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(영문) 서울고등법원 2020.07.02 2020누34348
재요양승인처분및최초요양급여신청반려처분취소
Text

1. The defendant's appeal is dismissed.

2. The costs of appeal shall be borne by the Defendant.

Purport of claim and appeal

1..

Reasons

1. The reasoning of the judgment of the court of first instance citing the reasoning of this case is as stated in the reasoning of the judgment of the court of first instance, except where the plaintiff added a judgment of the newly raised argument to this court when it comes to this case, and thus, it shall be quoted in accordance with Article 8(2) of the Administrative Litigation Act and Article 420 of the Civil Procedure Act.

2. Determination on addition

A. Comprehensively taking account of Article 51 of the Defendant’s assertion and Article 48 of the Enforcement Decree of the Industrial Accident Insurance Act, the additional medical care is the medical care provided for a certificate of merger due to the first injury or illness after the completion of the medical care. If the additional medical care is expanded to the case of a worker who has completed the treatment that is not under the medical care, the injury or disease resulting from the first injury or disease is both the first injury or disease, and the legal relationship such as temporary disability compensation benefits, disability benefits, etc. is distorted after the completion of the medical care.

Accordingly, the criteria for the defendant's additional injury or injury to the defendant's additional injury or injury to the worker who needs medical care after the completion of the medical care are determined to be dealt with according to the criteria for recognition of additional medical care in order to be paid medical care to the worker.

Therefore, the judgment of the court below that held otherwise is erroneous in the misapprehension of legal principles, even though the defendant's approval of the additional medical care was a legitimate disposition under the relevant statutes for the payment of medical care

B. Article 49 of the Industrial Accident Insurance Act provides, “Where an employee receiving medical care due to an occupational accident falls under any of the following, he/she may file an application for medical care benefits for the injury or disease (hereinafter referred to as “additional injury or disease”)”, and subparagraph 1 of Article 49 provides, “where the injury or disease which has already occurred due to the occupational accident is additionally discovered and requires medical care,” and subparagraph 2 of Article 49 provides, “a new disease caused by the occupational accident.”

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