In cases where a pneumoconiosis worker who was issued with a medical certificate before the enforcement of the Industrial Accident Compensation Insurance Act (amended by Presidential Decree No. 22492, Nov. 15, 2010) was determined as a disability grade after its enforcement, whether he/she can be eligible for pneumoconiosis accident consolation benefits (affirmative), and in cases where a pneumoconiosis worker was paid medical benefits, etc. under the former Industrial Accident Compensation Insurance Act, but did not receive the determination of a pneumoconiosis disability grade based on the benefit system under the Industrial Accident Compensation Insurance Act (amended by Act No. 10305, May 20, 2010), whether the ground for payment of pneumoconiosis consolation benefits under the amended Act

Article 24(1) and (3) of the former Pneumoconiosis Act (amended by Act No. 10304, May 20, 2010); Article 24(1) and (3) of the former Enforcement Decree of the Pneumoconiosis Act (amended by Act No. 10304, May 20, 2010; hereinafter referred to as the “Revised Pneumoconiosis Prevention Act”); Article 24(1) of the Addenda (amended by the Enforcement Decree of the Industrial Accident Compensation Insurance Act (amended by the Presidential Decree No. 10305, May 20, 2010; hereinafter referred to as the “Industrial Accident Insurance Act”) provides for the first time to determine the disability grade of a person subject to the Industrial Accident Compensation Insurance Act (hereinafter referred to as the “Industrial Accident Insurance Act”) and the first time to be amended by the Industrial Accident Compensation Insurance Act (amended by the Presidential Decree No. 10305, Nov. 15, 2010).

Article 24(1) and (3) of the former Act on the Prevention of Pneumoconiosis and Protection, etc. of Workers with Pneumoconiosis (Amended by Act No. 10304, May 20, 2010); Article 24(1) and (3) of the Act on the Prevention of Pneumoconiosis and Protection, etc. of Workers with Pneumoconiosis; Article 2 of the Addenda (Amended by May 20, 2010); Article 91-8(1), (2), and (3) of the Industrial Accident Compensation Insurance Act; Article 91-8(1), (2), and (3) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act; Article 83-2(1) [Attachment Table 11-2] and (2) [Attachment Table 11-3], Addenda (Amended by Presidential Decree No. 10304, Nov. 15, 2010)

Plaintiff (Attorney Lee Jae-hee, Counsel for plaintiff-appellant)

Korea Labor Welfare Corporation

Seoul High Court Decision 2016Nu30752 decided August 19, 2016

The appeal is dismissed. The costs of appeal are assessed against the plaintiff.

The grounds of appeal are examined.

1. The following provisions of Acts and subordinate statutes concerning compensation, etc. for pneumoconiosis workers shall be as follows:

Article 24 of the former Act on the Prevention of Pneumoconiosis and the Protection, etc. of Pneumoconiosis Workers (amended by Act No. 10304, May 20, 2010; hereinafter “former Pneumoconiosis Prevention Act”) provides that the types of pneumoconiosis consolation benefits shall be classified into “work transition allowances, disability consolation benefits, and bereaved family consolation benefits” (Article 1). Of them, disability consolation benefits shall be paid to “where a worker retired or retired from office becomes subject to disability benefits under the Industrial Accident Compensation Insurance Act due to pneumoconiosis” (Article 3).

On the other hand, the Act amended by Act No. 10304 on May 20, 2010 and enforced on November 21, 2010 (hereinafter “Revised Pneumoconiosis Prevention Act”) provides that Article 24 provides that “work transition allowances” and “ Pneumoconiosis injury consolation benefits” as the type of pneumoconiosis consolation benefits, and the former survivors’ consolation benefits system is abolished (paragraph (1). The pneumoconiosis accident consolation benefits shall be paid to “workers whose pneumoconiosis grade is determined pursuant to the pneumoconiosis determination under Article 91-8 of the Industrial Accident Compensation Insurance Act” (Paragraph (3), and subsequent Article 25) of the Addenda of the Act (hereinafter “the Addenda provision of this case”) provides that “this case’s application of the payment of pneumoconiosis consolation benefits” shall apply to those who first cause for the payment of pneumoconiosis consolation benefits after the enforcement of this Act.

Meanwhile, according to Article 91-8 of the Industrial Accident Compensation Insurance Act (amended by Act No. 10305, May 20, 2010; hereinafter “Industrial Accident Insurance Act”), the Korea Workers’ Compensation and Welfare Service shall determine the type of pneumoconiosis, whether or not there is a merger certificate, and the degree of cardiopulmonary function of the relevant worker after undergoing deliberation by the Pneumoconiosis Deliberation Committee (hereinafter “ Pneumoconiosis Determination”); (1) depending on the determination of pneumoconiosis; (2) whether or not to pay medical care benefits; (3) whether to pay pneumoconiosis compensation annuities thereunder; and (4) whether to determine the degree of cardiopulmonary function due to complication, etc., notwithstanding the criteria for the pneumoconiosis disability grade under paragraph (2) (Article 3); and (3) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act (amended by Presidential Decree No. 2135, Nov. 21, 2010; hereinafter “The Enforcement Decree of the Industrial Accident Compensation Insurance Act”) provides for the determination of pneumoconiosis and the criteria for recognition of pneumoconiosis subject to medical care pursuant to attached Table 12, [Attachment 1, 1, [Attachment 1, 3] and 1].

2. In full view of the contents and structure of the above relevant provisions, the history of revision, and the text of the supplementary provision of this case, etc., the pneumoconiosis accident compensation benefits newly introduced by the amendment method apply from the person who first caused the cause for payment of pneumoconiosis accident compensation benefits after the enforcement of the amended Act, and the cause for payment thereof arises when the pneumoconiosis grade is determined pursuant to the pneumoconiosis grade determination under Article 91-8 of the amended Industrial Accident Insurance Act. Meanwhile, Article 83-2 of the amended Enforcement Decree of the Industrial Accident Compensation Insurance Act, which provides the criteria for determining pneumoconiosis disability grades under Article 91-8 of the amended Industrial Accident Compensation Insurance Act, provides for the first time after the enforcement of the amended Enforcement Decree, the medical certificate or opinion for determining pneumoconiosis and insurance benefits, which provides for the period of application of the new criteria for determining pneumoconiosis disability grade under the amended Industrial Accident Insurance Act. However, even if the medical certificate was issued before the enforcement of the amended Act, the cause for payment can be considered as being entitled to temporary disability compensation benefits under the amended Pneumoconiosis Insurance Act.

3. The reasoning of the lower judgment and the record reveal the following facts.

From September 15, 1991, the Plaintiff worked as a mining father at ○ Mining Center and was under medical care at △△ Hospital, etc. on July 12, 201 after retirement from ○○ Mining Center on May 24, 1992. As a result of the precise diagnosis of pneumoconiosis on March 29, 201, the Plaintiff was determined as eligible for medical care after being judged as pneumoconiosis-type 1/0 and cardiopulmonary function F3 (high disability) (high disability). Since receiving KRW 51,241,360 on temporary layoff benefits on October 15, 2013, the Plaintiff was paid temporary layoff benefits until now.

On November 27, 2013, the Plaintiff filed an application with the Defendant for the payment of pneumoconiosis consolation benefits pursuant to Articles 24(1)2 and 25(2) and attached Table 2 of the amended Pneumoconiosis Prevention Act. On February 14, 2014, the Defendant rejected the Plaintiff’s application on the ground that “The Defendant, after the enforcement of the amended Pneumoconiosis Prevention Act, has first caused the cause for payment of pneumoconiosis consolation benefits to the Plaintiff (hereinafter “instant disposition”). In other words, “the person after the date of issuance of a medical certificate or medical opinion,” the Plaintiff was issued a pneumoconiosis diagnosis certificate on July 12, 2010, prior to the enforcement date of the amended Pneumoconiosis Prevention Act, and thus is not eligible for pneumoconiosis consolation benefits” (hereinafter “instant disposition”).

4. Examining these facts in light of the relevant provisions and legal principles as seen earlier, the Plaintiff cannot be deemed to have received medical care benefits and temporary disability compensation benefits under the former Industrial Accident Insurance Act as a pneumoconiosis worker, and, unless the Plaintiff was determined as a pneumoconiosis disability grade under the amended Industrial Accident Insurance Act, the Plaintiff cannot be deemed to have caused a cause for payment of pneumoconiosis injury consolation benefits under Article 24(1)2 of the amended Pneumoconiosis Prevention Act.

Therefore, the lower court’s “reasons for payment” of pneumoconiosis injury consolation benefits under the amended provisions of the Addenda to the instant case refers to the issuance of a medical certificate or opinion, which serves as the ground for determining pneumoconiosis disability grades pursuant to the determination of pneumoconiosis grade pursuant to Article 91-8 of the amended Industrial Accident Insurance Act. In so doing, it was erroneous for the Plaintiff to have determined that disability consolation benefits under the former Pneumoconiosis Act can be eligible for payment. However, it is justifiable in its conclusion that the instant disposition that the Plaintiff did not be eligible for pneumoconiosis injury consolation benefits is lawful. In so doing, contrary to what is alleged in the grounds of appeal, there were no errors by misapprehending the legal doctrine

5. Therefore, the appeal is dismissed, and the costs of appeal are assessed against the losing party. It is so decided as per Disposition by the assent of all participating Justices on the bench.

Justices Kwon Soon-il (Presiding Justice)