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(영문) 서울행정법원 2014.11.05 2014구단50746
최초요양급여신청불승인처분취소
Text

1. The Defendant’s disposition of non-approval of the first medical care benefit application rendered to the Plaintiff on November 13, 2013 is revoked.

2. The costs of lawsuit shall be.

Reasons

1. Details of the disposition;

A. A. Around December 2008, the Plaintiff (B) joined D&C Co., Ltd. (hereinafter “D&C”) and worked for approximately four years in the logistics warehouse.

From March 2009, the Plaintiff left from Korea on July 31, 2013, when receiving physical treatment from one Council member or from one Council member, and was hospitalized on or around August 29, 2013 after being transferred to an ambulances, and on September 4, 2013, the Plaintiff was diagnosed as the result of the MIM shooting on September 4, 2013.

B. On October 14, 2013, the Plaintiff filed an application for medical care benefits for the instant injury and disease with the Defendant. However, the Defendant rendered a non-approval disposition on November 13, 2013 (hereinafter “instant disposition”) on the ground that “The Non-approval Order of November 13, 2013 (hereinafter “instant disposition”) was rendered on the following grounds: (a) the Non-approval Order of November 13, 2013 (hereinafter “instant disposition”) was observed in a acute position; (b) the content of the business; (c) the substance of the business; and (d) the career of the applicant’s injury and injury, taking into account; and (d) it is deemed that it caused a sudden marity that was not visible at the time of retirement.”

[Ground of recognition] Unsatisfy, Gap evidence 1

2. The gist of the plaintiff's assertion is that the plaintiff joined the company of this case while engaged in the business of dealing with heavy objects for four years, and this led to the injury and disease of this case. Thus, the causal relationship between the business is recognized.

3. Whether the instant disposition is lawful

A. In full view of the facts of recognition, medical opinion evidence No. 1 to No. 7, and evidence No. 1 to No. 6, and the overall purport of the argument at the request of the medical record appraisal to the head of the Gamama Hospital at the Korea National University, the following facts and medical opinion can be acknowledged.

1) The status of the Plaintiff’s work performance: Occupational Classification - Goods Manager (bags, handbags), working hours-0 to 18:00, average remaining working hours-18:00 to 20:00, and the number of working days per week (including leave days):

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