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(영문) 서울행정법원 2019.05.01 2018구단53422
재요양 및 추가상병불승인처분취소
Text

1. On May 12, 2017, the Defendant’s disposition of additional medical care and the disposition of non-approval of additional injury and disease rendered to the Plaintiff is revoked.

2...

Reasons

1. Details of the disposition;

A. At around 15:00 on May 19, 2016, the Plaintiff, as an employee belonging to the “B” restaurant, was killed in cleaning air conditioners at the above restaurant (hereinafter “instant accident”) and was subject to the approval of the medical care for the “damage to the emotional alutism on the left hand,” and was receiving medical care until February 15, 2017. On April 24, 2017, the Plaintiff filed an application for additional medical care and additional medical care with the Defendant on the following grounds: (a) the instant injury was caused by additional injury.

B. However, on May 12, 2017, the Defendant rendered a decision not to approve the Plaintiff’s application for additional medical care and additional medical care (hereinafter “instant disposition”) according to the result of deliberation by the Defendant advisory society that the details of inspection submitted by the Plaintiff at the time of filing the said application for additional medical care and additional medical care fall short of the standard for diagnosis of the instant injury and disease (hereinafter “instant disposition”).

C. The Plaintiff filed a petition for review against the instant disposition, but the petition for review was dismissed on November 14, 2017.

[Reasons for Recognition] Unsatisfy, Gap evidence 3-1 and 2-2, the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. When considering the symptoms and signs shown to the Plaintiff in relation to the instant medical branch in accordance with the criteria for the diagnosis of the instant injury and disease established by the organization C around 2004 and the criteria for the diagnosis of the instant injury and disease that were modified by the Defendant (hereinafter “the instant diagnosis criteria”), the Plaintiff may be recognized as having caused the instant injury and disease. Thus, the instant disposition based on the premise that the symptoms and signs shown to the Plaintiff fall short of the instant diagnosis criteria is unlawful.

나. 관계 법령 등 ▣ 산업재해보상보험법 제49조(추가상병 요양급여의 신청) 업무상의 재해로 요양 중인 근로자는 다음 각 호의 어느 하나에 해당하는 경우에는 그...

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