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(영문) 서울행정법원 2016.05.27 2014구단11185
요양비일부부지급처분취소
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 January 9, 2014, the Plaintiff was recognized as an occupational accident and claimed one grade nursing fee for the period from January 19, 2014 to February 19, 2014 during which medical care was provided. The Plaintiff claimed one grade nursing fee for the period from January 19, 2014 to February 19, 2014.

B. On February 25, 2014, the Defendant rendered a disposition to pay only class 3 nursing fees according to medical opinions that “the payment of class 3 nursing fees is reasonable for both sides of the Plaintiff” (hereinafter the instant disposition).

C. The Plaintiff filed a petition for review against the instant disposition, but was dismissed on May 13, 2014.

[Ground of recognition] Facts without dispute, Gap 1, 2, purport of the whole pleadings

2. Whether the disposition is lawful;

A. The plaintiff's assertion is that the plaintiff has no urology and urology with the lower half-class part of his/her mouth, and needs another person's assistance at all times, such as the occurrence of bathing, and thus, he/she should be paid one-class nursing

Therefore, the instant disposition is unlawful.

B. According to Article 40(4) and (5) of the Industrial Accident Compensation Insurance Act, the scope of medical care benefits includes nursing and nursing, and the criteria for calculating medical care benefits, such as the scope of medical care benefits and expenses, are to be determined by Ordinance of the Ministry of Employment and Labor. Accordingly, Article 11(1) and (2) of the Enforcement Rule of the same Act provides nursing services to an employee under medical care separately depending on the degree of injury, disease, and need for nursing, and where it is recognized that the state of injury or disease of the employee under medical care is medically in need of nursing of another person, “in cases where the injury or disease of the employee under medical care is medically in need of nursing” due to paralysis, etc., or where a person who needs to change his/her body from time to time to time to prevent a

Furthermore, Article 13 of the Enforcement Rule of the Industrial Accident Compensation Insurance Act takes into account the degree of nursing.

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