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(영문) 서울행정법원 2016.12.16 2016구단56601
요양불승인처분취소
Text

1. On March 14, 2016, the Defendant’s disposition of non-approval for medical care rendered to the Plaintiff is revoked.

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

Reasons

1. Details of the disposition;

A. On December 9, 2015, the Plaintiff was employed as a daily worker at the construction site where C was permanently located (hereinafter “instant construction site”) and worked until January 8, 2016, when the Plaintiff was permanently employed on a permanent basis by December 9, 2015.

B. From January 4, 2016 to January 8, 2016, the Plaintiff received dental treatment in D and E and E departments. From January 11, 2016 to February 1, 2016, the Plaintiff was hospitalized in Korea University Ansan Hospital, and was hospitalized in the hospital at Korea University Ansan Hospital, and was diagnosed “the instant injury and disease” (hereinafter “instant injury and disease”).

C. On January 21, 2016, the Plaintiff filed an application with the Defendant for medical care benefits by asserting that the concrete entered the right eye at the construction site of this case, and that the disease of this case was caused due to the decline in eyesight.

On March 14, 2016, the Defendant rendered a disposition not to grant medical care to the Plaintiff on the ground that the instant injury and disease had no proximate causal relation with the Plaintiff’s business.

[Ground of recognition] Facts without dispute, Gap evidence 2, 3, 4, Eul evidence 1 to 3, the purport of the whole pleadings

2. Whether the instant disposition is lawful

A. On December 31, 2015, the Plaintiff asserted that, at the construction site of this case on December 31, 2015, concrete (cement water) among the works of building site retaining walls entered the right eye, and the disease of this case was caused thereby, the Defendant’s disposition of this case on a different premise is unlawful, even if there was a proximate causal relation with the work of this case.

B. The occupational accident under the Industrial Accident Compensation Insurance Act refers to the accident caused by the worker's work while performing his/her duties, and if the accident is a disease, there should be a proximate causal relation between the work and the other.

In this case, the existence of proximate causal relationship between work and accident should be determined on the basis of the health and physical conditions of the worker concerned, not on the average person, and also on the degree of proof of causal relationship.

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