[Judgment of the court below]

Korea Labor Welfare Corporation

April 23, 2015

1. The plaintiff's claim is dismissed.

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

On April 18, 2013, the Defendant revoked the payment disposition of temporary layoff benefits against the Plaintiff.

1. Details of the disposition;

A. During the work on September 28, 2003, the Plaintiff was recognized as a wound (hereinafter “the first approved wound in this case”) such as the blood species on the right side, the blood species on the right side, the blood species on the right side, the blood fever on the right side, the net fever with the upper part on the right side, the high part on the right side, the high part on the right side, the erode of weight, the right shoulder, and the right control infection. The Plaintiff provided first medical treatment as to the above first approved wound from September 28, 2003 to April 7, 2008.

B. On July 12, 2007, the Plaintiff initially received a diagnosis of “the right to the right to the end of the field of light position check, and the right to the field of the field of the field of the field of the field of the field of the check infection (hereinafter “the additional disease in this case”)” and filed an application for additional injury or disease to the Defendant. However, on February 28, 2013, the Plaintiff filed an administrative litigation seeking revocation of the non-approval (Seoul Administrative Court Decision 2009Gudan7342, Seoul High Court Decision 2010Nu36512, the revocation of the disposition of revocation of additional injury or disease approval) with the Plaintiff’s winning judgment became final and conclusive.

C. On March 27, 2013, the Plaintiff filed a claim against the Defendant for the payment of temporary layoff benefits from April 8, 2008 to March 25, 2013 (hereinafter “instant request period”). On April 18, 2013, the Defendant issued a disposition that the Plaintiff would not pay temporary layoff benefits (hereinafter “instant disposition”).

【Recognition of Fact-finding】 The fact that there is no dispute, Gap's No. 1, 3, 5, 7 through 10, 17, and the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The parties' assertion

(1) The plaintiff's assertion

The Plaintiff received medical care at hospital and home until the time the instant additional disease was recognized through administrative litigation. The Plaintiff was unable to engage in business for the purpose of medical care during the period of request. Therefore, the Defendant should pay temporary layoff benefits to the Plaintiff during the said period of request.

Therefore, the defendant's disposition that did not pay temporary layoff benefits to the plaintiff is unlawful.

Shed Defendant’s argument

The plaintiff provided sufficient medical care during the first period of the medical care, and the symptoms have been fixed, and in fact, there is no fact that the plaintiff provided medical care to the extent that employment was difficult due to the instant additional injury and disease, and thus, it is not subject to temporary layoff benefits.

(b) Fact of recognition;

(1) The Plaintiff received 67,607,310 won of temporary layoff benefits from the Defendant during the pertinent period, while receiving medical care for the first approved injury and disease from September 28, 2003 to April 7, 2008 due to occupational accidents that occurred on September 28, 2003.

B. On July 18, 2007, the first approved disease of this case, the Plaintiff was diagnosed by the ○ Hospital for the first approved injury and disease of this case and received a diagnosis of the additional injury and disease of this case. The Plaintiff’s doctor of the ○ Hospital was diagnosed by the need for a three-time medical treatment and rehabilitation exercise treatment for approximately six months after the surgery of the Plaintiff.

Article 22(1) of the Civil Act provides that “The head of ○○ Hospital’s principal” shall be the first type of medical treatment on April 7, 2008 and the first type of medical treatment on the instant additional disease.” The Plaintiff did not receive medical treatment on the grounds of the instant additional disease for about seven months from April 8, 2008 to November 4, 2008.

x) The Plaintiff received physical treatment, such as 58 times in total due to the reason of the “satisfyer of standing unknown” from November 5, 2008 to March 11, 2013, at the Dogsung Public Health Center, at intervals of 1 to 2 times a month, such as a 58-time fundamental fact fact fact-finding, an ICT for the treatment of indirect electric current, and an outboard ship.

[Ground of recognition] The fact that there is no dispute, Gap evidence 1 through 12, 18, 19 through 25 (including each number), the result of the request for the examination of medical records to the head of the Macheon-do University Hospital, the purport of the whole pleadings

C. Determination

(i) Relevant legal principles

㈎ 산업재해보상보험법 제52조 가 규정하고 있는 휴업급여는 업무상 부상으로 요양 중에 있는 근로자와 그 가족의 최저생활을 보장하여 주기 위한 것이다. 그리고 위 규정상 '요양으로 인하여 취업하지 못한 기간'이라 함은 근로자가 업무상 부상으로 요양을 하느라고 근로를 제공할 수 없었기 때문에 임금을 받지 못한 기간을 의미하는 것이므로, 근로자가 의료기관에서 업무상 부상을 치료받은 기간뿐만 아니라 근로자가 자기 집에서 요양을 하느라고 실제로 취업하지 못하였기 때문에 임금을 받지 못한 기간도 포함된다( 대법원 1989. 6. 27. 선고 88누2205 판결 등 참조).

㈏ 한편 산업재해보상보험법 제5조 제4호 는 ‘“치유”란 부상 또는 질병이 완치되거나 치료의 효과를 더 이상 기대할 수 없고 그 증상이 고정된 상태에 이르게 된 것을 말한다’고 규정하고 있고, 같은 법 제47조 및 같은 법 시행령 제41조 는 산재보험 의료기관이 요양기간 연장이 필요하다는 진료계획을 제출한 경우 피고는 그 진료계획이 적절한지를 심사하여 치료의 종결 또는 치료예정기간의 단축을 명하는 등 필요한 조치를 할 수 있도록 규정하고 있다. 또한 산업재해보상보험법 제51조 는 요양급여를 받은 사람이 치료 후 요양 대상이 되었던 업무상 부상이나 질병이 재발하거나 치유 당시보다 상태가 악화되어 이를 치유하기 위한 적극적인 치료가 필요할 경우에는 ‘재요양’을 받을 수 있도록 규정하고 있고, 같은 법 제57조 는 부상이나 질병이 치유된 후 신체 등에 장해가 있는 경우에는 장해급여를 지급한다고 규정하고 있다. 위 각 규정들의 내용 및 그 입법 취지 등을 종합하여 보면, 휴업급여의 지급을 위해서는 업무상 재해로 인한 상병이 존재한다는 사실뿐만 아니라, 그 상병으로 인하여 실제로 요양을 하였고, 이로 인하여 취업하지 못하였다는 사실이 밝혀져야 한다. 따라서 근로자의 상병을 호전시키기 위한 치료가 아니라 단지 고정된 증상의 악화를 방지하기 위한 치료만을 한 경우에는 위 요양에 해당한다고 할 수 없어 장해급여의 지급 여부가 문제됨은 별론으로 하고, 요양을 전제로 하는 휴업급여의 대상이 된다고 할 수 없다( 대법원 2009. 9. 10. 선고 2009두7332 판결 등 참조).

㈐ 나아가 설령 그 증상이 고정되지 아니하여 지속적인 요양이 필요한 상태라고 하더라도, 근로자가 입은 업무상 부상의 정도, 현재의 상태, 치료의 방법, 치료의 빈도 등에 비추어 요양을 하느라고 취업하지 못한 것이 아니라 일부 노동력의 상실은 있을지언정 실제 취업이 가능함에도 취업하지 아니한 것이라면 그 기간에 대하여 휴업급여를 지급할 수는 없다.

Shed Judgment

㈎ 위와 같은 법리에 따라 먼저 이 사건 청구기간 동안 원고의 증세가 고정되지 않아 요양이 필요한 상태였는지 여부에 관하여 살펴본다.

According to the Plaintiff’s evidence No. 22, 23, and 26 within the instant period of request, it is recognized that the Plaintiff prepared an opinion that the instant medical care needs to be continuously treated with respect to the “unexplosible disease” of the Plaintiff, and that the instant medical care needs to be provided by △△△○ University Hospital. However, according to the above evidence, the Plaintiff’s medical care and the instant medical care need to be provided for about 3 weeks after the instant medical care and for 6 months after the instant medical care were performed, and that the instant medical care need to be provided to the instant hospital’s public health clinic for 20 days after the instant medical care and the instant medical care need not be provided to the instant hospital’s public health clinic for more than 0 days. However, the Plaintiff presented an opinion that the instant medical care need to be provided to the public health clinic for more than 2 months after the instant medical care and rehabilitation campaign, and that the instant medical care period was not provided for more than 7 months after the date of the instant medical care.

㈏ 나아가 설령 이 사건 청구기간 동안 원고의 증상이 고정된 상태가 아니었다고 하더라도, 그 기간 동안 원고가 월 1~2회 정도의 물리치료만을 받은 것에 불과하고, 달리 집에서 자가 요양을 하였는지 여부에 관하여도 원고가 아무런 주장·입증을 하지 못하고 있는 점에 비추어 볼 때, 비록 원고가 이 사건 추가상병으로 노동력의 손실과 종사할 수 있는 업종의 제한은 받았을지언정 원고의 위 진료내역만으로는 원고가 요양으로 인하여 취업할 수 없는 상태였다고 보기에 부족하고, 달리 이를 인정할 증거가 없다.

【Court Decision】

Therefore, the plaintiff cannot be deemed to be entitled to temporary disability compensation during the period of request of this case. Thus, the defendant's disposition issued on the same premise is legitimate.

3. Conclusion

Thus, the plaintiff's claim of this case is dismissed as it is without merit.

Judge So-young