Supreme Court Rules in Favor of Pneumoconiosis Workers
The Supreme Court has ruled that if the Korea Workers' Compensation and Welfare Service delays the payment of a lump-sum disability compensation to a worker diagnosed with pneumoconiosis while working in a dust-exposed workplace, thereby reducing the actual value of the insurance benefits, the average wage should be adjusted up to the date of the insurance benefit payment decision.
The Supreme Court Special Division 1 (Presiding Justice Kim Seon-su) overturned the lower court’s ruling that dismissed Mr. A’s lawsuit against the Korea Workers' Compensation and Welfare Service seeking correction of the average wage and payment of the difference in insurance benefits (2019Du45616) on the 16th of last month, and remanded the case to the Seoul High Court.
Mr. A was diagnosed with pneumoconiosis in March 2004 and began receiving medical treatment. Initially, the Service did not pay disability benefits to pneumoconiosis workers undergoing treatment, but after a series of contradictory rulings, it changed its operational guidelines to pay disability benefits. Accordingly, Mr. A applied for disability benefits in March 2016 and September 2017, but the Service rejected the applications citing “statute of limitations.”
In January 2018, a ruling was finalized in another pneumoconiosis worker’s lawsuit that the Service’s refusal to pay disability benefits due to the statute of limitations was unjust. Subsequently, the Service established new standards and paid Mr. A a lump-sum disability compensation of 9,011,360 KRW in April 2018. This amount was calculated by multiplying Mr. A’s average wage of 91,023 KRW at the time of the detailed pneumoconiosis diagnosis in March 2004 by the 99 days of disability benefit payment. In May 2018, Mr. A requested correction of the average wage and payment of the difference in insurance benefits from the Service, but the request was denied. Dissatisfied, Mr. A filed a lawsuit.
The key issue in the lawsuit was whether the period from the detailed pneumoconiosis diagnosis date to the date of the lump-sum disability compensation payment decision should be subject to adjustment of the average wage.
The Industrial Accident Compensation Insurance Act calculates the average wage based on the date the cause for calculation arises. The plaintiff argued that the average wage should be adjusted up to the insurance benefit payment decision date in April 2018. On the other hand, the defendant contended that the lump-sum disability compensation should only be adjusted up to the date the insurance benefit payment cause arises, i.e., the disability diagnosis date, and since in pneumoconiosis cases the date the cause arises and the payment cause date are the same, there is no need to adjust the average wage further.
The first and appellate courts ruled that the period from the detailed pneumoconiosis diagnosis to the lump-sum disability compensation payment decision date is not subject to average wage adjustment and dismissed Mr. A’s claim.
However, the Supreme Court held that if the Korea Workers' Compensation and Welfare Service unjustifiably refuses or delays payment of insurance benefits, thereby reducing the actual value of the benefits, the average wage must be adjusted up to the insurance benefit payment decision date, and remanded the case to the lower court.
The Supreme Court stated, “Article 36(3) of the Industrial Accident Compensation Insurance Act does not specifically limit cases where the average wage must be adjusted, nor does it separately regulate the timing (end point) of the adjustment. The defendant applies various timings or end points for adjusting the average wage to maintain the actual value of the insurance benefits. Adjusting the average wage up to the insurance benefit payment decision date in cases of unjustified refusal or delay is essential to protect injured workers and ensure administrative legality, and aligns with the purpose of the average wage adjustment system.”
Hong Yoon-ji, Legal News Reporter
※This article is based on content supplied by Law Times.
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