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(영문) 서울행정법원 2014.09.26 2013구단11713
요양급여불승인처분취소
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 is a worker employed by B (mutually referred to as “C”) on August 1, 2006, who performed the duties of entering, leaving, delivering, and managing the screen board.

나. 원고는, 자신이 2008. 7.경 창고에서 무게 60~80kg 의 스크린원단을 혼자 들다가 허리를 삐끗하였고 2012. 7. 7. 창고에서 원단 적치대를 이동하던 중 다시 허리를 삐끗하여 ‘제5요추-제1천추간 추간판탈출증’이 발생하였다고 주장하면서, 2012. 9. 26. 피고에게 요양급여를 청구하였다.

The Defendant rendered the disposition of non-approval on February 12, 2013, on the ground that it is difficult to recognize the relevance to the work because the reason why the Plaintiff’s scam escape symptoms are unclear in the marical image (MRI) taken on July 23, 2012, on the ground that the Plaintiff’s scam escape symptoms are not continuous.

(hereinafter referred to as “instant disposition”). [The grounds for recognition] Nos. 1, 2, and 4

2. Whether the instant disposition is lawful

A. From the date of joining the Plaintiff’s assertion, the Plaintiff engaged in the duty of delivering approximately 60-80km in weight, KRW 2-3 meters in length to 7-8 times a month, and KRW 10,000 in weight to 25 km each day, while carrying about the duty of delivering approximately 60-80km in weight to 7-8 meters in length.

Since the work has been put repeatedly, it should be deemed that the change in the fallion of the 5th century rapidly worse due to the work that imposes a burden on the lusium, and the occurrence of the escape certificate of the 5th century-1,000s.

(b) Relevant statutes: Attached Form;

다. 의학적 소견 ⑴ 원고의 주치의 ㈎ 2012. 7. 23.자 D병원 판독소견 및 2012. 9. 11.자 소견서 : 2012. 7. 23. 촬영한 원고의 요추부 자기공명영상에서 제5요추간-제1천추간 중심성 추간판탈출증이 관찰된다.

㈏ 2013. 4. 30.자 E병원 소견서 : 원고는 2012. 7. 무거운 물건을 든 후 제5요추간-제1천추간 추간판내장증을 진단받고 비수술적치료에도 증상의 호전이 없어 2013. 1. 30. 수술을 시행하였다....

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