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(영문) 서울행정법원 2020.07.02 2019구단70998
요양급여부지급처분취소
Text

1. On August 8, 2019, the Defendant revoked the disposition of non-approval for medical care granted to the Plaintiff.

2. The costs of the lawsuit are assessed against the defendant.

Reasons

1. Details of the disposition;

A. On June 22, 2016, the Plaintiff (B) was diagnosed as “D construction site (hereinafter “instant construction site”)’s worker employed by C, with a view to having suspended work and returned home at around 15:0 on the 15th and October 21, 2016, while performing pipinging work at the instant construction site (hereinafter “instant construction site”), resulting in loss of awareness at around 21:00 on the same day.”

B. The Plaintiff filed an application for medical care benefits with respect to the instant injury and disease with the Defendant, but on August 8, 2019, the Defendant rendered a disposition of non-approval for medical care (hereinafter “instant disposition”) on the grounds that it is difficult to recognize the instant injury and disease as an occupational disease based on the following review results.

It is reasonable to view that an applicant’s disease is naturally occurring due to personal factors, such as existing symptoms and age increase, rather than occupational factors, by comprehensively taking into account the following factors: (a) the occurrence of a sudden accident related to the former duties is not confirmed; (b) there is no proof of a short-term increase in work burden; (c) the average work hours per week between four weeks and twelve weeks prior to the outbreak and the relevant Acts and subordinate statutes and the relevant public notice; and (d) the fact that the person dealt with heavy goods in the course of performing duties and the burden factors arising from the working environment were partly involved; (b) however, it is difficult to deem that the degree of occupational burden was significantly affected by cerebrovascular’s normal function; and (c) it is difficult to deem that the applicant’s disease was naturally occurring due to personal factors

[Ground of recognition] Facts without dispute, Gap evidence No. 1, Eul evidence No. 1, the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The Plaintiff’s assertion accumulated overwork hours prior to the occurrence of the instant accident with excessive work hours, and the inside temperature at the work site is very high above 30°C price, and the Plaintiff wears the Jinmake and the Jindo.

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