[1] The requirements for additional medical care under the Industrial Accident Compensation Insurance Act and the meaning of and the method and degree of proof of proximate causal relation in medical science as the requirements for additional medical care

[2] The case holding that there is no proximate causal relation in medical science between the upper region of the application for additional medical care and the upper region of the injury and disease, in case where Eul applied for additional medical care after the completion of the medical care and the approval of the medical care for the injury and disease of the deceased and Eul applied for additional medical care, but the Korea Workers' Compensation and Welfare Service rendered the disposition of non-approval of additional medical care

[1] The requirements for the additional medical care under the Industrial Accident Compensation Insurance Act do not meet the requirements for the medical care, except that the medical care is provided after the completion of the medical care. Therefore, it is sufficient to view that there is a medical opinion that there is a proximate causal relation between the first injury and the medical care in addition to the requirements for the additional medical care, and that there is a medical opinion that the symptoms aggravated compared to the present injury and disease at the time of the completion of the medical care or the injury and disease at the time of the payment of disability benefits, and that the effect of the additional

In this context, the medical proximate causal relationship refers to not only the condition relationship with the first injury or disease applied for the medical care, but also the relationship which is a relatively significant cause in light of the empirical rule. The method and degree of proof does not necessarily have to be clearly proved by direct evidence, but it is sufficient if it is proved to the extent that it can be inferred by indirect facts based on the health and physical conditions of the relevant worker. However, without this degree, the proximate causal relationship cannot be acknowledged only with the fact that the first injury or disease is generally likely to occur, as well as with the fact that the conditional causal relationship is not clearly denied.

[2] The case holding that the above disposition is lawful, in a case where Eul, while working for Gap corporation and obtained approval for the medical care as a wound, filed an application for the re-medical care on the left-hand scopic brain scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scopic scop

[1] Article 51(1) and (2) of the Industrial Accident Compensation Insurance Act, Article 48(1) and (2) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act / [2] Article 51(1) and (2) of the Industrial Accident Compensation Insurance Act, Article 48(1) and (2) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act

[1] Supreme Court Decision 96Nu18755 delivered on March 28, 1997 (Gong1997Sang, 1263)

Plaintiff (Attorney Han-chul et al., Counsel for plaintiff-appellant)

Korea Labor Welfare Corporation

November 14, 2013

1. The plaintiff's claim is dismissed.

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

The Defendant’s disposition of non-approval of additional medical care rendered to the Plaintiff on February 21, 2012 is revoked.

1. Details of the disposition;

A. On November 4, 1997, the Plaintiff was working for the Young Fung Machinery Co., Ltd. (hereinafter “Yung Fung Machinery”) and returned to an emergency room on March 10, 200, and it was sent to the emergency room due to the failure to occur after the next day. This was recognized as an occupational accident, and the medical treatment was completed on August 9, 200 and was determined as class 9 of the disability grade.

B. On January 9, 2012, the Plaintiff filed an application for re-treatment with the Defendant on the ground that the treatment is necessary due to the occurrence of symptoms that have recently been seriously impaired and fluoral disorder, and the result of the MRI examination conducted by the Plaintiff, on the left-hand fluoral brain fluor, resulting in the need for the treatment.

C. On February 21, 2012, the Defendant issued a disposition not to grant additional medical care (hereinafter “instant disposition”) to the Plaintiff on the ground that “the Plaintiff’s application for additional medical care does not have any requirements for recognition of additional medical care and a proximate causal relation with the medical treatment.”

[Reasons for Recognition] Unsatisfy, entry of Eul Nos. 1, 2, and 5 (including virtual numbers), the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. The plaintiff's assertion

After the outbreak of the cerebral Spony on March 10, 200, the Plaintiff recently caused the cerebral Sponym (hereinafter “the instant Sponym”). Since the outbreak of the cerebral Sponym (hereinafter “the instant Sponym”), it is difficult to say that the cerebral Spon is another disease even if there are different levels of the outbreak, and the risk factors are the same, so the instant Spony on the extension line of the past cerebral Sponym should be deemed to have occurred. Accordingly, the instant disposition based on a different premise is unlawful.

B. Facts of recognition

1) Situation at the time of the outbreak of an anti-cerebral disease

A) On November 4, 1997, the Plaintiff joined the Young Fung machine and puts the press and shower service on the press room. The Plaintiff, who is in charge of shower service, mainly at the place of work where only male, did not engage in shower service or engaged in press service when there is no manpower for press service.

B) As to the occurrence of an occupational anti-cerebral disease, the Plaintiff filed a suit against the Ulsan District Court 2003Kadan4197 (O). The Plaintiff asserted that an anti-cerebral disease has occurred due to excessive work stress as it did not take necessary measures, such as reducing the Plaintiff’s excessive work burden, placing the Plaintiff’s excessive work burden to work together with other women, and allowing them to take appropriate rest.

C) The Plaintiff was diagnosed with high blood pressure with 172 cm in the employment physical examination, 96 cm in body, and 150/110 in the blood pressure. After that, as a result of the worker’s health examination conducted in the field machinery, the body weight was 81 km, and blood pressure was 140/90 in the body body, but it was proved only by high blood pressure, rain, and was recommended to measure low blood pressure.

(ii) medical opinions

A) Plaintiff Dental (Dong River Hospital, January 26, 2012)

Since the completion of medical care on September 30, 2002, the medical care system has been used to prevent the recurrence of brain color until now.

○○ At the time of the origin of the Republic of Korea, there was an additional greflex on the left side of the greflex, softing rate decline, swaling disorder, etc., and there was an additional neological disorder such as the fall of the greflex on the left side of the greflex, the movement of the research opening, and swaling disorder, and accordingly, the patient complained of the heat and telegraph because the greflex occurred differently from the patient’s pulmonation.

○ The failure of the instant injury to the injury is different from the father at the time of the first medical care due to the concealment of the left-hand edge.

It is considered that the brain stroke in the past had a significant risk to the injury of this case and there is a substantial causal link with the injury of the injury of the first injury of the injury of the injury of this case.

(ii)a consulting doctor of the original disposition body;

○ advisory doctor 1: It is not reasonable to approve additional medical care because it is judged that there is a natural transitional outbreak that is not related to the approval of relocation due to a disease that is newly caused on another side than the outbreak of relocation.

○ advisory doctor 2: Even if the industrial accident was approved due to the cerebral tension in the previous 2000, it is deemed that the application for industrial accident approval was newly made by the acute disease on the training department. In the case of the Plaintiff, it is reasonable to regard the stroke as a natural outbreak caused by the aggravation of the Plaintiff’s inherent risk factors and the high blood pressure. In the case of the additional medical care, the additional medical care is non-recognition of the additional medical care. The additional medical care is limited to the aggravation of the injury or the same side disease.

C) The Defendant headquarters advisory doctor

○ The injury and disease of this case is considered to be brain-explosion caused by high blood pressure, etc., which is another Plaintiff’s personal disease, which is the first approved injury and disease. The causal relationship between the Plaintiff’s brain-explosion and the first approved injury and disease is considered to be difficult to recognize.

(d) Indones University Busan White Hospital;

(1) Results of physical appraisal commission ( May 9, 2013)

○ It is difficult to say that there is no photographs of cerebral cerebrovascular at the time of 2000, and therefore, they can be viewed as being in a state with the same danger factor, even though the coconchivity of cerebral cerebral cerebrovascular appears to be both in the middle cerebral chroner and the low chroner, and even if there are differences in the parts of the outbreak of cerebral tension, the risk factor can be said to be identical to the same factor.

○ In itself, it can be seen as a person with serious danger to the injury and disease in the instant case, which had been suffering from cerebrovascular diseases in the past.

It seems difficult to say that the injury and disease of this case at all were irrelevant to the injury and disease of this case in the past 2000 merely on the ground that the outbreak level differs from each other.

The general cause of ○ cerebral typhism can be the cause of various dangerous factors, such as old age, high blood pressure, urology, urology, fladism, urine, heart disease, blood coagum, disability, salting, smoking, drinking, etc., but it also causes diseases by multiple risk factors in combination.

(2) Results of the entrustment of appraisal of medical records ( July 9, 2013)

○ It is difficult to say that the cause of brain flasing is different from that of the outbreak, and that it is another disease. For example, patients with high blood pressure can lead to brain flasing, such as the Plaintiff, even after the brain flasing in 2000. Therefore, the brain flasing and the instant injury can only be regarded as the same injury and disease.

○ The Plaintiff has a main blood pressure, which is an existing disease, and is believed to be related to the outbreak of the instant injury.

○ In the case of a high-tension, such as the Plaintiff, the brain color may be re-exploited on another side. In general, the brain color is likely to re-explosion on the part, other than the first one, once a year. Re-explosion of a brain-explosion patient may occur on the part of the first one. Re-explosion of a brain-exploiting patient is more likely to occur with existing brain-exploitation rather than with the existing brain-exploitation. There are no previous MRA and no verification could be made due to the absence of the previous MRA, but there are several opinions of cocomploitation in the blood testing conducted at the time of the re-exploitation in 200. In other words, there is a possibility that re-exploitation might occur on the part of the existing brain-exploiting patient, rather than with the brain-exploitation in 200.

○ With regard to the requirements for recognition of additional medical care under the Industrial Accident Compensation Insurance Act, the Plaintiff’s injury of this case and the previous brain fluencies are believed to have a proximate causal relationship, and the aggravation of function which is to be used more than the time of cure causes new symptoms rather than aggravation of the existing symptoms.

(3) Results of fact-finding ( October 23, 2013)

○ Since the brain color of this case is a light that occurs in the brain and the injury and disease of this case are colors that occur between brain, each side is different from the brain surface due to an autopsy for brain structure. The brain mathy which caused the brain death and the brain mathy that caused the injury and disease of this case are completely different from the brain mathy.

○ The main cause of the instant injury can be seen as an existing cerebral color and can be seen as a unique risk factor with the Plaintiff.

Although ○○, brain color does not seem to have been completely independent from another side even if it was re-exploited. In other words, there are cases where the cause at the time of the outbreak of brain color is not found, and in such cases, re-exploitation is possible. In other cases, it is difficult to think that the brain color itself may cause re-exploitation. In other cases, it is difficult to think that brain color has occurred on the other side. brain color is a blood-related disease, and may occur in an unfloited state at the time of the outbreak of brain color, and unless this factor is resolved, it is possible to re-exploitate, and it may occur on the other side.

[Reasons for Recognition] The entry of Eul No. 2 (including paper numbers), the result of the commission of physical examination to the director of the Incheon University Busan University Hospital in this Court, the result of the commission of medical examination, the result of fact inquiry

C. Relevant statutes

[Attachment] The “relevant Acts and subordinate statutes” is indicated.

D. Determination

1) The requirements for the additional medical care under the Industrial Accident Compensation Insurance Act do not meet the requirements for the additional medical care, except that the medical care is provided after the completion of the medical care. Accordingly, it is sufficient that there is a medical proximate causal relation between the first injury and the first injury and the injury and the injury and disease subject to the additional medical care in addition to the requirements for the additional medical care, and there is a medical opinion that the symptoms aggravated compared to the injury and disease at the time of the completion of the medical care or the payment of disability benefits, and that the treatment effect can be expected by the additional medical care. The medical proximate causal relation here means not only the condition relationship with the injury and disease for which the first injury and disease applied for the medical care, but also the relationship which has a relatively significant cause in light of the empirical rule, and the method and degree of proof does not necessarily require a clear medical and natural science based on direct evidence, but it cannot be found that there is no possibility of a proximate causal relation between the first injury and disease merely because it does not reach this degree, nor can it be found that there is no medical causal relation between 97158 and 97.

2) According to the above facts, there is a medical opinion suggesting that the existing cerebral tension between the above upper branch of this case differs from its father, that new symptoms have occurred rather than the aggravation of the existing symptoms, ② cerebral rapy may occur unless these factors are resolved, and there may occur a recurrence, at any time, other parts, unless it is resolved. In the case of the plaintiff, it is difficult to view that the previous cerebral cerebral tension between the two existing cerebral tensions were likely to occur with the previous cerebral tensions, and that there is no possibility that the previous cerebral tensions might occur between the previous cerebral tensions, and that there is no possibility that the plaintiff would have been suffering from the previous cerebral tension with the previous cerebral tensions, and that there is no possibility that the plaintiff would have been suffering from the previous cerebral tension with the previous cerebral tensions due to additional stress on the previous cerebral tensions.

3) Therefore, the instant disposition is lawful, and the Plaintiff’s assertion is without merit.

3. Conclusion

The plaintiff's claim is dismissed. It is so decided as per Disposition.

[Attachment] Relevant Statutes: omitted

Judges Kim Gyeong-Gyeong (Presiding Judge) et al.