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(영문) 서울행정법원 2016.09.01 2016구단50566
추가상병불승인처분취소 등
Text

1. All of the plaintiff's claims are dismissed.

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

Reasons

1. On September 23, 2014, the Plaintiff filed an additional injury and disease application with the Defendant on June 24, 2013, and filed an application for an additional two-class nursing charges for the period from August 6, 2014 to November 25, 2014 with the Defendant on September 23, 2014, while the Plaintiff was receiving medical care approval for an accident that occurred on the part of June 24, 2013 (e.g., an electrical panel going up with the wall attached to the wall during the operation of machinery distribution) and fell down to approximately two meters.

On February 9, 2015, the Defendant rendered a decision on the non-approval of an additional injury or disease on the ground that the applicant's injury or disease was not related to the existing injury or disease, and rendered a decision on the payment of the above nursing fee to the Plaintiff on the ground that the nursing service was required due to the non-approval of an additional injury or disease.

(hereinafter referred to as “each disposition of this case”). 【No dispute exists, evidence Nos. 3-1, 12-2, the purport of the whole pleadings.

2. Whether the disposition is lawful;

A. Since the injury or disease claimed by the Plaintiff was caused by the weather approval and its surgery, or the existing disease was rapidly aggravated above nature, each of the dispositions in this case is unlawful.

B. Determination additional medical care benefits are recognized in cases where an injury or disease already caused by an occupational accident is additionally discovered, or where medical care is necessary due to a new disease caused by an injury or disease caused by an occupational accident (Article 49 of the Industrial Accident Compensation Insurance Act). In cases where the cause of an accident is not clear, it cannot be presumed that it is caused

(See Supreme Court Decision 2003Du8449 delivered on December 26, 2003, etc.). According to the result of the request for the examination of medical records with respect to an Ansan Hospital of Korea University, whether the applicant’s injury or disease was caused by the injury or disease, surgery thereof, or by any other cause, such as identifying the cause of the request.

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