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(영문) 서울고등법원 2020.04.10 2019누63135
요양불승인처분취소
Text

1. The plaintiff's appeal is dismissed.

2. The plaintiff shall bear the costs of appeal.

Purport of claim and appeal

The first instance court.

Reasons

1. The facts below the facts of recognition are either in dispute between the parties or in full view of the overall purport of the arguments as to Gap evidence 1 to 12, Eul evidence 1 (including the number of branch numbers) and C Hospital of the court of first instance with respect to C Hospital of the court of first instance.

[1] On January 24, 2004, the Plaintiff was involved in a collision between the vehicle and the fence during his work.

The Plaintiff obtained the approval for medical care for “brain, spathal spathal spathal spathal, spathal spathal spathal, left-hand spathal spathal, spathal spathal spathal, and spathal spathal spathal spathal.”

On the other hand, the plaintiff applied for medical care on the "Plap-4, No. 3-5, No. 4-5, No. 3-4, and No. 4-5, No. 5-6, and No. 6-7, and No. 6-7," but the plaintiff was not approved.

The Plaintiff received medical care from January 24, 2004 to March 1, 2009, and re-medical care from June 5, 2009 to February 28, 2014, and re-medical care from December 20, 2016.

On September 19, 2017, the Plaintiff submitted a medical treatment plan from October 1, 2017 to October 30, 2018 during the period of re-medical care. The period of medical care was reduced to November 30, 2017.

[2] On November 15, 2017, the Plaintiff was diagnosed at B Hospital No. 3-4 and No. 4-5 (hereinafter “the instant injury and disease”), which had been approved for the reduction as above, and was diagnosed as “the W Hospital No. 3-4 and No. 8” (hereinafter “the instant injury and disease”), and was expected to receive surgery medical treatment (Evidence A).

On November 24, 2017, the Plaintiff filed an application with the Defendant for medical treatment for transfer of the disease of this case to B hospital on the grounds that the medical treatment of the disease of this case is needed.

On December 7, 2017, the Defendant rendered a non-approval of the medical treatment that the Plaintiff applied for, as above, on the ground that the instant injury and disease was not an approved injury and disease, but an injury and disease requiring surgery is not observed.

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