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(영문) 서울행정법원 2019.09.26 2017구단80366
진료계획불승인처분취소
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. From April 9, 1995 to December 31, 2012, the Plaintiff: (a) was a person having mining business capacity; (b) was approved of an occupational disease; and (c) was given medical treatment from September 4, 2013 to October 30, 2013; and (d) on October 6, 2015, the Plaintiff was given medical treatment for “blue blue blusitis on the left side and fruit blusium on the left side” after obtaining approval of each occupational disease from August 1, 2016 to March 31, 2017.

B. On March 18, 2017, the Plaintiff was diagnosed with the “satise satisfy, right satfy satfy satfy,” and on March 24, 2017, the Plaintiff applied for an additional injury or disease to the Defendant on March 24, 2017, but the Defendant approved only the “satfy satch satfy sat (hereinafter “the instant injury or disease”).

C. Accordingly, the Plaintiff submitted a medical treatment plan for the instant injury and disease to the Defendant from April 1, 2017 to June 30, 2017. However, on December 6, 2017, the Defendant again issued a medical treatment plan for the period from April 1, 2017 to June 30, 2017, which was held on April 6, 2017 by a panel of advisory doctors who reviewed the Plaintiff’s medical treatment plan and held on April 1, 2017 to June 30, 2017, to make a decision not to approve (as of April 12, 2017) (as of the date of determination). The Defendant again issued a medical treatment plan for the period from November 30, 2017 (as of April 1, 2017 to June 30, 2017) (hereinafter “instant medical treatment plan”).

On the other hand, on April 6, 2017, the Plaintiff submitted a medical treatment plan related to the instant injury and disease to the Defendant [the hospital] from April 1, 2017 to June 30, 2017. On April 12, 2017, the Plaintiff received a medical treatment plan non-approval disposition from the Defendant on the ground that “the instant injury and disease need not be actively treated such as surgery.”

[Ground of recognition] Facts without dispute, Gap evidence 1, 4, 8, Eul evidence 4, the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The Plaintiff’s assertion that the injury and disease of this case were in line with the doctor’s opinion, is “Grade 4”.

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