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(영문) 서울행정법원 2016.04.28 2015구단10172
최초요양급여불승인처분취소
Text

1. The plaintiff's claim is dismissed.

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

Reasons

Details of the disposition

From August 26, 2014, the Plaintiff is a person who has served as a special sponsor in the “sprinking facility for gas use by subdivision and the site for the improvement of measurement hedging pipes” performed by a national highway construction company.

On October 8, 2014, the Plaintiff was diagnosed by the Plaintiff as an accident (hereinafter “instant accident”). On October 11, 2014, the Plaintiff was diagnosed as the “erode base” and “the escape certificate of the 3-4 conical protruding signboards,” and the “erode of the 5th century-1,000 conical signboards” (hereinafter “the instant injury”).

On January 15, 2015, the Plaintiff asserted that the instant accident occurred with the relevant wound and claimed that the instant wound occurred, and the Defendant applied for the approval of the medical care. However, on January 26, 2015, the Defendant approved the Plaintiff for the medical care, and issued a disposition not to grant the medical care (hereinafter “instant disposition”) on the ground that the instant wound is not recognized as a causal relationship with the instant accident due to a sedentary disease (hereinafter “instant disposition”).

【In the absence of dispute, the Plaintiff’s assertion as to the legitimacy of the instant disposition and the overall purport of the pleading of the evidence Nos. 1, 16, and 17 was conducted without any special doubt or difficulty on the prosecution before the instant accident occurred. However, since the instant accident occurred, the Plaintiff started to feel symptoms to the extent that it should undergo continuous medical treatment on the essential side immediately after the instant accident occurred.

Therefore, even though it is clear that the injury and disease of this case occurred due to the accident of this case, the defendant's disposition of this case which did not recognize the proximate causal relation between the injury and the plaintiff's business is unlawful.

Facts of recognition

In addition, on October 8, 2014, the Plaintiff suffered from the instant accident, which happens while transporting the ADD Gas container, and experienced not less than lusium, but at 20:00 after temporarily rest, the Plaintiff terminated work normally at around 20:0.

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