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(영문) 창원지방법원 2020.09.02 2018구단12368
추가상병불승인처분취소
Text

The plaintiff's claim is dismissed.

Litigation costs shall be borne by the plaintiff.

Reasons

Details of the disposition

The plaintiff served as an employee of the Changwon Farmland Improvement Association (former original branch of the Korea Rural Community Corporation) on September 18, 1997 and provided medical care until November 30, 2004 after obtaining approval for medical care for the "the 4-5th standing signboard escape certificate" (hereinafter referred to as the "the medical care of this case") due to an occupational accident that is moved to by the Trackter while working as an employee of the Changwon Farmland Improvement Association (former original branch of the Korea Rural Community Corporation). After receiving approval for medical care, the plaintiff provided medical care from June 28, 2005 to April 30, 2006.

On September 11, 2012, the Plaintiff received a diagnosis of “the instant additional injury and disease” (hereinafter “the instant additional injury and disease”) from the prime doctor, and applied for additional medical care and additional injury and disease to the Defendant Corporation on August 30, 2017.

On October 30, 2017, the Defendant rendered a disposition of non-approval of additional medical care (hereinafter “instant disposition”) in accordance with the opinion of the advisory society to the effect that “The instant additional injury and disease is not confirmed when referring to obligatory records and video data, and the need for additional medical care is not recognized.”

The Plaintiff, who was dissatisfied with the request for review, was made a decision to dismiss it on February 2, 2018, and the request for review was made, but the decision to dismiss it was made on June 29, 2018.

[Ground of recognition] A without dispute, Gap evidence Nos. 1 through 15, Eul evidence Nos. 1 through 5 (including each number), and the plaintiff's assertion as to the purport of the whole oral argument as to the purport of the whole. The plaintiff obtained approval of the medical care injury and disease of this case due to occupational accident, and the additional injury and disease of this case diagnosed thereafter is recognized as the necessity of additional medical care due to proximate causal relation with the medical care of this case, the disposition of this case is unlawful.

Judgment

According to Articles 49 and 51 of the Industrial Accident Compensation Insurance Act and Article 48 of the Enforcement Decree of the same Act, the "additional Injury or Disease" is additionally discovered, or is caused by the occupational accident.

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