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(영문) 서울행정법원 2018.09.19 2017구단6719
최초요양급여불승인 처분 취소
Text

1. The Defendant’s disposition of non-approval of the first medical care benefit rendered against the Plaintiff on February 19, 2016 is revoked.

2. The costs of lawsuit shall be.

Reasons

1. Details of the disposition;

A. On December 14, 2015, the Plaintiff, as an employee of the C (representative: D; hereinafter “instant workplace”) located in Seongbuk-gu, Changwon-si (hereinafter “the instant workplace”), was diagnosed as “the Plaintiff, at around 11:35 on the same day while performing the work for CO2 contact from S3107 H12 block at the instant workplace on the same date.” After suspending the work, the Plaintiff was diagnosed as an employee of the E Hospital and was diagnosed as “the Plaintiff’s disease of this case” (hereinafter “the instant disease”).

B. After that, on December 29, 2015, the Plaintiff applied for the first medical care benefit for the instant injury and disease against the Defendant. However, on February 19, 2016, the Defendant rendered a disposition to deny the Plaintiff’s first claim for medical care benefit (hereinafter “the instant disposition”) to the Plaintiff on the ground of the deliberation by the Busan Busan Committee on Determination of Disease in Services, stating that “The Defendant: (a) on February 19, 2016, it is difficult to deem that the Plaintiff was in excess of the degree to cause the instant injury and disease; (b) it is difficult to deem that there was any unexpected or sudden change in work environment, and thus, there is no proximate causal relation between the Plaintiff’s first claim for medical care benefit and the instant injury and disease.”

C. The Plaintiff filed a request for examination against the Plaintiff, but the Defendant dismissed the Plaintiff’s request for examination on August 8, 2016, and the Plaintiff filed a request for reexamination against the request for reexamination. However, the Defendant dismissed the Plaintiff’s request for reexamination on November 18, 2016.

[Ground of recognition] Facts without dispute, Gap evidence Nos. 8, Eul evidence Nos. 1, 8, 9, and 10, and the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The summary of the Plaintiff’s assertion was engaged in CO2 contact work in a narrow narrow space where no ventilation was made on the date of the occurrence of the instant injury, but it was unreasonable to be exposed to large quantities of harmful gases, etc. generated during that process.

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