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(영문) 서울행정법원 2016.08.29 2015구단59207
요양급여부지급처분취소
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. On January 17, 2015, the Plaintiff filed an initial medical care benefit application with the Defendant on January 21, 2015, after receiving the diagnosis of “self-exploital brain in substance, i.e., self-exploital transfusion, i.e., self-exploital surgery, and arbitral surgery (the on-site side and arbitral part)” (hereinafter “the instant injury”).

On March 19, 2015, the Defendant rendered a decision not to approve the said application on the ground that it is difficult to recognize the proximate causal relation between the Plaintiff’s work and the instant injury and disease.

(hereinafter referred to as “instant disposition”). [Grounds for recognition] without dispute, Gap’s evidence Nos. 1-4, and the purport of the entire pleadings

2. Whether the disposition is lawful;

A. The Plaintiff asserted that: (a) during one week prior to the occurrence of the instant injury and disease, the Plaintiff performed duties for more than 63% of the usual size; (b) worked while carrying out shock and packing of cosmetics samples; and (c) performed a duty to maintain a high level of concentration in the state where the tension cannot be delayed by doing so by doing so; (d) the instant injury and disease were deemed as constituting “a limited task”; and (e) the instant disposition was unlawful since the instant injury and disease were caused by the said limited period of time and stress or by the aggravation of existing diseases beyond natural progress.

B. The term “occupational accident” under Article 5 subparag. 1 of the Industrial Accident Compensation Insurance Act refers to the injury, disease, physical disability, or death of an employee who was caused by his/her duties during the performance of his/her duties. As such, there should be causation between the duties and the occurrence of the accident, and the causal relationship must be attested by the party

Even if the overwork or stress in modern medical science can generally cause the outbreak or aggravation of disease, it is related to the work.

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