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(영문) 서울행정법원 2016.10.27 2015구단63619
일부 요양불승인처분 취소청구의소
Text

1. On June 23, 2015, the Defendant’s revocation of the disposition of partial refusal of medical care against the Plaintiff.

2. The costs of the lawsuit are assessed against the defendant.

Reasons

1. Details of the disposition;

A. On May 20, 2014, the Plaintiff was a worker belonging to SNT, Inc., Ltd. (hereinafter, Nonparty Company 2). On May 20, 2014, the Plaintiff was diagnosed as “the instant injury and disease” (hereinafter, referred to as “the instant injury and disease”) No. 7 in MaI as a result of the MRI’s test, which was conducted on January 23, 2015, while carrying out steel-replacement removal works, and was conducted with a slatitis due to an accident that goes behind the body while going beyond the slatum.

B. The Plaintiff asserted that the instant injury was caused by an accident that occurred on May 20, 2014, and filed a medical care application with the Defendant for the instant injury branch. However, in light of the fact that the Defendant was not found with a plesy test conducted on May 21, 2014 after the instant accident on June 23, 2015, on the ground that the instant injury and disease appears to have occurred due to any other cause, not a disaster as of May 20, 2014, the instant injury and disease were subject to a disposition of non-approval of part of medical care which is recognized as only for the instant injury and disease (the instant disposition was conducted under the following).

[Ground of recognition] Facts without dispute, Gap evidence 1, 2, Eul evidence 1, Eul evidence 3, the purport of the whole pleadings

2. Determination on the legitimacy of the disposition

A. The plaintiff's assertion did not discover the injury or disease of this case in the X-ray inspection taken on the day following the accident of this case, and rather, it appears that the injury or disease of this case occurred due to other reasons after the accident of this case was diagnosed in light of the circumstances after a considerable period of time from the date of the accident of this case. However, the injury or disease of this case occurred on the premise that it is difficult to confirm as a simple chest radiation inspection, and the plaintiff did not receive treatment due to a similar accident or the same disease after the accident of this case, and the plaintiff was also after the accident of this case.

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