[Plaintiff, Appellant] Plaintiff
[Defendant, Appellee] Korea Workers' Compensation & Welfare Service
[Judgment below] Seoul High Court Decision 2003Nu20250 decided February 4, 2005
[Order]
The judgment below is reversed, and the case is remanded to the Seoul High Court.
[Reasoning]
The grounds of appeal are examined.
1. Article 42 of the former Industrial Accident Compensation Insurance Act (산업재해보상보험법) (before its full amendment by Act No. 8373 on April 11, 2007; the same shall apply hereinafter) (currently Article 40) provides that where a worker sustains an injury or contracts a disease due to an occupational cause and, after treatment, is left with a disability in the body, etc., the worker shall be paid a disability compensation pension or disability compensation lump sum in an amount equal to a certain number of days' average wage according to the grade of disability. Article 4 (currently Article 5), item 2 of the same Act provides that "average wage" as used in this Act means the average wage under the Labor Standards Act (근로기준법). Meanwhile, Article 19 of the former Labor Standards Act (before its full amendment by Act No. 8372 on April 11, 2007) (currently Article 2(1)6) defines average wage as the amount obtained by dividing the total amount of wages paid to the worker during the three months prior to the date on which the cause for calculation arose by the total number of days in that period. Article 2(1) of the Enforcement Decree of the Labor Standards Act provides that certain periods, such as the period of probationary employment, the period of suspension of business due to a cause attributable to the employer, the period of maternity leave, the period of leave for medical treatment of an occupational injury, and the period of childcare leave, and the wages paid during such periods, shall be excluded from the period and the total amount of wages used as the basis for calculating average wage. The reason for excluding certain periods and the wages paid during such periods from the calculation period and total wage amount for average wage is to ensure that ordinary living standards are guaranteed by accurately reflecting the worker's living wage when calculating various benefits under the Labor Standards Act, the Industrial Accident Compensation Insurance Act, etc., based on the average wage.
In light of the purpose of the average wage system, which is to factually reflect the ordinary living wage, and the fact that the cause for calculating average wage, such as an occupational disease, arises from the performance of duties during the existence of the employment relationship, where a retired worker is diagnosed with an occupational disease and, taking the date on which the diagnosis of the occupational disease is confirmed as the date on which the cause for calculating average wage arose (see Article 48 of the Enforcement Decree of the Labor Standards Act), the average wage is calculated and insurance benefits under the Industrial Accident Compensation Insurance Act are paid accordingly, the period from the worker's date of retirement to the date on which the cause for calculating average wage arose, i.e., the date the diagnosis was confirmed, must likewise be excluded from the average wage calculation period. Furthermore, if the period excluded from the average wage calculation period is three months or longer, the average wage shall be calculated by treating the first day of the excluded period as the date on which the cause for calculating average wage arose (see Article 4 of the Enforcement Decree of the Labor Standards Act and Article 1(1) of the Ministry of Labor Notice No. 2004-22, Special Cases for Calculation of Average Wage), and the amount so calculated shall be adjusted upward or downward according to the wage fluctuation rate for workers in the same occupation pursuant to Article 38(3) (currently Article 35) of the former Industrial Accident Compensation Insurance Act and Article 25(1) of the Enforcement Decree of the same Act, and the resulting amount shall be used as the average wage serving as the basis for calculating the worker's insurance benefits.
2. Meanwhile, Article 38(5) (currently Article 35) of the former Industrial Accident Compensation Insurance Act provides: "Where, in calculating insurance benefits, it is deemed inappropriate for the protection of a worker who is to receive insurance benefits due to an occupational disease prescribed by Presidential Decree, such as pneumoconiosis, to apply that worker's average wage, the amount calculated according to the method of calculation prescribed by Presidential Decree shall be deemed the average wage of that worker." Pursuant thereto, Article 26(2) of the Enforcement Decree of the same Act and Article 12(2) of the Enforcement Rule of the same Act provide, with respect to the method of calculating average wage in such cases, that the amount shall be calculated by dividing the sum of the monthly wage amounts, as shown in the monthly labor statistics survey report prepared by the Minister of Labor, of workers who are similar in gender and occupation to the worker concerned among workers belonging to a business similar to the business, industry, and scale to which the worker concerned belongs, for the one-year period from the last day of the quarter two quarters prior to the quarter in which the date the occupational disease was confirmed falls, by the number of days in that period. The purpose of this special provision for calculating average wage for workers afflicted with occupational disease is as follows: in the case of certain occupational diseases such as pneumoconiosis, diagnosis is not easy, and there are cases where a worker continues to perform work without the occupational disease such as pneumoconiosis being confirmed even though the worker has in fact contracted the disease due to work; since it would be inappropriate for the protection of the worker to calculate the average wage based on the wage amount actually received in such cases where the worker was unable to properly provide labor and receive wages due to the occupational disease, the purpose of the provision is, in such cases, to use the wage amount shown in the labor statistics survey report for workers of the same occupation, instead of that worker's actual average wage, as the average wage of that worker for the purpose of calculating insurance benefits under the Industrial Accident Compensation Insurance Act.
Furthermore, Article 26(3) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act provides: "In applying Article 38(5) (currently Article 35) of the Act, where an occupational disease is confirmed after the business to which the worker concerned belonged has been suspended or closed, the wage shall be calculated pursuant to paragraph (2) on the basis of the date of such suspension or closure, and the amount adjusted upward or downward pursuant to Article 25(1) up to the date the occupational disease is confirmed shall be deemed the average wage of the worker concerned." This provision, too, is one of the provisions implementing in concrete form Article 38(5) (currently Article 35) of the former Industrial Accident Compensation Insurance Act, which is designed to prevent insurance benefits from being calculated based on an average wage that has been calculated at a low level due to a decline in wage level resulting from a decrease in work capacity, when calculating insurance benefits for a worker afflicted with an occupational disease.
According to the content and purpose of the relevant statutory provisions as described above, for a worker whose occupational disease diagnosis is confirmed three months or more after retirement due to the closure of the business, the wage amount for workers of the same occupation as shown in the labor statistics survey report based on the date of closure of the business, adjusted upward or downward for average wage fluctuations, shall be used as that worker's average wage only where the average wage calculated as described above—that is, the average wage calculated based on the wages received during the three months prior to the date of retirement, adjusted upward or downward for average wage fluctuations—falls short of the wage amount for workers of the same occupation as shown in the labor statistics survey report based on the date of closure of the business, adjusted upward or downward for average wage fluctuations, such that it is inappropriate for the protection of the worker. It should not be the case that the above provision is automatically applied to all workers whose occupational disease diagnosis is confirmed after the closure of the business, and the wage amount for workers of the same occupation as shown in the labor statistics survey report based on the date of closure of the business, adjusted upward or downward for average wage fluctuations, is immediately used as that worker's average wage without comparing the two average wages.
3. According to the reasoning of the judgment below, the following facts are found: the Plaintiff began working as a tunneling worker at a coal mine in 1970, and from July 24, 1994, worked as a tunneling worker at △△ Coal Mine located in ○○-myeon, Nonsan-si; on September 1, 1994, the Plaintiff suffered an occupational injury, sustaining injuries including "herniated disc at C3-4-5-6, contusion of the neck, etc.," and received medical treatment therefor from that date until February 28, 1998; however, the said △△ Coal Mine closed on December 1, 1994, and upon terminating its business on September 16, 1995, paid the Plaintiff retirement pay for the period from the date of hire to September 16, 1995, calculated on the basis of an average wage of KRW 75,440.09; upon completing medical treatment on February 28, 1998, the Plaintiff's symptoms from the aforementioned injury having stabilized, the Plaintiff received a disability compensation lump sum from the Defendant, and in calculating that disability compensation lump sum, the average wage applied to the Plaintiff was KRW 97,089.44; thereafter, on April 29, 2002, the Plaintiff underwent a detailed pneumoconiosis examination and was confirmed to have developed pneumoconiosis, and claimed disability benefits from the Defendant; in response, the Defendant, applying Article 26(3) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act, determined the average wage to be applied to the Plaintiff as KRW 60,255.12, which is the amount obtained by adjusting KRW 30,942.91—calculated by taking into account, as of the date of closure of the said △△ Coal Mine, the wage amount, as shown in the monthly labor statistics survey report prepared by the Minister of Labor, of a worker similar in gender and occupation to the Plaintiff among workers belonging to a business similar to the business, industry, and scale to which the Plaintiff belonged—upward or downward according to the wage fluctuation rate for the period from the date of closure of the coal mine to the date the pneumoconiosis diagnosis was confirmed, and paid the disability compensation lump sum accordingly.
Given these facts, the Plaintiff, while receiving medical treatment for three months or more due to an occupational injury, retired due to the closure of the business and was thereafter diagnosed with pneumoconiosis. The average wage for calculating the Plaintiff's disability compensation lump sum in this case should be the amount obtained by adjusting, up to the date the pneumoconiosis diagnosis was confirmed, the average wage calculated by treating the first day of the period excluded from the calculation period—that is, the date of the occupational injury—as the date the cause for calculating average wage arose (absent special circumstances, this appears to be the amount obtained by adjusting KRW 75,044.09, the average wage determined at the time retirement pay was paid in September 1995, up to the date the diagnosis was confirmed). Since that amount would be higher than the amount (KRW 60,255.12) obtained by adjusting the wage amount of workers of the same occupation as shown in the labor statistics survey report based on the date of closure of the business up to the date the diagnosis was confirmed, the disability compensation lump sum for the pneumoconiosis in this case should not be calculated for the Plaintiff using the average wage calculated pursuant to Article 26(3) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act; rather, the disability compensation lump sum should be calculated using, as the average wage, the amount obtained by adjusting the Plaintiff's average wage as of the date of the occupational injury up to the date the diagnosis was confirmed.
Nevertheless, the court below merely held that, since there were no wages paid to the Plaintiff during the three months prior to the date the pneumoconiosis diagnosis was confirmed, this was a case in which average wage could not be calculated, and therefore the Plaintiff's disability compensation lump sum should be calculated using the amount calculated pursuant to Article 26(3) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act. This constitutes an error affecting the judgment by misunderstanding the legal principles concerning the calculation of average wage for a worker whose occupational disease was confirmed after retirement due to the closure of the business, and the legal principles concerning the interpretation and application of Article 38(5) (currently Article 35) of the former Industrial Accident Compensation Insurance Act and Article 26(3) of the Enforcement Decree of the same Act. The ground of appeal pointing this out has merit.
4. Accordingly, the judgment below is reversed, and the case is remanded to the court below for further hearing and determination, by the unanimous opinion of the participating Justices, as set forth in the Order.
Justice Ahn Dae-hee (Presiding Justice), Kim Young-ran, Kim Hwang-sik (Justice in charge), Lee Hong-hoon