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(영문) 대구고등법원 2017.04.07 2016누6109
재요양불승인 처분 취소
Text

1. The plaintiff's appeal is dismissed.

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

The purport of the claim and appeal is the purport of the appeal.

Reasons

1. Details of the disposition;

A. On January 20, 1996, the Plaintiff (B) was a worker belonging to Samcheon Construction Co., Ltd., and was faced with an accident that happens while working at the construction site of the new apartment in Gyeongbuk-si (hereinafter “the instant accident”). After obtaining the approval of the medical care from the injury and disease of the 5th to 1,000 square meters (hereinafter “existing injury and disease”), the Plaintiff (B) was determined to complete the first operation and the medical care after receiving the re-operation on December 3, 2001, while receiving the medical care on June 3, 2002.

B. On August 12, 2015, the Plaintiff: (a) performed surgery on August 21, 2015, 3-4-5 (livered Nos. 3-5-5-1 of the Mestal, vertebrate Corresponding symptoms, etc. (hereinafter “diseases who applied for additional medical care”); and (b) received surgery on August 21, 2015 at C Hospital 3-4-5-1.

C. On October 14, 2015, the Plaintiff filed an application for the approval of the additional medical care with the Defendant. On October 29, 2015, the Defendant rendered a disposition of non-approval of the additional medical care (hereinafter “instant disposition”) to the Plaintiff on the ground that “the Plaintiff’s application for additional medical care is due to changes in chronic recidivism, and there is no causal link between the instant disaster and the instant accident” (hereinafter “instant disposition”).

[Ground of recognition] Unsatisfy, Gap evidence No. 1, whole purport of pleading

2. Whether the instant disposition is lawful

A. The Plaintiff’s assertion that the Plaintiff’s claim for additional medical care is not due to the change of recidivism, but due to the aggravation of existing injury and disease caused by the instant disaster, and thus, the additional medical care should be approved. Thus, the instant disposition that did not approve additional medical care is unlawful.

B. The requirements for additional medical care under the Industrial Accident Compensation Insurance Act are not different in nature from the first medical care except that the injury or disease in question occurs after the completion of the medical care, or that the medical care is provided after the completion of the medical care. Thus, the requirements for additional medical care are not satisfied, except that the medical care is provided after the completion of the medical care.

Therefore, additional medical care.

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