopulmonary function of the relevant worker in the above review process shall determine whether to pay medical care benefits, etc. According to the Enforcement Decree of the same Act, the determination of pneumoconiosis and the determination of insurance benefits shall be based on the determination of the criteria for pneumoconiosis and the progress of pneumoconiosis, and the progress of pneumoconiosis shall be determined by the reading of chest simple radiation, and if the form of pneumoconiosis is merely a proof of pneumoconiosis, all insurance benefits shall not be provided in principle. 2) The evidence submitted by the Plaintiff alone is insufficient to recognize that the type of pneumoconiosis of the Plaintiff falls under Type 1. Rather, taking into account the written evidence No. 1 and the purport of the entire arguments in the examination of the medical record

Therefore, the plaintiff's assertion is without merit.

3. As such, the plaintiff's claim is dismissed as it is without merit.

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