Workbear재주넘는곰
대법원 99두11424

Revocation of Disapproval of Medical Care (Workers' Compensation) Benefits요양불승인처분취소

Decided2000. 05. 12. Court대법원Worker 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 made shoe midsole molds collapsed from acute myocardial infarction (급성심근경색) while on the job. The Supreme Court found that the poor working environment—excessive noise, dust, and heat—caused physical fatigue and mental stress that aggravated the worker's pre-existing condition, thereby constituting an industrial accident (산업재해). The court revoked the Korea Workers' Compensation and Welfare Service's (근로복지공단) denial of medical care benefits, ruling in favor of the worker.

Key takeaways
  • CaseA shoe mold worker suffered a heart attack while working in a noisy, dusty, and overheated factory environment.
  • OutcomeThe Supreme Court ruled that the harsh working conditions aggravated his health and recognized it as a work-related injury, overturning the denial of benefits.
  • LessonEmployers and insurers must recognize that an industrial accident (산업재해) can be established through reasonable inference from circumstantial evidence, even without conclusive medical proof of direct causation.
Issues
  • Whether aggravation of a pre-existing illness due to work conditions constitutes an industrial accident (산업재해)
  • What degree of proof is required to establish a substantial causal relationship (상당인과관계) between work and illness
  • Whether overwork and stress caused by poor working conditions can be found to have triggered a myocardial infarction
Key reasoning

The court held that even a pre-existing illness unrelated to the job can qualify as an industrial accident if work conditions aggravate the illness or trigger its symptoms. It clarified that a 'substantial causal relationship' (상당인과관계) between work and the illness does not require clear medical proof, but may be inferred from the overall circumstances of the case. Here, the court reasoned that the harsh working environment—marked by noise, dust, and high heat—caused significant physical overwork and psychological stress, which in turn was inferred to have triggered the myocardial infarction. Therefore, the causal link between the working conditions and the health event was sufficiently established without requiring definitive medical certainty.

Summary of Decision (English, AI translation)

[1] "Occupational injury" under Article 4, Subparagraph 1 of the former Industrial Accident Compensation Insurance Act (산업재해보상보험법) (before its amendment by Act No. 6100 of December 31, 1999) means an injury or illness sustained by a worker as a result of the performance of his or her duties, and therefore there must be a causal relationship between the duties and the occurrence of the injury or illness. However, even if the injury or illness is a pre-existing disease not directly related to the duties, if it has been aggravated or its symptoms have first manifested due to an accident or other event that occurred in connection with the duties, a causal relationship between the duties and the injury or illness must be deemed to exist. In such a case, the party asserting the causal relationship bears the burden of proving it, but the causal relationship need not necessarily be clearly established in a medical or scientific sense; even in cases where, taking into account all relevant circumstances such as the worker's state of health at the time of employment, the circumstances surrounding the onset of the disease, the nature of the disease, and the course of treatment, a proximate causal relationship between the duties and the disease can be inferred, such proof shall be deemed to have been established.

[2] A case upholding the lower court's determination that an employee's acute myocardial infarction, who was in charge of making molds for shoe midsoles, constituted an occupational injury, on the ground that it could be inferred that the illness was induced by physical fatigue and mental stress caused by the workplace environment, including noise, dust, and high temperatures.

Full text (English, AI translation) 7,495 chars

[Plaintiff, Appellee] Plaintiff (Attorney: Busan Dongbu Law Firm, in charge of the case, Attorney Choi Jang-rak)
[Defendant, Appellant] Korea Workers' Compensation & Welfare Service
[Judgment Below] Busan High Court Decision 99Nu646, decided October 15, 1999

[Order]

The appeal is dismissed. The costs of the appeal shall be borne by the Defendant.

[Reasoning]

The grounds for appeal are examined.

An occupational injury under Article 4, Item 1 of the former Industrial Accident Compensation Insurance Act (산업재해보상보험법) (before its amendment by Act No. 6100 on December 31, 1999) means an injury sustained by a worker arising from the performance of his or her duties, and thus there must be a causal relationship between the duties and the occurrence of the injury. However, even where the injury is a pre-existing disease not directly related to the duties, if the disease has been aggravated, or its symptoms have first manifested, due to an accident or other event occurring in connection with the duties, a causal relationship between the duties and the injury must be found to exist. In such a case, the party asserting the causal relationship bears the burden of proving it, but the causal relationship need not necessarily be clearly established in medical or natural scientific terms; even where it can be inferred that there is a proximate causal relationship between the duties and the disease, taking into account all relevant circumstances such as the worker's health condition at the time of employment, the circumstances of the onset of the disease, the nature of the disease, and the course of treatment, such proof shall be deemed to have been established (see, e.g., Supreme Court Decision 99Du10360, decided December 10, 1999).

According to the reasoning of the judgment below, the court below, comprehensively considering the evidence adopted in its judgment, found as follows: the Plaintiff joined Non-Party 1 Company (hereinafter "the Non-Party Company"), a workplace subject to the Industrial Accident Compensation Insurance Act, on August 16, 1996, and worked as a section chief in the Development Department, which was in charge of manufacturing molds for shoe midsoles; the Plaintiff's usual working hours were from 8:00 a.m. to 6:30 p.m., but about once or twice a week he worked overtime until around 10:00 p.m.; around July 1997, when the accident occurred, although the Plaintiff did not work night shifts, the Development Department staff, including the Plaintiff, were manufacturing molds in response to about 19 requests from foreign companies and others; the work of the Development Department consisted of pattern-making work, sponge grinder work, and press work, among which the pattern-making work was mainly handled by Non-Party 2, the department manager, while the Plaintiff, the section chief, and Non-Party 3, a development worker, were mainly in charge of the sponge grinder work and press work in the first-floor workshop; the sponge grinder work involved cutting sponge to fit the shoe midsole and finishing the edges, which generated powder and dust during the process, making the air in the workshop somewhat turbid and also generating considerable noise; meanwhile, the press work involved placing sponge into a mold heated to about 140 to 145℃ and then cooling it, and the workshop was hot due to the high heat generated by the mold, with the temperature inside the workshop reaching close to 40℃ especially in summer, and there was also severe noise such as the sound of the heating plates colliding; on July 26, 1997, around 11:30 a.m., while working at the first-floor press workshop, the Plaintiff suddenly complained that his chest felt tight and said he needed to rest, and went up to the office on the third floor, where he broke into a cold sweat, clutched his chest, and complained of pain; a co-worker then hurriedly took the Plaintiff to a hospital for emergency treatment, but the Plaintiff eventually lost consciousness, and the diagnoses were sudden cardiac death, hypoxic encephalopathy, and acute inferior wall myocardial infarction; sudden cardiac death is a condition in which an atherosclerotic plaque ruptures due to acute myocardial infarction, suddenly blocking a coronary artery, causing necrosis of the heart muscle and rendering the myocardium electrically unstable, and as the heart fails to pump properly, hypoxic encephalopathy accompanies this condition; the main cause of such symptoms is generally known to be arteriosclerosis, but there is no material establishing that arteriosclerosis is the sole cause, and about half of the cases of myocardial infarction present without any particular precipitating factor, while physical overwork or mental stress can also be a precipitating factor for myocardial infarction; prior to the onset of the disease, in the annual physical examinations conducted on the Plaintiff, apart from a somewhat elevated cholesterol level (total cholesterol level of 238 at the health examination on June 23, 1997) and blood pressure (140/90 mmHg at the same examination), the Plaintiff had no particular health problems and was generally in good health, and although his personality was somewhat introverted, apart from worrying about his wife's two miscarriages, he had not experienced any particular worries or conflicts over family matters. Based on these findings, the court below determined that the Plaintiff's occupational injury was an occupational accident, in consideration of the following circumstances comprehensively: although the Plaintiff's work at the Non-Party Company was not to the extent of requiring night work, from June 1997 until the time the accident occurred, he was in a situation where he had to handle ongoing development work without a single day off; moreover, the environment of the workshop where the Plaintiff worked, due to noise, dust, and high heat, appeared to have imposed considerable physical fatigue and mental stress; the Plaintiff, who was 37 years old at the time of onset and generally in good health, suddenly fell ill while working at the Non-Party Company and lost consciousness; and physical overwork or mental stress can be a precipitating factor for myocardial infarction, which is the cause of sudden cardiac death. In light of these circumstances, the court below found that it could be sufficiently inferred that the overwork or stress arising from the Plaintiff's work at the Non-Party Company, together with other pre-existing precipitating factors possessed by the Plaintiff, induced the Plaintiff's myocardial infarction, and therefore concluded that a causal relationship was recognized between the Plaintiff's overwork or stress and the injury and disease in this case.

Examining the record in light of the foregoing legal principles, the fact-finding and determination of the court below as set forth above are acceptable, and there is no illegality therein, such as a violation of the rules of evidence or a misunderstanding of the legal principles concerning the Industrial Accident Compensation Insurance Act, as pointed out in the grounds for appeal. The grounds for appeal cannot be accepted.

Therefore, the appeal is dismissed, and the costs of the appeal are to be borne by the Defendant, the appellant. This judgment is rendered by the unanimous opinion of the participating Justices, as set forth in the Order.

Justice Lee Yong-woo (Presiding Justice), Kim Hyung-seon, Lee Yong-hoon (Justice in charge), Cho Mu-je

【판결요지】

[1] 구 산업재해보상보험법(1999. 12. 31. 법률 제6100호로 개정되기 전의 것) 제4조 제1호 소정의 업무상 재해라 함은 근로자가 업무수행에 기인하여 입은 재해를 뜻하는 것이어서 업무와 재해발생과의 사이에 인과관계가 있어야 하지만 그 재해가 업무와 직접 관련이 없는 기존의 질병이더라도 그것이 업무와 관련하여 발생한 사고 등으로 말미암아 더욱 악화되거나 그 증상이 비로소 발현된 것이라면 업무와의 사이에는 인과관계가 존재한다고 보아야 할 것이고, 이 경우 인과관계에 관하여는 이를 주장하는 측에서 입증하여야 하는 것이지만 그 인과관계는 반드시 의학적, 자연과학적으로 명백하게 입증되어야 하는 것은 아니고, 근로자의 취업 당시의 건강상태, 발병 경위, 질병의 내용, 치료의 경과 등 제반 사정을 고려할 때 업무와 질병 사이에 상당인과관계가 있다고 추단되는 경우에도 그 입증이 있다고 보아야 할 것이다.

[2] 신발 중창의 모형 제작을 담당하던 근로자의 급성심근경색증이 소음, 분진, 고열 등 작업장의 환경으로 인한 육체적 과로와 정신적 스트레스로 유발되었으리라고 추단된다는 이유로 위 상병이 업무상 재해에 해당한다고 본 원심을 수긍한 사례.

【참조조문】

[1] 구 산업재해보상보험법(1999. 12. 31. 법률 제6100호로 개정되기 전의 것) 제4조 제1호, 민사소송법 제187조, 제261조, 행정소송법 제8조 제2항, 제26조[입증책임]

[2] 구 산업재해보상보험법(1999. 12. 31. 법률 제6100호로 개정되기 전의 것) 제4조 제1호, 민사소송법 제187조, 제261조, 행정소송법 제8조 제2항, 제26조[입증책임]

【참조판례】

[1] 대법원 1989. 7. 25. 선고 88누10947 판결(공1989, 1308), 대법원 1989. 11. 14. 선고 89누2318 판결(공1990, 55), 대법원 1991. 11. 8. 선고 91누3727 판결(공1992, 131), 대법원 1992. 5. 12. 선고 91누10022 판결(공1992, 2026), 대법원 1999. 4. 23. 선고 97누16459 판결(공1999상, 1061), 대법원 1999. 12. 10. 선고 99두10360 판결(공2000상, 210)

【주문】·【이유】 전문 2,839자 · 펼쳐 보기

【원고, 피상고인】 원고 (소송대리인 법무법인 부산동부 담당변호사 최장락)

【피고, 상고인】 근로복지공단

【원심판결】 부산고법 1999. 10. 15. 선고 99누646 판결

【주 문】

상고를 기각한다. 상고비용은 피고의 부담으로 한다.

【이 유】 상고이유를 판단한다.

구 산업재해보상보험법(1999. 12. 31. 법률 제6100호로 개정되기 전의 것) 제4조 제1호 소정의 업무상 재해라 함은 근로자가 업무수행에 기인하여 입은 재해를 뜻하는 것이어서 업무와 재해발생과의 사이에 인과관계가 있어야 하지만 그 재해가 업무와 직접 관련이 없는 기존의 질병이더라도 그것이 업무와 관련하여 발생한 사고 등으로 말미암아 더욱 악화되거나 그 증상이 비로소 발현된 것이라면 업무와의 사이에는 인과관계가 존재한다고 보아야 할 것이고, 이 경우 인과관계에 관하여는 이를 주장하는 측에서 입증하여야 하는 것이지만 그 인과관계는 반드시 의학적, 자연과학적으로 명백하게 입증되어야 하는 것은 아니고, 근로자의 취업 당시의 건강상태, 발병 경위, 질병의 내용, 치료의 경과 등 제반 사정을 고려할 때 업무와 질병 사이에 상당인과관계가 있다고 추단되는 경우에도 그 입증이 있다고 보아야 할 것이다(대법원 1999. 12. 10. 선고 99두10360 판결 등 참조).

원심판결 이유에 의하면, 원심은 그 판결에서 채용하고 있는 증거들을 종합하여, 원고는 1996. 8. 16. 산업재해보상보험법의 적용을 받는 사업장인 소외 1 회사(이하 '소외 회사'라고 한다)에 입사하여 신발 중창의 모형을 제작하는 작업을 담당하는 개발과의 주임으로 근무하여 온 사실, 원고의 평소 근무시간은 08:00부터 18:30까지이나 일주일에 1, 2회 정도는 밤 10시경까지 연장근무를 하기도 하였으며, 원고가 재해를 당한 1997년 7월 무렵에는 비록 야근을 하지는 아니하였으나 외국의 회사 등으로부터 19건 정도의 모형제작을 요청받아 원고를 비롯한 개발과 직원들이 이를 제작하고 있었던 사실, 개발과의 작업은 패턴제작작업, 스폰지 그라인더작업, 프레스작업 등으로 이루어져 있는데, 그 중 패턴제작작업은 과장인 소외 2가 주로 담당하고, 주임인 원고와 개발공인 소외 3은 1층의 작업장에서 스폰지 그라인더작업 및 프레스작업을 주로 담당하여 온 사실, 스폰지 그라인더작업은 신발 중창에 맞도록 스폰지를 자르고 둘레를 다듬어 마무리하는 작업으로서 그 작업과정에서 분말과 분진이 발생하기 때문에 작업장은 공기가 다소 혼탁할 뿐만 아니라 소음도 상당히 발생하였고, 한편 프레스작업은 140 내지 145℃ 정도의 금형에 스폰지를 넣어 가열하고 이를 냉각하는 작업으로서 그 작업장은 금형으로부터 발생하는 고열로 인하여 더웠으며, 특히 여름철에는 작업장 내의 기온이 40℃ 가까이 이르렀고, 열판이 부딪히는 소리 등의 소음도 심하였던 사실, 원고는 1997. 7. 26. 11:30경 1층의 프레스 작업장에서 작업을 하다가 갑자기 가슴이 답답하다고 하면서 좀 쉬어야겠다며 3층의 사무실에 올라갔는데, 그 곳에서 진땀을 흘리면서 가슴을 움켜쥐고 통증을 호소하였고, 이에 동료 직원이 원고를 급히 병원으로 데려가 응급치료를 받게 했으나 결국 의식소실의 상태에 빠지고 말았는데, 그 병명은 심장급사, 저산소성 뇌병증, 하벽 급성심근경색증 등인 사실, 심장급사는 급성심근경색으로 인하여 동맥경화반이 파열되어 급작스럽게 관상동맥혈관이 막힘으로써 심장근육이 괴사되어 심근이 전기적으로 불안정한 상태가 되어 나타나는 증세로서, 심장이 펌프질을 하지 못하게 되어 저산소성 뇌병증이 수반되는데, 이러한 증세의 주된 원인은 일반적으로 동맥경화증이라고 알려져 있으나, 동맥경화가 유일한 원인이라고 인정할 자료는 없고 절반 정도는 특별한 유발요인 없이 심근경색의 증세를 나타내기도 하며, 육체적 과로나 정신적 스트레스도 심근경색의 유발요인이 될 수 있는 사실, 원고는 발병 이전까지 매년 실시하는 신체검사에서 콜레스테롤 수치(1997. 6. 23. 건강진단시 총콜레스테롤 수치 238)와 혈압(같은 날짜 건강진단시 140~90mmHg)이 다소 높게 나온 것 이외에는 건강에 별다른 이상이 없었고 평소에도 건강한 편이었으며, 성격은 내성적인 편이었으나 처가 두 차례 유산을 하여 걱정한 이외에는 집안 일로 고민을 하거나 갈등을 겪은 일은 없었던 사실을 각 인정한 다음, 원고의 소외 회사에서의 업무는 비록 야근을 하여야 할 정도는 아니었지만 1997년 6월 이후 재해발생 당시까지는 하루도 결근 없이 계속되는 개발업무를 처리하여야 할 형편이었던 점, 더구나 원고가 작업을 하였던 작업장의 환경은 소음·분진 및 고열로 인하여 상당한 육체적인 피로와 정신적인 스트레스를 가하였으리라고 보여지는 점, 원고는 발병 당시 만 37세로서 건강한 편이었는데 소외 회사에서 작업 중 갑자기 발병하여 의식소실에 이른 점, 육체적 과로나 정신적 스트레스가 심장급사의 원인인 심근경색의 유발인자가 될 수 있는 점 등의 사정을 종합하여 보면 원고의 소외 회사에서의 작업으로 인한 과로나 스트레스가 기존에 원고가 보유하고 있던 다른 유발인자와 함께 원고의 심근경색을 유발하였을 것으로 넉넉히 추단할 수 있고, 따라서 원고의 과로나 스트레스와 이 사건 상병 사이에는 인과관계가 인정된다는 이유로 원고의 위 상병은 업무상의 재해에 해당한다고 판단하고 있다.

기록과 위와 같은 법리에 비추어 살펴보면, 원심의 위와 같은 사실인정과 판단은 수긍이 가고, 거기에 상고이유에서 지적하는 바와 같은 채증법칙 위배나 산업재해보상보험법에 관한 법리오해의 위법이 없다. 상고이유는 받아들일 수 없다.

그러므로 상고를 기각하고, 상고비용은 상고인인 피고의 부담으로 하기로 관여 법관의 의견이 일치되어 주문과 같이 판결한다.

대법관 이용우(재판장) 김형선 이용훈(주심) 조무제

Related statutes

Similar cases

Cases with high content similarity to this one.

#1
2011누1223 · 서울고등법원 0001-01-01
Revocation of Disposition Denying Medical Care Benefits
#2
2008구단18017 · 서울행정법원 0001-01-01
Revocation of Disposition Denying Medical Care Benefits
#3
2010구단1258 · 서울행정법원 0001-01-01
Revocation of Disposition Denying Medical Care Benefits
#4
2020구단2183 · 수원지방법원 0001-01-01
Revocation of Disposition Denying Medical Care Benefits
#5
2019구단11036 · 광주지방법원 0001-01-01
Revocation of Disposition Denying Medical Care Benefits

Cases citing this decision

2007다84420 · 대법원 2008-03-27
진료비
2003두12912 · 대법원 2004-09-03
Revocation of Disposition Denying Survivors' Benefits and Fu
2003두12530 · 대법원 2004-04-09
Revocation of Non-Approval of Medical Care Benefits (요양불승인처분
2003두12844 · 대법원 2004-03-26
Revocation of Disposition Denying Survivors' Compensation an
2003두5501 · 대법원 2003-11-14
Revocation of Disposition Denying Survivor Benefits and Fune

Related tools & guides

AI answers need an account (free accounts: 2 per month) — submit and you'll return to this question after logging in. Search and case reading stay free.

Cross-check the original: 국가법령정보센터 (auxiliary link)