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(영문) 서울행정법원 2016.06.20 2015구단20070
진료계획불승인등처분취소
Text

1. All of the plaintiff's claims are dismissed.

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

Reasons

1. On June 30, 2012, the Plaintiff is an former executive officer of the Korea Workers’ Compensation and Welfare Service (Grade 1) retired from office.

The Plaintiff, while in office of the Korea Labor Welfare Corporation, was receiving medical care by recognizing the “compactary and liver cell cancer” as an occupational disease.

Even after retirement, the Plaintiff obtained approval for medical care until June 30, 2014 with respect to the liveral leukosis and the liver cell cancer.

(1) The Defendant’s audit room pointed out that the initial disposition was not followed by the advisory panel’s deliberation procedure, and the Defendant, after deliberation by the advisory panel on April 30, 2014, determined to approve the remainder of the initial disposition against the Plaintiff (from May 1, 2014 to June 30, 2014) as the condition for employment treatment from May 1, 2014 to May 9, 2014, and to revise the non-approval from May 10, 2014 to June 30, 2014.

(A) On May 8, 2014, the Plaintiff submitted to the Defendant a medical treatment plan for outpatients and liver cells surgery from May 10, 2014 to June 30, 2014.

On May 13, 2014, the defendant issued a disposition not to approve the above medical treatment plan on the ground that the treatment plan needs to be terminated due to symptoms and conditions against the plaintiff.

(hereinafter “Non-approval of the instant medical treatment plan”). On June 5, 2014, the Plaintiff filed a claim for temporary layoff benefits against the Defendant from May 1, 2014 to May 31, 2014.

On June 12, 2014, the Defendant paid temporary layoff benefits to the Plaintiff only on May 7, 2014 during the period of the above application, and issued a disposition to pay temporary layoff benefits for the remainder of the period (from May 1, 2014 to May 6, 2014, and from May 8, 2014 to May 31, 2014).

(hereinafter “Partial Disposition on Site Wage for Temporary Disability Compensation Benefits of this case”). 【No dispute exists, Gap’s evidence Nos. 1, 2, and 7, Eul’s evidence Nos. 1 through 4, and the purport of the whole pleadings

2. Whether the disposition is lawful;

A. Plaintiff 1’s assertion was approved as a medical care injury and disease, and was final for medical care injury and disease treatment.

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