Workbear재주넘는곰
대법원 2019두31426

Claim for Disaster Consolation Payment [Recipient and Amount of Disaster Consolation Payment (재해위로금) Equivalent to Lump-Sum Disability Compensation (장해보상일시금) under the Coal Industry Act (석탄산업법)]재해위로금지급[석탄산업법에 따른 장해보상일시금 상당의 재해위로금 수급권자와 그 액수]

Decided2020. 10. 29. Court대법원Worker (surviving family) won
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 died of pneumoconiosis (진폐증) after his coal mine closed had his disability grade (장해등급) upgraded posthumously. The Korean Supreme Court ruled that his surviving family is entitled to receive the disaster consolation payment (재해위로금) calculated according to the newly upgraded disability grade, and that this amount must be paid in full without deducting any lump-sum disability compensation (장해보상일시금) that the worker had never actually received.

Key takeaways
  • CaseA coal miner died of pneumoconiosis after his mine closed, and his disability grade was later upgraded posthumously without him ever receiving disability compensation for his original grade.
  • OutcomeThe Supreme Court ruled that his family must receive the full disaster consolation payment based on the upgraded disability grade, with no deduction for unpaid prior benefits.
  • LessonEmployers and industry funds cannot deny or reduce disaster consolation payments (재해위로금) simply because a disability grade change occurred after the worker's death, especially when no prior benefit was ever actually paid out.
Issues
  • Whether the surviving family of a worker from a closed coal mine, whose disability grade was upgraded after his death, retains the right to receive the disaster consolation payment (재해위로금) based on the new grade
  • How to calculate the disaster consolation payment when the disability grade is changed after death and the worker never received disability benefits under the original, lower grade
Key reasoning

Because of the unique progressive nature of pneumoconiosis, the exact timing when a disability grade is reassessed or upgraded is essentially unpredictable and incidental. Therefore, even if the grade change occurs after the worker's death, the survivors should not be denied the disaster consolation payment (재해위로금) reflecting that updated grade. Furthermore, since the worker never actually received the lump-sum disability compensation (장해보상일시금) tied to his earlier, lower disability grade, there is no double payment issue that would justify deducting that amount from the consolation payment. Accordingly, the full amount corresponding to the upgraded disability grade must be paid to the family without any offset.

Summary of Decision (English, AI translation)

[1] Considering the characteristics of pneumoconiosis, the content of the relevant provisions, and the legislative purpose of disaster consolation payments (재해위로금) paid as part of the closed-mine countermeasure expenses, when the disability grade is changed after the death of a worker who suffered an occupational injury due to pneumoconiosis at a closed mine, the disaster consolation payment corresponding to the changed disability grade must be paid to the bereaved family.

[2] The purpose of Article 58(3)2 of the former Enforcement Decree of the Industrial Accident Compensation Insurance Act (산업재해보상보험법 시행령) (before amendment by Presidential Decree No. 23468 on December 30, 2011; hereinafter the “former Enforcement Decree of the Industrial Accident Compensation Insurance Act”) is to prevent the unreasonable result whereby a person who received medical care benefits and a lump-sum disability compensation for an occupational injury, and whose disability condition worsens after receiving further medical care such that the disability grade is changed, would receive duplicate disability benefits—including for the portion already compensated—if that person were to receive the full lump-sum disability compensation corresponding to the changed disability grade. Therefore, in a case where a person who suffered a bodily disability due to an occupational injury did not claim disability benefits according to the disability grade determined at that time, and thus received no compensation at all for the pre-existing disability, and only later, after the pre-existing disability condition worsened and the disability grade was changed, claimed a lump-sum disability compensation according to the changed disability grade, the unreasonable result of duplicate payment as described above does not arise. Accordingly, the Korea Workers’ Compensation and Welfare Service (근로복지공단) must pay the lump-sum disability compensation according to the number of payment days corresponding to the changed disability grade, and must not, on the basis of Article 58(3)2 of the former Enforcement Decree of the Industrial Accident Compensation Insurance Act, withhold payment of the lump-sum disability compensation for a period corresponding to the number of payment days under the pre-existing disability grade that the worker was never actually paid. This reasoning applies equally to a case where the right to claim disability benefits under the pre-existing disability grade became extinguished by prescription while the claim was never made.

[3] Considering the content and structure of Article 51(1) and Article 60(2) of the former Industrial Accident Compensation Insurance Act (산업재해보상보험법) (before amendment by Act No. 11141 on December 31, 2011) and Article 58(3)2 of the former Enforcement Decree of the Industrial Accident Compensation Insurance Act (산업재해보상보험법 시행령) (before amendment by Presidential Decree No. 23468 on December 30, 2011; hereinafter the “former Enforcement Decree of the Industrial Accident Compensation Insurance Act”), together with the purpose of Article 58(3)2 of the former Enforcement Decree of the Industrial Accident Compensation Insurance Act, in a case where a person who suffered an occupational injury due to pneumoconiosis at a closed mine failed to claim, and thus did not receive, the disaster consolation payment corresponding to the pre-existing disability grade, and only later, after the disability condition worsened and the disability grade was changed, claimed the disaster consolation payment according to the changed disability grade, the disaster consolation payment must be paid based on “the lump-sum disability compensation calculated according to the changed disability grade, without deducting the number of payment days corresponding to the lump-sum disability compensation for the previous disability grade.”

Full text (English, AI translation) 23,120 chars

[Plaintiffs, Appellees] Plaintiff 1 and 2 others (Law Firm Hansu, Attorney Cho Young-gi, Counsel for the plaintiffs)
[Defendant, Appellant] Korea Mine Reclamation Corporation
[Judgment Below] Seoul High Court Decision 2018Nu65318 dated December 13, 2018

[Order]

All appeals are dismissed. The costs of appeal are to be borne by the Defendant.

[Reasoning]

The grounds of appeal (to the extent supplemented by the supplementary brief on grounds of appeal submitted after the expiration of the period for submitting the grounds of appeal) are examined as follows.

1. Outline of the case and issues

A. According to the reasoning of the judgment below and the record, the following facts may be found.

1) The deceased Non-party (hereinafter referred to as “the Deceased”) worked as a coal-mining worker at ○○ Mining Station (hereinafter “the Mining Station in this case”) from around 1977 to around May 1989, and the Mining Station in this case was closed on September 5, 1989.

2) While working at the Mining Station in this case, the Deceased was diagnosed with pneumoconiosis on October 27, 1982, and was determined to have a disability grade of Class 11, Item 9 under the Industrial Accident Compensation Insurance Act (산업재해보상보험법), and on July 6, 1983, received a lump-sum disability compensation of 2,053,900 won accordingly.

3) The Deceased's condition gradually worsened, as shown by the following detailed pneumoconiosis diagnoses: on September 27, 1984, “pneumoconiosis pattern 2/2”; on July 22, 1996, “pneumoconiosis pattern 1/2, cardiopulmonary function F0 (normal)”; on October 30, 2000, “pneumoconiosis pattern 2/2, cardiopulmonary function F0 (normal)”; on December 4, 2007, “pneumoconiosis pattern 2/2, F1/2 (minor impairment)”; and on January 15, 2009, “pneumoconiosis pattern 2/2, cardiopulmonary function F1 (mild impairment), complication emphysema (em).” On April 30, 2009, the Deceased was determined eligible for medical care, and while receiving such care, died of pneumoconiosis on February 22, 2011.

4) Around July 2018, a decision was made to raise the Deceased's disability grade under the Industrial Accident Compensation Insurance Act to Class 7, Item 15, based on the detailed pneumoconiosis diagnosis result dated January 15, 2009. Plaintiff 1, the Deceased's spouse, received 53,833,250 won [≒135,942 won 57 jeon × (616 days − 220 days)], calculated as the lump-sum disability compensation for Class 7 disability (616 days of average wage) applicable at the time of the Deceased's death, minus the previously paid lump-sum disability compensation for Class 11 disability (220 days of average wage).

B. The issues in this case are: ① whether, where a worker who suffered an occupational injury due to pneumoconiosis at a closed mine has died and the disability grade is subsequently changed, disaster consolation money for the change in disability grade must be paid to the bereaved family pursuant to Article 41(3)4 of the former Enforcement Decree of the Coal Industry Act (석탄산업법 시행령) (before its amendment by Presidential Decree No. 12899 of January 3, 1990) (hereinafter “the Provision in this case”); and ② where a worker who suffered an occupational injury due to pneumoconiosis at a closed mine did not claim disaster consolation money based on the original disability grade and thus did not receive it, and later, after the disability condition worsened and the disability grade was changed, claimed disaster consolation money based on the changed disability grade for the first time, how the amount of such disaster consolation money should be calculated — that is, whether it should be “the sum of the lump-sum disability compensation under the previous disability grade and the additional lump-sum disability compensation payable under the changed disability grade (the amount obtained by multiplying the average wage by the number of days obtained by subtracting the number of payment days for the lump-sum disability compensation corresponding to the previous disability grade from the number of payment days for the lump-sum disability compensation corresponding to the changed disability grade),” or “the lump-sum disability compensation calculated according to the changed disability grade without deducting the number of payment days for the lump-sum disability compensation corresponding to the previous disability grade.”

2. Whether, where the disability grade is changed after the death of the injured worker, disaster consolation money for the change in disability grade must be paid to the bereaved family

A. Article 39-3(1) of the former Coal Industry Act (석탄산업법) (before its amendment by Act No. 4541 of March 6, 1993) provides that “where a coal mining business operator of a mine subject to payment of mine-closure countermeasure expenses has completed registration of extinguishment of the relevant mining right, mining lease right, or continuing operation right, the Coal Industry Rationalization Agency shall pay the following amounts as mine-closure countermeasure expenses to the retired workers and coal mining business operators, etc. of the relevant mine,” and Item 4 thereof provides for “other mine-closure countermeasure expenses prescribed by Presidential Decree.” Pursuant to this delegation, the Provision in this case provides: “Disaster consolation money paid to a person who suffered an occupational injury within one year retroactive from the date of mine closure and whose disability grade has been finalized as of the date of mine closure, or to a person whose disability grade has not been finalized as of the date of mine closure regardless of the period of occurrence of the injury. In this case, the amount of disaster consolation money shall be the same as the lump-sum disability compensation under Article 9-5(1) of the Industrial Accident Compensation Insurance Act or the lump-sum survivor compensation under Article 9-6(1) of the same Act received by the retired worker.”

B. The disaster consolation money paid, as part of mine-closure countermeasure expenses, to a worker who suffered an occupational injury at a closed mine has the character of a consolation payment given, from a social security perspective, in addition to the ordinary disaster compensation, to a worker who will face particular difficulties such as changing occupations due to an injury suffered at a mine that is closed because, in light of the domestic coal supply and demand situation, it is determined to be uneconomical and that continuing coal mining there would rather be undesirable for the balanced development of the national economy (see Supreme Court Decision 2001Du9592 delivered on March 29, 2002).

Pneumoconiosis is a representative occupational disease that may occur among workers at coal mining stations; it cannot be completely cured even by modern medicine, continues to progress even after leaving the dust-generating workplace, and its degree of progression is difficult to predict (see Supreme Court Decision 98Du5149 delivered on June 22, 1999). Furthermore, once a person contracts pneumoconiosis, they are exposed to various complications, and medical care benefits are mainly paid to treat complications caused by pneumoconiosis. Considering these characteristics of pneumoconiosis, whether pneumoconiosis that arose before the date of mine closure is severe enough to immediately warrant a disability grade, or whether it gradually worsens such that a disability grade is assigned only after the date of mine closure, is merely a matter of chance depending on the unpredictable rate of progression of pneumoconiosis (see Supreme Court Decision 2017Du69830 delivered on July 25, 2019). Therefore, “a person whose disability grade has not been finalized as of the date of mine closure regardless of the period of occurrence of the injury” under the Provision in this case includes an injured worker who, having once completed initial medical care and received a disability grade determination and the corresponding disaster consolation money, later, after the date of mine closure, suffers a recurrence of the relevant injury or disease or develops a complication caused by the relevant injury or disease and receives renewed medical care. In such a case, the difference between the disaster consolation money based on the new disability grade after the renewed medical care and the disaster consolation money based on the original disability grade must be additionally paid (see Supreme Court Decision 98Du12598 delivered on January 26, 1999).

C. Synthesizing the characteristics of pneumoconiosis, the content of the relevant provisions, and the legislative purpose of the disaster consolation money paid as part of mine-closure countermeasure expenses, it must be held that where a worker who suffered an occupational injury due to pneumoconiosis at a closed mine has died and the disability grade is subsequently changed, the disaster consolation money for the change in disability grade must be paid to the bereaved family. The specific reasons are as follows.

1) Since the change in the Deceased's disability grade was based on the detailed pneumoconiosis diagnosis result (the detailed diagnosis dated January 15, 2009) that occurred during the Deceased's lifetime, only the determination of the change in disability grade occurred after death, while the substantive grounds for the change in disability grade existed during the Deceased's lifetime. Therefore, it is reasonable to view that the right to disaster consolation money accrued to the Deceased at the time the Deceased, while alive, came to satisfy “the criteria for change in disability grade,” and that this right, as inherited property, was inherited by the Plaintiffs, who are the Deceased's heirs.

2) The diagnosis that forms the premise for the disability grade determination occurred during the Deceased's lifetime, and the determination of the disability grade and payment of the lump-sum disability compensation based thereon could have occurred during the Deceased's lifetime. It is difficult to find any need to treat differently, in terms of whether disaster consolation money equivalent to the lump-sum disability compensation should be paid, the case where the change in disability grade occurred during the Deceased's lifetime and the Deceased received the lump-sum disability compensation, from the case where the change in disability grade occurred after death and the bereaved family received the lump-sum disability compensation.

3) Although the latter part of the Provision in this case refers to “the lump-sum disability compensation received by the retired worker,” there may be cases where a disability grade determination was made but the corresponding lump-sum disability compensation was not received; therefore, it cannot be interpreted to mean that disaster consolation money is paid only in the case where “the retired worker received the lump-sum disability compensation during their lifetime.” Such an interpretation would also be contrary to the purpose of disaster consolation money, which has the character of a consolation payment given, from a social security perspective, in addition to the ordinary disaster compensation, to a worker who will face particular difficulties such as changing occupations due to an injury suffered at a mine.

4) The Provision in this case sets forth, as a requirement for payment of disaster consolation money, that the disability grade be “finalized,” not merely “determined.” This must be understood, in consideration of the characteristics of pneumoconiosis, as premised on the fact that a disability grade determination made as of the date of mine closure may later be changed, and as intended to require that, where such a change occurs, disaster consolation money be paid according to the finally determined disability grade (see Supreme Court Decision 2017Du69830 delivered on July 25, 2019). Therefore, insofar as a retired worker contracted the occupational disease of pneumoconiosis due to coal mining work at a closed mine and died after retirement due to the worsening of the symptoms, there is no reason to exclude the deceased or the bereaved family from the scope of protection merely because the final disability grade determination was made after the retired worker's death.

D. In the same vein, the court below determined that the Defendant must pay to the Plaintiffs, who are the Deceased's heirs, disaster consolation money equivalent to the lump-sum disability compensation according to Class 7, the disability grade changed after the Deceased's death. There is no error in the judgment below, as alleged in the grounds of appeal, that misapprehended the legal principles concerning the scope of persons eligible for disaster consolation money under the Provision in this case, thereby affecting the conclusion of the judgment.

3. The amount of disaster consolation money equivalent to the lump-sum disability compensation to be paid to the Plaintiffs

A. Article 51(1) of the former Industrial Accident Compensation Insurance Act (산업재해보상보험법) (before its amendment by Act No. 11141 of December 31, 2011, hereinafter “the former Industrial Accident Compensation Insurance Act”) provides that “a person who received medical care benefits may receive renewed medical care again if, after recovery, the occupational injury or disease that was the subject of the medical care recurs, or if the condition worsens compared to the time of recovery such that there is a medical opinion that active treatment is necessary to cure it,” and Article 60(2) provides that “where, after receiving renewed medical care and recovering, the disability condition has worsened compared to the previous condition, disability benefits shall be paid according to the disability grade corresponding to the worsened disability condition, and in this case, the method of calculating and paying disability benefits after renewed medical care shall be prescribed by Presidential Decree.” Pursuant to this delegation, Article 58(3)2 of the former Enforcement Decree of the Industrial Accident Compensation Insurance Act (산업재해보상보험법 시행령) (before its amendment by Presidential Decree No. 23468 of December 30, 2011, hereinafter “the former Enforcement Decree of the Industrial Accident Compensation Insurance Act”) provides that “where a person who received a lump-sum disability compensation claims a lump-sum disability compensation because the disability condition after renewed medical care has worsened compared to the previous condition, the amount obtained by multiplying the average wage by the number of days obtained by subtracting the number of payment days for the lump-sum disability compensation corresponding to the previous disability grade from the number of payment days for the lump-sum disability compensation corresponding to the changed disability grade shall be paid.”

B. The purpose of Article 58(3)2 of the former Enforcement Decree of the Industrial Accident Compensation Insurance Act is to prevent the unreasonable result that would occur if a person who received medical care benefits and lump-sum disability compensation due to an occupational injury, and whose disability condition worsened after renewed medical care, were to receive the full amount of the lump-sum disability compensation corresponding to the changed disability grade, thereby receiving duplicate disability benefits even for the portion of disability already compensated. Therefore, where a person who suffered a physical disability due to an occupational injury did not claim disability benefits according to the disability grade determined at that time and thus received no compensation at all for the existing disability, and only after the existing disability condition worsened and the disability grade was changed did the person claim a lump-sum disability compensation according to the changed disability grade for the first time, such an unreasonable result of duplicate payment does not occur; therefore, the Korea Workers' Compensation and Welfare Service must pay the lump-sum disability compensation according to the number of payment days corresponding to the changed disability grade, and must not, on the basis of Article 58(3)2 of the former Enforcement Decree of the Industrial Accident Compensation Insurance Act, withhold payment of the lump-sum disability compensation for the period corresponding to the number of payment days for the lump-sum disability compensation according to the existing disability grade that was never actually paid to the worker. This principle applies equally to a case where the right to claim disability benefits according to the existing disability grade has been extinguished by the statute of limitations while the worker had not claimed it (see Supreme Court en banc Decision 2012Du26142 delivered on April 16, 2015).

C. Synthesizing the content and structure of the relevant provisions above with the purpose of Article 58(3)2 of the former Enforcement Decree of the Industrial Accident Compensation Insurance Act, it must be held that where a person who suffered an occupational injury due to pneumoconiosis at a closed mine did not claim disaster consolation money according to the existing disability grade and thus did not receive it, and only after the disability condition worsened and the disability grade was changed did the person claim disaster consolation money according to the changed disability grade for the first time, the disaster consolation money must be paid as “the lump-sum disability compensation calculated according to the changed disability grade, without deducting the number of payment days for the lump-sum disability compensation corresponding to the previous disability grade.” The specific reasons are as follows.

1) Since the Provision in this case uses as its criterion the “finalization,” not the mere “determination,” of the disability grade, it is reasonable that, even if there was a previous disability grade determination, if the disability grade was later changed, the amount of disaster consolation money should be calculated and paid based on the finally changed disability grade.

2) Article 58(3) of the former Enforcement Decree of the Industrial Accident Compensation Insurance Act legislates on the premise that “the worker actually received disability benefits,” by providing for the case where the disability condition of “a person who received a lump-sum disability compensation” has worsened after renewed medical care compared to the previous condition. This is intended to prevent duplicate payment with the disability benefits already paid according to the existing disability grade, in a case where a person who received disability benefits due to an occupational injury has the injury or disease recur, receives renewed medical care, and then the disability condition changes. Therefore, in the case of a worker who has not previously received disaster consolation money, such that the issue of duplicate payment of disaster consolation money does not arise in the first place, the amount of disaster consolation money should not be calculated by deducting the number of payment days for the lump-sum disability compensation corresponding to the previous disability grade.

3) Article 36(3) of the former Industrial Accident Compensation Insurance Act provides that, in calculating insurance benefits, where more than one year has passed since the date on which the cause for calculating the average wage of the relevant worker arose, the average wage shall be increased or decreased each year according to the rate of increase or decrease in the average wage amount of all workers, and after the worker reaches the age of 60, the average wage shall be increased or decreased according to the rate of change in consumer prices. This is intended to maintain the substantive economic value of insurance benefits by paying insurance benefits according to the average wage at the “time of payment of benefits,” rather than at the “time the cause for payment arose.” Calculating the amount of disaster consolation money to be paid to the Deceased according to the changed disability grade as the simple sum of “the lump-sum disability compensation according to the previous disability grade” and “the additional lump-sum disability compensation payable according to the changed disability grade” would fail to take into account at all the rate of increase in average wages, the rate of increase in consumer prices, etc., during the period from the previous disability grade determination to the time of payment of disaster consolation money, and thus would not accord with the purpose of the above provisions on the method of calculating insurance benefits under the Industrial Accident Compensation Insurance Act.

4) Whether a worker who suffered an occupational injury due to pneumoconiosis initially receives a determination of a lower disability grade and, as the symptoms gradually worsen, later has the disability grade raised, or instead receives a determination of a higher disability grade from the outset, is merely a matter of chance depending on the unpredictable rate of progression of pneumoconiosis. However, if disaster consolation money were to be paid as the simple sum of “the lump-sum disability compensation according to the previous disability grade” and “the additional lump-sum disability compensation payable according to the changed disability grade,” a person who initially received a determination of a lower disability grade and received the corresponding lump-sum disability compensation, and whose disability grade was later raised, would receive disaster consolation money of lower substantive economic value than a person who received a determination of a higher disability grade from the outset. However, it is difficult to find a reasonable basis for differentiating the amount of disaster consolation money between two persons whose finally determined disability grades are the same, merely because of a difference in the rate of progression of pneumoconiosis.

D. In the same vein, the court below determined that the disaster consolation money equivalent to the lump-sum disability compensation to be paid by the Defendant to the Plaintiffs is the same amount as the lump-sum disability compensation corresponding to the Deceased's final disability grade of Class 7, calculated as of the time of payment of the disaster consolation money. There is no error in the judgment below, as alleged in the grounds of appeal, that misapprehended the legal principles concerning the method of calculating disaster consolation money under the Provision in this case, thereby affecting the conclusion of the judgment.

4. Conclusion

Therefore, all appeals are dismissed, and the costs of appeal are to be borne by the losing party. This Judgment is rendered as stated in the Order by the unanimous opinion of the Justices participating in the decision.

Justice Ahn Cheol-sang (Presiding Justice), Park Sang-ok, Roh Jeong-hee, Kim Sang-hwan (Justice in charge)

【판결요지】

[1] 진폐증의 특성을 기초로 관련 규정의 내용과 폐광대책비의 일환으로 지급되는 재해위로금의 입법 목적을 종합하면, 폐광된 광산에서 진폐로 인한 업무상 재해를 입은 근로자가 사망한 후에 장해등급이 변경된 경우 장해등급 변경에 따른 재해위로금을 그 유족에게 지급하여야 한다.

[2] 구 산업재해보상보험법 시행령(2011. 12. 30. 대통령령 제23468호로 개정되기 전의 것, 이하 ‘구 산재보험법 시행령’이라 한다) 제58조 제3항 제2호의 취지는 업무상의 재해로 요양급여 및 장해보상일시금을 받은 사람이 재요양 후 장해상태가 악화되어 변경된 장해등급에 해당하는 장해보상일시금을 전액 받게 된다면 이미 보상받은 장해급여 부분에 대해서까지 중복하여 장해급여를 받는 결과가 되므로, 이러한 불합리한 결과가 발생하는 것을 막기 위함이다. 따라서 업무상 재해로 신체장해를 입은 사람이 그 당시에 판정된 장해등급에 따른 장해급여를 청구하지 아니하여 기존의 장해에 대해서 전혀 보상을 받지 못하고 있다가 기존의 장해상태가 악화되어 장해등급이 변경된 후 비로소 변경된 장해등급에 따라 장해보상일시금을 청구한 경우에는, 그와 같은 중복지급의 불합리한 결과는 발생하지 아니하므로, 근로복지공단으로서는 변경된 장해등급에 해당하는 장해보상일시금의 지급일수에 따라 장해보상일시금을 지급하여야 하고, 구 산재보험법 시행령 제58조 제3항 제2호를 근거로 삼아 근로자에게 지급한 적이 없는 기존의 장해등급에 따른 장해보상일시금의 지급일수에 해당하는 기간만큼의 장해보상일시금을 부지급하여서는 아니 된다. 그리고 이러한 이치는 기존의 장해등급에 대한 장해급여청구를 하지 않던 중 그 청구권이 시효 소멸된 경우에도 마찬가지로 적용된다.

[3] 구 산업재해보상보험법(2011. 12. 31. 법률 제11141호로 개정되기 전의 것) 제51조 제1항, 제60조 제2항, 구 산업재해보상보험법 시행령(2011. 12. 30. 대통령령 제23468호로 개정되기 전의 것, 이하 ‘구 산재보험법 시행령’이라 한다) 제58조 제3항 제2호의 내용과 체계에 구 산재보험법 시행령 제58조 제3항 제2호의 취지를 종합하면, 폐광된 광산에서 진폐로 인한 업무상 재해를 입은 사람이 기존 장해등급에 따른 재해위로금을 청구하지 아니하여 지급받지 못하고 있다가 장해상태가 악화되어 장해등급이 변경된 후 비로소 변경된 장해등급에 따라 재해위로금을 청구한 경우에는 ‘종전 장해등급에 해당하는 장해보상일시금의 지급일수를 공제하지 않고 변경된 장해등급에 따라 산정된 장해보상일시금’으로 재해위로금을 지급하여야 한다.

【참조조문】

[1] 구 석탄산업법(1993. 3. 6. 법률 제4541호로 개정되기 전의 것) 제39조의3 제1항 제4호, 구 석탄산업법 시행령(1990. 1. 3. 대통령령 제12899호로 개정되기 전의 것) 제41조 제3항 제4호(현행 제41조 제4항 제5호 참조)

[2] 구 산업재해보상보험법(2011. 12. 31. 법률 제11141호로 개정되기 전의 것) 제51조 제1항, 제60조 제2항, 구 산업재해보상보험법 시행령(2011. 12. 30. 대통령령 제23468호로 개정되기 전의 것) 제58조 제3항 제2호

[3] 구 석탄산업법(1993. 3. 6. 법률 제4541호로 개정되기 전의 것) 제39조의3 제1항 제4호, 구 석탄산업법 시행령(1990. 1. 3. 대통령령 제12899호로 개정되기 전의 것) 제41조 제3항 제4호(현행 제41조 제4항 제5호 참조), 구 산업재해보상보험법(2011. 12. 31. 법률 제11141호로 개정되기 전의 것) 제51조 제1항, 제60조 제2항, 구 산업재해보상보험법 시행령(2011. 12. 30. 대통령령 제23468호로 개정되기 전의 것) 제58조 제3항 제2호

【참조판례】

[2] 대법원 2015. 4. 16. 선고 2012두26142 전원합의체 판결(공2015상, 697)

【주문】·【이유】 전문 7,928자 · 펼쳐 보기

【원고, 피상고인】 원고 1 외 2인 (소송대리인 법무법인 한수 담당변호사 조영기)

【피고, 상고인】 한국광해관리공단

【원심판결】 서울고법 2018. 12. 13. 선고 2018누65318 판결

【주 문】

상고를 모두 기각한다. 상고비용은 피고가 부담한다.

【이 유】상고이유(상고이유서 제출기간이 지난 다음 제출된 상고이유보충서는 이를 보충하는 범위에서)를 판단한다.

1. 사건의 개요와 쟁점

가. 원심판결의 이유와 기록에 의하면, 다음과 같은 사정을 알 수 있다.

1) 망 소외인(이하 ‘망인’이라 한다)은 1977년경부터 1989. 5.경까지 ○○광업소(이하 ‘이 사건 광업소’라 한다)에서 채탄부 광원으로 근무하였고, 이 사건 광업소는 1989. 9. 5. 폐광되었다.

2) 망인은 이 사건 광업소 근무 중이던 1982. 10. 27. 진폐증 진단을 받아 산업재해보상보험법에 따른 제11급 제9호의 장해등급 판정을 받고, 1983. 7. 6. 이에 따른 장해보상일시금 2,053,900원을 지급받았다.

3) 망인은 1984. 9. 27. 진폐정밀진단 결과 ‘진폐병형 2/2형’, 1996. 7. 22. 진폐정밀진단 결과 ‘진폐병형 1/2형, 심폐기능 F0(정상)’, 2000. 10. 30. 진폐정밀진단 결과 ‘진폐병형 2/2형, 심폐기능 F0(정상)’, 2007. 12. 4. 진폐정밀진단 결과 ‘진폐병형 2/2형, F1/2(경미장해)’, 2009. 1. 15. 진폐정밀진단 결과 ‘진폐병형 2/2형, 심폐기능 F1(경도 장해), 합병증 폐기종(em)’으로 판정받는 등 그 증상이 점차 악화되었고 2009. 4. 30. 요양판정을 받아 요양하던 중 2011. 2. 22. 진폐증으로 사망하였다.

4) 2018. 7.경 망인의 산업재해보상보험법상 장해등급을 2009. 1. 15.자 진폐정밀진단 결과에 따라 제7급 제15호로 상향하는 결정이 이루어졌고, 망인의 배우자인 원고 1은 망인의 사망 당시의 장해등급 제7급의 장해보상일시금으로 평균임금의 616일분에서 기존에 지급된 장해등급 제11급의 장해보상일시금인 평균임금의 220일분을 뺀 53,833,250원[≒ 135,942원 57전 × (616일 - 220일)]을 지급받았다.

나. 이 사건의 쟁점은, ① 폐광된 광산에서 진폐로 인한 업무상 재해를 입은 근로자가 그로 인하여 사망한 후에 장해등급이 변경된 경우 구 석탄산업법 시행령(1990. 1. 3. 대통령령 제12899호로 개정되기 전의 것) 제41조 제3항 제4호(이하 ‘이 사건 조항’이라 한다)에 따라 장해등급 변경으로 인한 재해위로금을 그 유족에게 지급하여야 하는지 여부, ② 폐광된 광산에서 진폐로 인한 업무상 재해를 입은 근로자가 기존 장해등급에 따른 재해위로금을 청구하지 아니하여 지급받지 못하고 있다가 장해상태가 악화되어 장해등급이 변경된 후 비로소 변경된 장해등급에 따라 재해위로금을 청구한 경우, 그 재해위로금의 액수를 어떻게 산정할 것인지, 즉 ‘종전 장해등급에 따른 장해보상일시금과 변경된 장해등급에 따라 추가로 지급될 장해보상일시금(변경된 장해등급에 해당하는 장해보상일시금의 지급일수에서 종전의 장해등급에 해당하는 장해보상일시금의 지급일수를 뺀 일수에 평균임금을 곱한 금액)의 합계액’으로 할 것인지, 아니면 ‘종전 장해등급에 해당하는 장해보상일시금의 지급일수를 공제하지 않고 변경된 장해등급에 따라 산정된 장해보상일시금’으로 할 것인지 여부이다.

2. 재해근로자가 사망한 후 장해등급이 변경된 경우 장해등급 변경에 따른 재해위로금을 그 유족에게 지급하여야 하는지 여부

가. 구 석탄산업법(1993. 3. 6. 법률 제4541호로 개정되기 전의 것) 제39조의3 제1항은 ‘폐광대책비의 지급 대상이 되는 광산의 석탄광업자가 당해 광업권ㆍ조광권 또는 계속작업권의 소멸등록을 마친 때에는 석탄산업합리화사업단은 당해 광산의 퇴직근로자 및 석탄광업자 등에게 다음 각호의 금액을 폐광대책비로 지급하여야 한다’라고 규정하고, 그 제4호에서 ‘기타 대통령령이 정하는 폐광대책비’를 규정하고 있다. 그 위임에 따라 이 사건 조항은 "폐광일로부터 소급하여 1년 이내에 업무상 재해를 입은 자로서 폐광일 현재 장해등급이 확정된 자 또는 재해발생기간에 불구하고 폐광일 현재 장해등급이 확정되지 아니한 자에 대하여 지급하는 재해위로금. 이 경우 재해위로금액은 퇴직근로자가 지급받은 산업재해보상보험법 제9조의5 제1항의 규정에 의한 장해보상일시금 또는 동법 제9조의6 제1항의 유족보상일시금과 동일한 금액으로 한다."라고 규정하고 있다.

나. 폐광대책비의 일환으로 폐광된 광산에서 업무상 재해를 입은 근로자에게 지급되는 재해위로금은, 국내의 석탄수급상황을 감안하여 채탄을 계속하는 것이 오히려 국민경제의 균형발전을 위하여 바람직하지 못하다고 판단되는 경제성이 없는 석탄광산을 폐광함에 있어서 그 광산에서 입은 재해로 인하여 특히 전업 등에 특별한 어려움을 겪게 될 근로자에게 사회보장적인 차원에서 통상적인 재해보상금에 추가하여 지급되는 위로금의 성격을 갖는다(대법원 2002. 3. 29. 선고 2001두9592 판결 참조).

진폐증은 석탄광업소의 근로자에게 발생할 수 있는 대표적인 업무상 재해로서, 현대의학으로도 완치가 불가능하고 분진이 발생하는 직장을 떠나더라도 그 진행을 계속하는 한편, 그 진행 정도도 예측하기 어렵다(대법원 1999. 6. 22. 선고 98두5149 판결 참조). 또한 진폐증에 걸리면 여러 합병증에 노출되는데, 주로 요양급여는 진폐로 인한 합병증을 치료하기 위하여 지급된다. 이러한 진폐증의 특성을 고려하면, 폐광일 전에 발생한 진폐증이 그 즉시 장해등급이 부여될 정도인지 또는 점차 악화되어 폐광일 후에 장해등급이 부여될지 여부는 예측 곤란한 진폐증의 진행 속도에 따른 우연한 사정에 불과하다(대법원 2019. 7. 25. 선고 2017두69830 판결 참조). 따라서 이 사건 조항의 ‘재해발생기간에 불구하고 폐광일 현재 장해등급이 확정되지 아니한 자’에는 일단 최초의 요양을 종결하고 그에 따른 신체장해등급 판정을 받고 그에 상응하는 재해위로금을 받았다가 폐광일 이후 해당 상병이 재발하거나 또는 해당 상병에 기인한 합병증이 발생하여 재요양을 받게 된 피재근로자도 포함되며, 이 경우 재요양 후의 새로운 장해등급에 따른 재해위로금에서 최초 장해등급에 따른 재해위로금의 차액을 추가로 지급하여야 한다(대법원 1999. 1. 26. 선고 98두12598 판결 참조).

다. 진폐증의 특성을 기초로 관련 규정의 내용과 폐광대책비의 일환으로 지급되는 재해위로금의 입법 목적을 종합하면, 폐광된 광산에서 진폐로 인한 업무상 재해를 입은 근로자가 사망한 후에 장해등급이 변경된 경우 장해등급 변경에 따른 재해위로금을 그 유족에게 지급하여야 한다고 보아야 한다. 그 구체적인 이유는 다음과 같다.

1) 망인의 장해등급 변경은 생전에 있었던 진폐정밀진단 결과(2009. 1. 15.자 정밀진단)를 기초로 한 것이므로 장해등급 변경 판정만 사후에 있었을 뿐 실질적인 장해등급 변경사유는 생전에 있었던 것이다. 따라서 망인이 생전에 ‘장해등급 변경기준에 해당하게 된 때’ 재해위로금에 관한 권리가 망인에게 발생하였고 이는 상속재산으로서 망인의 상속인인 원고들에게 상속된다고 봄이 타당하다.

2) 장해등급 판정의 전제가 되는 진단은 망인의 생전에 있었던 것이고 그에 따른 장해등급 결정 및 장해보상일시금 지급은 망인의 생전에 이루어질 수도 있었던 것인데, 생전에 장해등급 변경이 이루어져 망인이 장해보상일시금을 지급받은 경우와 사망 후에 장해등급 변경이 이루어져 그 유족이 장해보상일시금을 지급받은 경우 사이에 장해보상일시금 상당의 재해위로금의 지급 여부를 달리할 필요를 인정하기 어렵다.

3) 이 사건 조항 후문은 ‘퇴직근로자가 지급받은 장해보상일시금’이라고 규정하고 있으나, 장해등급 판정을 받았지만 그에 따른 장해보상일시금을 지급받지 아니한 경우도 있을 수 있으므로 오직 ‘퇴직근로자가 장해보상일시금을 생전에 지급받은 경우’에만 재해위로금을 지급한다는 의미로 해석할 수는 없다. 그와 같은 해석은 광산에서 입은 재해로 전업 등에 특별한 어려움을 겪게 될 근로자에게 사회보장적인 차원에서 통상적인 재해보상금에 추가하여 지급하는 위로금의 성격을 갖는 재해위로금의 취지에도 반한다.

4) 이 사건 조항은 재해위로금 지급요건으로 장해등급 ‘판정’이 아니라 장해등급 ‘확정’을 규정하고 있다. 이는 진폐증의 특성을 고려하여, 폐광일 현재를 기준으로 한 장해등급 판정이 나중에 변경될 수 있음을 전제로 하는 것이고 변경된 경우 최종적으로 판정된 장해등급에 따라 재해위로금을 지급하라는 취지로 보아야 한다(대법원 2019. 7. 25. 선고 2017두69830 판결 참조). 따라서 퇴직근로자가 폐광된 광산에서의 탄광 업무로 인하여 진폐증이라는 업무상 질병을 얻게 되었고, 퇴직 후 그 증상 악화로 사망하게 된 이상, 최종 장해등급 판정이 퇴직근로자의 사망 후에 이루어졌다고 하여 망인이나 그 유족들을 그 보호대상에서 제외할 이유가 없다.

라. 같은 취지에서 원심은, 피고가 망인의 상속인인 원고들에게 망인이 사망한 후에 변경된 장해등급인 제7급에 따른 장해보상일시금 상당의 재해위로금을 지급하여야 한다고 판단하였다. 이러한 원심판단에 상고이유 주장과 같이 이 사건 조항에 따른 재해위로금의 지급 대상에 관한 법리 등을 오해하여 판결 결과에 영향을 미친 잘못이 없다.

3. 원고들에게 지급하여야 할 장해보상일시금 상당의 재해위로금의 액수

가. 구 산업재해보상보험법(2011. 12. 31. 법률 제11141호로 개정되기 전의 것, 이하 ‘구 산재보험법’이라 한다) 제51조 제1항은 ‘요양급여를 받은 자가 치유 후 요양의 대상이 되었던 업무상의 부상 또는 질병이 재발하거나 치유 당시보다 상태가 악화되어 이를 치유하기 위한 적극적인 치료가 필요하다는 의학적 소견이 있으면 다시 재요양을 받을 수 있다.’고 규정하고, 제60조 제2항은 ‘재요양을 받고 치유된 후 장해상태가 종전에 비하여 악화된 경우에는 그 악화된 장해상태에 해당하는 장해등급에 따라 장해급여를 지급하고 이 경우 재요양 후의 장해급여의 산정 및 지급 방법은 대통령령으로 정한다.’라고 규정하고 있다. 그 위임에 따라 구 산업재해보상보험법 시행령(2011. 12. 30. 대통령령 제23468호로 개정되기 전의 것, 이하 ‘구 산재보험법 시행령’이라 한다) 제58조 제3항 제2호는 ‘장해보상일시금을 받은 사람이 재요양 후의 장해상태가 종전에 비하여 악화되어 장해보상일시금을 청구한 경우에는 변경된 장해등급에 해당하는 장해보상일시금의 지급일수에서 종전의 장해등급에 해당하는 장해보상일시금의 지급일수를 뺀 일수에 평균임금을 곱한 금액을 지급한다.’라고 규정하고 있다.

나. 구 산재보험법 시행령 제58조 제3항 제2호의 취지는 업무상의 재해로 요양급여 및 장해보상일시금을 받은 사람이 재요양 후 장해상태가 악화되어 변경된 장해등급에 해당하는 장해보상일시금을 전액 받게 된다면 이미 보상받은 장해급여 부분에 대해서까지 중복하여 장해급여를 받는 결과가 되므로, 이러한 불합리한 결과가 발생하는 것을 막기 위함이다. 따라서 업무상 재해로 인하여 신체장해를 입은 사람이 그 당시에 판정된 장해등급에 따른 장해급여를 청구하지 아니하여 기존의 장해에 대해서 전혀 보상을 받지 못하고 있다가 기존의 장해상태가 악화되어 장해등급이 변경된 후 비로소 변경된 장해등급에 따라 장해보상일시금을 청구한 경우에는, 그와 같은 중복지급의 불합리한 결과는 발생하지 아니하므로, 근로복지공단으로서는 변경된 장해등급에 해당하는 장해보상일시금의 지급일수에 따라 장해보상일시금을 지급하여야 할 것이고, 구 산재보험법 시행령 제58조 제3항 제2호를 근거로 삼아 근로자에게 지급한 적이 없는 기존의 장해등급에 따른 장해보상일시금의 지급일수에 해당하는 기간만큼의 장해보상일시금을 부지급하여서는 아니 된다. 그리고 이러한 이치는 기존의 장해등급에 대한 장해급여청구를 하지 않고 있던 중 그 청구권이 시효 소멸된 경우에도 마찬가지로 적용된다고 보아야 한다(대법원 2015. 4. 16. 선고 2012두26142 전원합의체 판결 참조).

다. 위와 같은 관련 규정들의 내용과 체계에 구 산재보험법 시행령 제58조 제3항 제2호의 취지를 종합하면, 폐광된 광산에서 진폐로 인한 업무상 재해를 입은 사람이 기존 장해등급에 따른 재해위로금을 청구하지 아니하여 지급받지 못하고 있다가 장해상태가 악화되어 장해등급이 변경된 후 비로소 변경된 장해등급에 따라 재해위로금을 청구한 경우에는 ‘종전 장해등급에 해당하는 장해보상일시금의 지급일수를 공제하지 않고 변경된 장해등급에 따라 산정된 장해보상일시금’으로 재해위로금을 지급하여야 한다고 보아야 한다. 그 구체적인 이유는 다음과 같다.

1) 이 사건 조항은 장해등급 ‘판정’이 아닌 장해등급 ‘확정’을 기준으로 삼고 있으므로 종전에 장해등급 판정이 있었더라도 나중에 장해등급이 변경되었다면 변경된 최종 장해등급을 기준으로 재해위로금의 액수를 산정하여 지급함이 타당하다.

2) 구 산재보험법 시행령 제58조 제3항은 ‘장해보상일시금을 받은 사람’이 재요양을 한 후의 장해상태가 종전에 비하여 악화된 경우를 규정하여 ‘근로자가 장해급여를 실제 수령한 것’을 전제로 입법이 이루어져 있다. 이는 업무상 재해로 장해급여를 받은 자가 그 부상 또는 질병이 재발하여 재요양을 받은 후 장해상태가 변경된 경우 이미 지급된 기존 장해등급에 관한 장해급여와 중복지급을 방지하기 위한 것이다. 따라서 기존에 재해위로금을 지급받은 바 없어 재해위로금의 중복지급 문제 자체가 발생하지 않는 근로자의 경우에는 종전 장해등급에 해당하는 장해보상일시금의 지급일수를 공제하여 재해위로금의 액수를 산정할 것은 아니다.

3) 구 산재보험법 제36조 제3항은 보험급여를 산정하는 경우 해당 근로자의 평균임금을 산정하여야 할 사유가 발생한 날부터 1년이 지난 이후에는 매년 전체 근로자의 임금 평균액의 증감률에 따라 평균임금을 증감하되, 그 근로자의 연령이 60세에 도달한 이후에는 소비자물가변동률에 따라 평균임금을 증감하도록 하고 있다. 이는 급여 ‘지급사유 발생시점’이 아니라 ‘급여 지급시점’의 평균임금에 따라 보험급여를 지급함으로써 보험급여의 실질적인 경제적 가치가 유지되도록 하려는 것이다. 망인에게 변경된 장해등급에 따른 재해위로금을 지급하면서 그 액수를 ‘종전 장해등급에 따른 장해보상일시금’과 ‘변경된 장해등급에 따라 추가로 지급될 장해보상일시금’의 단순 합계액으로 산정하는 것은, 종전 장해등급 판정 후 재해위로금 지급시점까지의 기간 동안 평균임금상승률과 소비자물가상승률 등을 전혀 고려하지 않는 것이므로 위와 같은 산업재해보상보험법상 보험급여 산정방식 규정 취지에 부합하지 아니한다.

4) 진폐로 인한 업무상 재해를 입은 근로자가 처음에 낮은 등급의 장해등급 판정을 받았다가 서서히 증상이 악화되어 장해등급이 상향될 것인지 또는 처음부터 높은 등급의 장해등급 판정을 받을 것인지 여부는 예측 곤란한 진폐증의 진행 속도에 따른 우연한 사정에 불과하다. 그런데 만약 ‘종전 장해등급에 따른 장해보상일시금’과 ‘변경된 장해등급에 따라 추가로 지급될 장해보상일시금’의 단순 합계액으로 재해위로금을 지급할 경우에는 처음에 낮은 등급의 장해등급 판정을 받고 장해보상일시금을 지급받았다가 장해등급이 상향된 사람은 처음부터 높은 등급의 장해등급 판정을 받은 사람보다 실질적인 경제적 가치가 낮은 액수의 재해위로금을 지급받게 된다. 그러나 진폐증의 진행 속도에만 차이가 있을 뿐 최종적으로 확정된 장해등급이 같은 두 사람의 재해위로금 액수를 달리할 합리적 이유를 찾기 어렵다.

라. 같은 취지에서 원심은, 피고가 원고들에게 지급할 장해보상일시금 상당의 재해위로금은 재해위로금 지급 당시를 기준으로 망인의 최종 장해등급인 제7급에 해당하는 장해보상일시금과 동일한 금액이라고 판단하였다. 이러한 원심판단에 상고이유 주장과 같이 이 사건 조항에 따른 재해위로금 산정방식에 관한 법리 등을 오해하여 판결 결과에 영향을 미친 잘못이 없다.

4. 결론

그러므로 상고를 모두 기각하고 상고비용은 패소자가 부담하도록 하여, 관여 대법관의 일치된 의견으로 주문과 같이 판결한다.

대법관 안철상(재판장) 박상옥 노정희 김상환(주심)

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