Who may apply for the medical-care benefit, and when may the treating medical institution file the application on the worker's behalf?
General information · Not legal advice
Material to check
In a practice file we read the application form filed with the Korea Workers' Compensation and Welfare Service, the papers attached showing the workplace, how the accident happened and the medical opinion, and the worker's consent where the treating medical institution filed the application on the worker's behalf.
These are types of material to look for, not evidence already verified by PRO SE.
Where readings differ
One reading takes the scope of the provision first: it covers the medical-care benefit based on the general medical-care benefit provision, but excludes the benefit for pneumoconiosis, and a person who wishes to receive it must apply to the public corporation with a document stating the workplace, the circumstances of the accident, the medical opinion on that accident and whatever else the Minister of Employment and Labour requires by ordinance, with the procedure and method set by that ordinance.
Another reading concerns acting instead of the worker: a workers' compensation insurance medical institution that has treated the worker may handle the application, but only where it judges the worker's injury to be a work-related accident and only with the worker's consent, so without both the institution cannot file, and the provision does not say how either of those two conditions is to be shown in the file.
Your judgment
If a medical institution has filed the application and the worker later says the injury was not work-related, what in the papers shows whether the institution's finding and the worker's consent were both present at the time of filing?
PRO SE does not make this decision or keep a case record on this public site.When to reconsider
We look at this again if the provision is amended to change who may apply, the exclusion for pneumoconiosis or the documents required, or if a court decision explains when a medical institution's judgement that an injury is work-related is sufficient.