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(영문) 서울행정법원 2016.11.25 2016구단52067
요양급여부지급처분취소
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. Details of the disposition;

A. The Plaintiff, as an employee of the Gisung Factory Co., Ltd., Ltd., was approved of medical care benefits under the Industrial Accident Compensation Insurance Act on the 3-4th century, when performing lusium vibration operations for seven days from July 10, 2012.

B. On December 23, 2014, the Plaintiff (hereinafter “the instant additional disease”) diagnosed and applied for a medical care benefit for an additional injury or disease to the Defendant on March 4, 2015, but was subject to a disposition of non-approval on March 4, 2015. In other words, on December 7, 2015, the Plaintiff again applied for a medical care benefit for an additional injury or disease to the Defendant, but was subject to a disposition of non-approval on December 24, 2015 (hereinafter “instant disposition”).

[Ground of recognition] Facts without dispute, Gap 1 (including a provisional number; hereinafter the same shall apply), 2, 4, Eul 1, 2, the purport of the whole pleadings

2. Whether the disposition is lawful;

A. The Plaintiff’s assertion that the instant additional injury and disease occurred due to the Plaintiff’s performance of the melting Damage and Vibration operations for seven days from July 10, 2012, and thus, the instant additional injury and disease was unlawful.

B. Determination 1) An employee receiving medical care due to an occupational accident may file an application for medical care benefits for an additional injury or disease in cases where medical care is necessary due to additional discovery of an injury or disease that has already occurred due to the occupational accident, or where medical care is necessary due to a new disease due to an injury or disease that has already occurred due to the occupational accident (Article 49 of the Industrial Accident Compensation Insurance Act). An additional injury or disease must have a causal relation with the occupational accident or the first injury or disease, and the Plaintiff has the burden of proof. 2) According to the evidence evidence No. 3 of the Plaintiff, the Plaintiff’s main injury or disease in the instant case was conducted as to the additional injury or disease on February 4, 2015.

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