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(영문) 서울행정법원 2015.11.20 2015구단59641
진폐보험급여부지급처분취소
Text

1. On June 25, 2015, the Defendant’s disposition to pay pneumoconiosis insurance benefits payable to the Plaintiff is revoked.

2. The costs of lawsuit shall be.

Reasons

1. Details of the disposition;

A. The Plaintiff applied for medical care benefits for pneumoconiosis to the Defendant, who was engaged in dusty work in Btane, etc.

B. From April 8, 2015 to April 10, 2015, the Plaintiff undergone a precise diagnosis of pneumoconiosis at an Ansan Hospital of the Korea Workers’ Compensation and Welfare Service. At the chest video examination, there was 1/1’s opinion in shape/scalep/s, and noise level density, and the primary quantity (FE51) in the pulmonary function examination was 67% of the normal predicted value.

C. On June 25, 2015, the Defendant determined that the Plaintiff’s pneumoconiosis type (0/0) was normal (0/1) and cardiopulmonary function (F1) as a result of the deliberation by the Pneumoconiosis Review Board on the diagnosis of pneumoconiosis, and rendered a disposition of non-approval for pneumoconiosis medical care to the Plaintiff.

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

2. Whether the instant disposition is lawful

A. The Plaintiff asserted that the Plaintiff’s claim constituted a person entitled to pneumoconiosis insurance benefits on a different premise, even though he/she constitutes a person entitled to pneumoconiosis insurance benefits, the instant disposition based on a different premise is unlawful, inasmuch as the shape and size ofp/s, and noise levels are Type 1/1 with a density of pneumoconiosis 1/1, and at the same time, the daily primary quantity (FEV1) is merely 67% of the normal predicted value and thus has a light disability (F1) in cardiopulmonary function.

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

C. According to Article 83-2(1) [Attachment 11-2] of the Enforcement Decree of the Industrial Accident Compensation Insurance Act, in order to be eligible for pneumoconiosis insurance benefits, the pneumoconiosis type should be more than Type 1; whether the pneumoconiosis type has been affected by pneumoconiosis and the progress of pneumoconiosis is determined by reading chest simple radiation; and the classification of pneumoconiosis type should be in accordance with the complete classification prescribed by the International Classification of Pneumoconiosis (ILO) of the International Labor Organization (ILO).

The following circumstances, i.e., the court’s appraisal of the Plaintiff’s chest images, which can be seen by comprehensively considering the records Nos. 1 and 2 as well as the overall purport of the arguments as a result of the request for the examination of medical records to the head of the Korea National University Cancer Hospital, are P/q.

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