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(영문) 서울행정법원 2014.08.21 2012구단22266
요양비부지급처분취소
Text

1. The plaintiff's claim is dismissed.

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

Reasons

1. Details of disposition;

A. On August 6, 2008, the Plaintiff was an employee belonging to the Co., Ltd. of the Co., Ltd. of the Co., Ltd. of the Co., Ltd. and obtained the approval for medical care by suffering from the injury of the “Salley and the 12 chest pressure frame” due to an accident falling in the two tank during the work process. On August 18, 2010, the Plaintiff received the approval for additional injury and disease related to the “One-Class Embio-Maccomae Co., Ltd.” (hereinafter “instant injury and disease”). On August 6, 2008, the Plaintiff received the approval for additional injury and disease related to each of the above injury and injury and received the treatment for hospitalized treatment for 306 days from August 6, 2008 to October 31, 201, and 876 days in total, 1,182 days in total.

B. On October 24, 201, the Plaintiff submitted a medical treatment plan for the period from November 1, 201 to January 31, 2012 to the Defendant. However, the Defendant, on November 2, 201, refused to approve the pains after November 1, 201, and decided to terminate the medical treatment on October 31, 201. While the Plaintiff filed a request for reexamination, there was a dismissal ruling of the Industrial Accident Compensation Insurance Review Committee on May 17, 2012.

C. From November 1, 201 to July 27, 2012, the Plaintiff continued to provide medical treatment for the instant injury and disease, and filed a claim for KRW 2,39,500 for medical expenses to the Defendant. However, on August 20, 2012, the Defendant rendered a site-based disposition (hereinafter “instant disposition”) on the ground that it does not fall under the scope prescribed in medical care benefits beyond the period of approval for medical care.

[Ground of recognition] without any dispute, Gap evidence 1 through 5, Eul evidence 1 through 3, purport of whole pleading

2. Whether the disposition is lawful;

A. Since the Plaintiff’s assertion was continuously treated as the injury and disease of this case, and symptoms have spread to the present time, it is not completely cured, nor cannot it be deemed that the Plaintiff could no longer expect the effect of treatment, or its symptoms have been fixed.

The instant disposition that did not approve the treatment plan by deeming that the treatment for the Plaintiff was terminated and that did not pay subsequent medical care costs is unlawful.

B. The Plaintiff’s judgment on November 2, 201, as to the non-approval disposition of the medical treatment plan issued on November 2, 201.

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