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(영문) 서울행정법원 2020.11.25 2020구단60539
미지급보험급여부지급처분취소
Text

The plaintiff's claim is dismissed.

Litigation costs shall be borne by the plaintiff.

Reasons

1. Details of the disposition;

A. The deceased B, who is the spouse of the Plaintiff, worked in the D Mining Center (hereinafter “the deceased”), was diagnosed with pneumoconiosis on July 21, 2006, and as a result of the precise diagnosis of pneumoconiosis from August 28, 2006 to September 2, 2006, the disability grade No. 13 grade No. 16 was determined. 16.

B. Although the Deceased was judged as Grade 16 of the disability grade based on the diagnosis of pneumoconiosis continuously after the diagnosis of pneumoconiosis on June 25, 2019, he/she received a re-examination from the E Hospital on August 19, 2019 to August 21, 2019, “ Pneumoconiosis-type Nos. 1 (1/0), combined pulmonary tuberculosis (tbbbb), and re-examination of cardiopulmonary function (tbbbbb: shortage of credibility of cardiopulmonary function examination)” (hereinafter “the result of the instant precise examination”), and was re-examined at the E Hospital on October 30, 2019, and was requested again for re-examination due to lack of credibility of cardiopulmonary function examination.

C. On December 9, 2019, the Deceased died before re-inspection. The Plaintiff, the deceased’s spouse, filed a claim for unpaid insurance benefits ( Pneumoconiosis compensation annuity) against the Defendant on the ground that the deceased’s pneumoconiosis disability grade falls under class 1 on the grounds of the instant precise diagnosis result. However, on February 13, 2020, the Defendant determined that the result of the instant precise diagnosis conducted from August 19, 2019 to August 21, 2019 by the K Hospital requires a re-inspection at the K Hospital, but it is confirmed that the result of re-inspection is not returned.”

[Ground of recognition] The fact that there is no dispute, entry of Gap's 1 through 5, purport of whole pleading

2. Whether the instant disposition is lawful

A. At the time of the death of 2019, the Plaintiff’s assertion of the pneumoconiosis type 1, and the cardiopulmonary function of the deceased as at the time of the death of 2019, falls under class 1, and thus, the pneumoconiosis grade of the deceased should be considered as class 1. However, the premise is different.

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