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(영문) 서울행정법원 2015.07.24 2014구단50753
진폐요양불승인처분취소
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. From December 12, 1975 to January 1, 1980, the Plaintiff filed a claim for medical care benefits for pneumoconiosis with the Defendant. However, the Defendant issued a precise diagnosis with the Plaintiff from November 5, 2013 to July 7 of the same month, and on December 9, 2013, on the ground that the Plaintiff’s symptoms constitute “mick-type: Medical Certificate (0/1), Embropulmonary disorder (F1), and bropulmonary disorder (institutional infection)” (hereinafter “instant disposition”).

[Ground of recognition] Unsatisfy, Gap 1

2. Whether the disposition is lawful;

A. Since the Plaintiff’s alleged pneumoconiosis type 1 or more is the Plaintiff’s pneumoconiosis type, the instant disposition is unlawful.

(b) Entry in the attached Form of relevant Acts and subordinate statutes;

C. 1) Determination 1) For the diagnosis of pneumoconiosis under the Industrial Accident Compensation Insurance Act, it is necessary to examine the pneumoconiosis review committee as to the result of the health examination. In light of the above review process, the determination of the type of pneumoconiosis, the existence and type of combination, and the degree of cardiopulmonary function of the relevant worker, etc., and determine whether to pay medical care benefits. According to the Enforcement Decree of the same Act, the determination of pneumoconiosis and the determination criteria for insurance benefits and the progress of pneumoconiosis shall be determined by reading a chest simple radiation image, and if the pneumoconiosis type is merely proven, it is not subject to all insurance benefits in principle, but is exceptionally subject to medical care benefits and nursing benefits only when the active pulmonary tuberculosis is merged. 2) The evidence submitted by the Plaintiff is insufficient to recognize that the Plaintiff’s disease type of pneumoconiosis is either type 1, or the Plaintiff’s condition constitutes a case where the pulmonary tuberculosis is merged with the symptoms symptoms. Rather, in light of the statement of subparagraph 3, and the medical record review report on this court chief of the Association of Medical Doctors against this Court.

3. Therefore, it is based on the same premise.

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