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(영문) 서울행정법원 2019.10.11 2018구단59406
요양비부지급처분취소
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. On December 11, 2015, the Plaintiff: (a) performed a shoulder-sharing work, such as a astronomical work and crushing work, while working for a long-term digging area in the Korea Coal Corporation, the Korea Coal Corporation; and (b) accordingly, (c) received a diagnosis as a “stowing-out to the right side” (hereinafter “instant injury and disease”); and (d) filed an application for medical care benefits with the Defendant.

B. On February 2, 2016, the Defendant rendered a disposition of non-approval for medical care on the ground that there is no proximate causal relation between the Plaintiff’s work and the injury and disease of the instant case, and the Plaintiff filed a lawsuit seeking the revocation of the disposition of non-approval for medical care as the court 2016Gudan52.

C. On June 28, 2017, the Defendant revoked the disposition of non-approval of the medical care and decided to approve the medical care for the instant injury and disease by setting the period from December 11, 2015 to January 31, 2016 to the Plaintiff on the recommendation of this court during the instant lawsuit.

On July 4, 2017, the Plaintiff filed a claim against the Defendant for medical care expenses for the period from December 11, 2015 to June 30, 2017, and the Defendant decided to pay the Plaintiff only for medical care expenses for the period from July 19, 2017, according to the deliberation opinion by the Defendant’s advisory society that “it is reasonable to deem that the treatment of the instant injury and disease was terminated on January 31, 2016 as a result of the review of various medical records, etc. by the Plaintiff.”

E. On February 27, 2018, the Plaintiff filed a claim against the Defendant for medical care expenses for the period from February 1, 2016 to June 30, 2017. On March 13, 2018, the Defendant rendered a decision that the Defendant would not pay the Plaintiff medical care expenses for the said period according to the deliberation of the Defendant’s advisory society, stating that “The medical care is recognized within the period of approval for the existing medical care (from December 11, 2015 to January 31, 2016)” (hereinafter “instant disposition”).

[Reasons for Recognition] Facts without dispute, Gap evidence Nos. 1 through 3, 5, Eul evidence Nos. 1 and 2, and the purport of all pleadings.

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