Workbear재주넘는곰
대법원 94누2565

Revocation of Decision Denying Survivor Benefits (유족급여) and Funeral Expense Benefits (장의비)유족급여및장의비급여부지급결정처분취소

Decided1994. 06. 28. Court대법원Case reversed and remanded (파기환송) — the bereaved family's claim was given another chance for review under the correct legal standard
AI-generated English translation (summary, key points, decision summary and full text) for reference only — not an official translation and without legal effect. The Korean original below is authoritative.
AI Easy read — AI summary of this decision
AI-generated summary for reference only — the Korean original below is authoritative.

A worker who suffered severe injuries from a fall accident at work later died of an undetermined cause while still under treatment. The Supreme Court (대법원) reversed and remanded the lower court's ruling, finding that the lower court had misapplied the law by denying a substantial causal relationship between the workplace accident and the worker's death. The Court held that proving work-related injury (업무상 재해) causation does not require clear medical or scientific proof—it is sufficient if a substantial causal link can be reasonably inferred from the overall circumstances.

Key takeaways
  • CaseA worker fell during work, sustained severe injuries, and later died of an undetermined cause while receiving treatment.
  • OutcomeThe Supreme Court ruled that the lower court wrongly denied causation and sent the case back for reconsideration under a more lenient, common-sense standard of proof.
  • LessonIn work-related injury (업무상 재해) claims, causation does not need to be proven with scientific certainty—courts and employers should evaluate the full context of the worker's condition and circumstances before denying a claim.
Issues
  • The burden of proof and required standard of proof for establishing causation between work duties and illness or death in work-related injury (업무상 재해) cases
  • Whether a substantial causal relationship exists between the injuries from the fall accident and the worker's subsequent death
Key reasoning

The Supreme Court clarified that causation in work-related injury (업무상 재해) cases need not be proven with medical or scientific certainty. Instead, courts should consider all relevant circumstances—such as the worker's health condition, the course of onset, the nature of the illness, and the treatment history—to determine whether a substantial causal relationship can reasonably be inferred. If such an inference is reasonable, causation is deemed established as a matter of law. The lower court, however, hastily rejected the causal link without conducting sufficient additional examination of these factors, which constituted a misunderstanding of the applicable legal standard.

Summary of Decision (English, AI translation)

a. "Occupational accident" under Article 3(1) of the Industrial Accident Compensation Insurance Act (산업재해보상보험법) refers to an accident that occurs to an employee in the course of performing his or her duties and is attributable to those duties. Therefore, where the accident consists of a disease or death resulting from a disease, there must be a proximate causal relationship between the employee's work and the disease or the death caused by the disease. In such a case, the party asserting the causal relationship between the employee's work and the disease or the death resulting from the disease bears the burden of proving it; however, such causal relationship need not necessarily be clearly proven in medical or natural-scientific terms. Even in cases where, considering all the relevant circumstances such as the employee's state of health at the time of employment, the circumstances of the onset of the disease, the nature of the disease, and the course of treatment, a proximate causal relationship between the work and the disease or the death resulting therefrom can reasonably be inferred, such proof shall be deemed to have been established.

b. This is a case in which the court reversed the judgment below—on the grounds of misapprehension of the law and insufficient examination—where the court below had denied the existence of a proximate causal relationship between the injury caused by a fall accident and the death, in a case where an employee who suffered severe injuries in a fall accident during work and received continuous hospitalization and outpatient treatment until his death died without a clearly identified cause of death; although the death certificate indicated, as a physical condition unrelated to the cause of death, a presumed weakening of cardiopulmonary function due to overall exhaustion and starvation, the general blood test, liver function test, and urinalysis conducted on the deceased before his death were diagnosed as normal.

Full text (English, AI translation) 7,690 chars

[Plaintiffs, Appellants]

[Defendant, Appellee] Chief of Boryeong Regional Labor Office, Ministry of Labor
[Judgment Below] Daejeon High Court Decision 93Gu942 rendered on January 21, 1994

[Order]

The judgment below is reversed, and the case is remanded to the Daejeon High Court.

[Reasoning]

The Court examines the grounds of appeal submitted by the Plaintiffs' litigation representative.

According to the reasoning of the judgment below, the court below found the following facts: Non-party 1, who worked as an electrician for Non-party Shinan Electric Co., Ltd., while performing scaffolding board removal work together with Non-party 2 and others at an electric tower construction site located in Dokgot-ri, Daesan-myeon, Seosan-gun, Chungcheongnam-do, at around 11:00 on November 18, 1990, was struck on the back of the head by a scaffolding board approximately 5 meters long and 20 cm in diameter that Non-party 2 accidentally dropped, and fell to the ground 3 meters below, sustaining injuries including a compression fracture of the first lumbar vertebra, cerebral contusion, contusions of the left thigh and pelvic area, and herniation of the 3rd, 4th, and 5th lumbar intervertebral discs. The court below found that Non-party 1, having sustained these injuries, was immediately transferred to Yong Hospital located near Seosan City, and received inpatient treatment there as medical care benefits under the Industrial Accident Compensation Insurance Act (산업재해보상보험법) from that time until November 30 of the same year, and was then transferred on December 1 of the same year to Gil Hospital located near his residence in Cheorwon-gun, Gangwon-do, where he was hospitalized for approximately six months, from that time until May 4, 1991, and continuously received treatment as medical care benefits (during which period, from January 16 to January 21, 1991, he was transferred to the Department of Neurosurgery of Jungang Gil Hospital in Incheon for treatment), and was discharged once he had recovered to the extent that he had no difficulty walking. The court below further found that Non-party 1, even after being discharged from Gil Hospital as described above, continued to receive outpatient treatment, but on May 15, 1991, due to severe lumbar pain and bilateral leg radiating pain, he was readmitted to Gil Hospital and received medication and physical therapy, and was discharged on July 6 of the same year; that from that time until August 20 of the same year he again received outpatient treatment; and that he died at his residence at around 03:00 on August 23 of the same year, the exact cause of death being unclear, with the death certificate merely stating, as another physical condition unrelated to the cause of death, an estimate of weakened cardiopulmonary function due to general exhaustion and starvation. The court below also found that as of August 20, 1991, immediately before Non-party 1's death, only aftereffects requiring periodic medication and physical therapy remained, he had no difficulty walking, and general blood tests, liver function tests, and urine tests showed no abnormalities. Based on these findings, the court below rejected the Plaintiffs' argument that Non-party 1 died as a result of an occupational accident, holding that there was no material to find that Non-party 1's death was caused by the aggravation of the aforementioned injury or that there was a proximate causal relationship between the injury and the death.

However, "occupational accident" under Article 3, Paragraph 1 of the Industrial Accident Compensation Insurance Act (산업재해보상보험법) refers to an accident that occurs to a worker in the course of performing his duties and that arises from such duties; therefore, where the accident is a disease or death resulting from a disease, there must be a proximate causal relationship between the work and the disease or death. In such a case, the causal relationship between the worker's work and the disease, or between the disease and the resulting death, must be proven by the party asserting it; however, such causal relationship need not necessarily be clearly proven in medical or natural scientific terms, and it should be deemed to have been proven even where the proximate causal relationship between the work and the disease or the resulting death can be inferred by considering all relevant circumstances, such as the worker's state of health at the time of employment, the circumstances of the onset of the disease, the nature of the disease, and the course of treatment (see this Court's Decisions 93Nu9408 rendered on October 12, 1993; 91Nu8586 rendered on February 25, 1992, etc.).

Now, in the present case, the injuries sustained by the deceased Non-party 1 in the fall accident at issue at around 11:00 on November 18, 1990 — namely, the compression fracture of the first lumbar vertebra, cerebral contusion, contusions of the left thigh and pelvic area, and herniation of the 3rd, 4th, and 5th lumbar intervertebral discs — must be regarded as quite serious injuries in light of their location and severity. Moreover, according to the facts found by the court below and the record, it can be seen that the deceased had been healthy before being injured in the fall accident, but after being injured in this accident, he continuously received inpatient and outpatient treatment until his death; that at the time of his death, his physical condition had deteriorated to such a degree that his cardiopulmonary function had weakened due to general exhaustion and starvation; that around the time of his death he had continuously complained of severe headaches; and that the staff of Gil Hospital had also recommended that the deceased be moved to another general hospital for treatment. Given these circumstances, the court below should have, even though the results of the general blood test, liver function test, and urine test conducted on the deceased at Gil Hospital three days before his death, on August 20 of the same year, were diagnosed as normal, further examined the following: the cause and course of the deterioration of the deceased's health — who had otherwise been healthy — to the point where his cardiopulmonary function weakened due to general exhaustion and starvation after sustaining the aforementioned serious injuries in this fall accident and undergoing treatment; the changes in the deceased's physical condition during the course of treatment; the course of treatment; whether there was room for any cause other than the aforementioned injury to have contributed to the deceased's death; and the reasons why Gil Hospital recommended transfer to another hospital. The court below should have carefully examined whether there was a causal relationship between the injury and the death based on such further examination.

The court below, without going this far, hastily concluded, based solely on the aforementioned reasons, that there was no proximate causal relationship between the injury and the death. This cannot escape criticism for having misapprehended the legal principles concerning the causal relationship required for "occupational accident" under Article 3, Paragraph 1 of the Industrial Accident Compensation Insurance Act (산업재해보상보험법), or for having failed to conduct the necessary examination, thereby affecting the outcome of the judgment. The argument pointing out this error is well-founded.

Therefore, the judgment below is reversed and the case is remanded, this decision being rendered unanimously by the participating Justices, as stated in the Order.

Justice Ahn Woo-man (Presiding Justice), Kim Yong-jun, Cheon Kyung-song (Justice in Charge), Ahn Yong-deuk

【판결요지】

가. 산업재해보상보험법 제3조 제1항 소정의 "업무상의 재해"라 함은 근로자가 업무수행중 그 업무에 기인하여 발생한 재해를 말하므로 그 재해가 질병 또는 질병에 따른 사망인 경우에는 업무와의 사이에 상당인과관계가 있어야 하고, 이 경우 근로자의 업무와 질병 또는 위 질병에 따른 사망 간의 인과관계에 관하여는 이를 주장하는 측에서 입증하여야 하는 것이지만, 그 인과관계는 반드시 의학적, 자연과학적으로 명백히 입증하여야만 하는 것은 아니고, 근로자의 취업 당시의 건강상태, 발병경위, 질병의 내용, 치료의 경과 등 제반 사정을 고려할 때 업무와 질병 또는 그에 따른 사망과의 사이에 상당인과관계가 있다고 추단되는 경우에도 그 입증이 있다고 보아야 한다.

나. 작업중 추락사고로 인하여 중상을 입고 사망할 때까지 계속하여 입원 및 통원치료를 받던 근로자가 정확한 사인이 밝혀지지 않은 채 사망하였고 사망진단서상 사인과 관계없는 신체상황으로 전신탈진 및 기아로 인한 심폐기능약화로 추정되었으나 사망 전 위 망인에 대하여 한 일반혈액검사, 간기능검사, 요검사 결과가 정상이라고 진단된 경우 추락사고로 인한 상해와 사망간에 상당인과관계를 부정한 원심판결을 법리오해와 심리미진을 이유로 파기한 사례.

【참조조문】

산업재해보상보험법 제3조 제1항, 행정소송법 제26조[입증책임]

【참조판례】

가. 대법원 1989.7.25. 선고 88누10947 판결(공1989,1308), 1992.5.12. 선고 91누10022 판결(공1992,2026) , 1993.10.12. 선고 93누9408 판결(공1993하,3101) / 나. 대법원 1992.2.25. 선고 91누8586 판결(공1992,1184)

【주문】·【이유】 전문 2,694자 · 펼쳐 보기

【원고, 상고인】

【피고, 피상고인】 노동부 보령지방노동사무소장

【원심판결】 대전고등법원 1994.1.21. 선고 93구942 판결

【주 문】

원심판결을 파기하고 사건을 대전고등법원에 환송한다.

【이 유】 원고들소송대리인의 상고이유를 본다.

원심판결 이유에 의하면 원심은, 소외 주식회사 신안전기에 전공으로 근무하던 소외 1은 1990.11.18. 11:00경 소외 2 등과 함께 충남 서산군 대산면 독곳리 소재 전기철탑공사 작업장에서 족장목 철거작업을 하다가 위 소외 2가 실수로 떨어뜨린 길이 약 5m, 직경 20cm의 족장목에 뒷머리를 강타당하면서 3m 아래의 땅바닥에 떨어져 요추1번압박골절, 뇌좌상, 좌측대퇴부 및 골반부좌상, 제3, 4, 5요추 추간판탈출증 등의 상해를 입은 사실, 위 소외 1은 위 상해를 입고 즉시 인근 서산시 소재 용병원에 후송되어 그때로부터 같은 달 30.까지 산업재해보상보험법상의 요양급여로써 입원치료를 받다가 같은 해 12.1. 그 주거지 인근의 강원 철원군 소재 길병원으로 전원되었고, 다시 그때로부터 1991.5.4.까지 위 요양급여로써 약 6개월간 위 병원에 입원하여 계속적으로 치료를 받은 후(그 사이인 1991.1.16.부터 같은 달 21.까지는 인천 소재 중앙길병원 신경외과로 전원하여 치료) 보행에 지장이 없을 정도가 되어 퇴원한 사실, 위 소외 1은 위와 같이 위 길병원에서 퇴원을 한 뒤에도 계속적으로 통원치료를 받다가 1991.5.15. 요추부동통과 양측하지방사통이 심하여지자 위 길병원에 다시 입원하여 약물치료 및 물리치료를 받고, 같은 해 7.6. 퇴원을 하였으며, 그때로부터 같은 해 8.20.까지 다시 통원치료를 받다가 같은 해 8.23. 03:00경 주거지에서 사망하였는데 정확한 사인이 밝혀지지 않았고 단지 사망진단서상 사인과 관계없는 기타의 신체상황으로 전신탈진 및 기아로 인한 심폐기능약화 추정이 된다고 하는 기재가 있을 뿐인 사실, 위 소외 1이 사망하기 직전인 1991.8.20. 당시 주기적인 약물가료와 물리치료를 요하는 후유장애만이 남아 있을 뿐 보행에 지장이 없었고, 일반혈액검사, 간기능검사, 요검사에서 아무런 이상이 없었던 사실을 인정한 다음 위 소외 1의 사망이 앞서 본 상해가 악화되어 발생된 것이라거나 그와 상당인과관계가 있다고 볼 자료가 없다고 하여 위 소외 1이 업무상 재해로 인하여 사망하였다는 원고들의 주장을 배척하였다.

그러나 산업재해보상보험법 제3조 제1항 소정의 "업무상의 재해"라 함은 근로자가 업무수행 중 그 업무에 기인하여 발생한 재해를 말하므로 그 재해가 질병 또는 질병에 따른 사망인 경우에는 업무와의 사이에 상당인과관계가 있어야 하고, 이 경우 근로자의 업무와 질병 또는 위 질병에 따른 사망 간의 인과관계에 관하여는 이를 주장하는 측에서 입증하여야 하는 것이지만, 그 인과관계는 반드시 의학적, 자연과학적으로 명백히 입증하여야만 하는 것은 아니고, 근로자의 취업 당시의 건강상태, 발병경위, 질병의 내용, 치료의 경과 등 제반사정을 고려할 때 업무와 질병 또는 그에 따른 사망과의 사이에 상당인과관계가 있다고 추단되는 경우에도 그 입증이 있다고 보아야 할 것이다(당원 1993.10.12. 선고 93누9408 판결; 1992.2.25. 선고 91누8586 판결 등 참조).

그런데 이 사건 경우, 위 망 소외 1이 1990.11.18. 11:00경 이 사건 추락사고로 입은 요추1번압박골절, 뇌좌상, 좌측대퇴부 및 골반부좌상, 제3, 4, 5요추 추간판탈출증 등의 부상은 그 상해의 부위 정도로 보아 상당히 중상이라고 할 것이고, 또 원심이 인정한 사실과 기록에 의하면 위 망인은 위 추락사고로 부상하기 전에는 건강하였는데 이 사건 사고로 부상한 이후에는 사망할 때까지 계속하여 입원 및 통원치료를 받아왔는데도 위 사망 당시는 전신탈진 및 기아로 인하여 심폐기능이 약화될 정도의 건강상태가 되어 사망하였다는 것이며 사망할 무렵 계속적으로 극심한 두통을 호소하고 있었고 위 길병원측에서도 위 망인에게 다른 종합병원으로 옮겨서 치료를 받아 보도록 권고하였던 것을 알 수 있는바, 사정이 이와 같다면 원심으로서는 비록 위 길병원에서 위 망인의 사망 3일 전인 같은 해 8.20. 위 망인에 대하여 한 일반혈액검사, 간기능검사, 요검사 결과가 정상이라고 진단되어 있다고 하더라도 위와 같이 평소에는 건강하였던 위 망인이 이 사건 추락사고로 인하여 위와 같은 중상을 입고 치료를 받던 중 전신탈진 및 기아로 인한 심폐기능이 약화될 정도로 건강상태가 악화된 원인과 경위, 위 망인이 치료를 받던 도중의 신체상태의 변화, 치료의 경과, 위 망인의 사망원인으로 위 상해 이외의 다른 원인이 가공될 여지가 있었는지 여부, 위 길병원에서 다른 병원으로 전원을 권하게 된 연유 등을 좀더 심리하여 위 상해와 사망과의 사이에 인과관계가 있는지 여부를 면밀히 검토하여 보았어야 할 것이다.

원심이 이에 이르지 아니하고 만연히 위와 같은 이유만으로 위 상해와 사망과의 사이에 상당인과관계가 없다고 단정하고 만 것은 산업재해보상보험법 제3조 제1항 소정의 "업무상 재해"의 인과관계에 관한 법리를 오해하였거나 필요한 심리를 다하지 아니함으로써 판결결과에 영향을 미쳤다는 비난을 면하기 어렵고 이 점을 지적하는 논지는 이유 있다.

그러므로 원심판결을 파기환송하기로 하여 관여 법관의 일치된 의견으로 주문과 같이 판결한다.

대법관 안우만(재판장) 김용준 천경송(주심) 안용득

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Revocation of Disposition Denying Survivors' Benefits and Fu
#5
2013구합10939 · 서울행정법원 0001-01-01
Revocation of Disposition Denying Survivors' Benefits and Fu

Cases citing this decision

99두10438 · 대법원 2000-01-28
Revocation of Disposition Denying Survivor Benefits, etc. (유
98두10103 · 대법원 1999-01-26
Revocation of Disposition Denying Lump-Sum Survivor Benefits
97누7011 · 대법원 1997-09-05
Revocation of Disposition Denying Survivors' Benefits, etc.
94누2633 · 대법원 1994-08-26
Revocation of Denial of Medical Care Benefits (요양급여부지급처분취소)

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