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(영문) 부산지방법원 2020.05.27 2019구단20178
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. The Plaintiff, while working in B on June 15, 1996, was shocked to things away from the head of the family list and was treated as an industrial accident for 23 years after being approved as an industrial accident.

B. On August 28, 2018, the Plaintiff’s principal hospital submitted a medical treatment plan to the Defendant from September 5, 2018 to March 4, 2019.

On October 29, 2018, the Defendant approved the reduction of a medical treatment plan to the effect that the medical treatment is recognized by December 31, 2018, on the ground that “the medical treatment is to be completed after the medical treatment is performed as a result of an increase in the premium, until December 31, 2018,” and decided to the effect that the medical treatment is terminated after the reduction.

C. On December 12, 2018, on behalf of the Plaintiff, the Plaintiff’s doctor submitted a re-written medical treatment plan (hereinafter “instant medical treatment plan”) to the Defendant on the following grounds: (a) during the period from January 1, 2019 to March 31, 2019, for which the Plaintiff needs to undergo medical treatment, such as medication, rehabilitation treatment, and physical therapy (hereinafter “instant medical treatment plan”).

On December 20, 2018, the Defendant decided not to approve the instant medical treatment plan (hereinafter referred to as “instant disposition”) according to the medical opinion that “the medical treatment plan is unreasonable as an symptoms.”

[Ground of recognition] Facts without any dispute, Gap's 1, 3, 4, and Eul's 1 through 3

2. Whether the instant disposition is lawful

A. The Plaintiff’s assertion has been subject to emergency measures at an emergency room from time to time due to symptoms, such as climatic changes based on the Galinology register, frequent recurrence of luminous infections, climatic depressions caused by voluntary resistant disorder, respiratory difficulty, high blood pressure, etc., while receiving treatment at a medical institution for 23 years from the instant injury and disease.

At present, the emergency situation caused by the unexpected symptoms frequently occurs.

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