Parties to Requests for Examination
Requester for examination
- A requester for examination refers to a person with legal standing to seek the revocation or modification of a disposition by protesting against a result of a request for examination such as a decision, etc. on insurance benefits (Article 13 (1) of the Administrative Appeals Act and Article 111 (3) of the Industrial Accident Compensation Insurance Act)
Succession to status of a requester for examination
- Where a requester for examination or reexamination dies, if they are a beneficiary of insurance benefits, their status shall be succeeded by their survivors, and, if not, by their heirs or heiresses or a person who has succeeded to the right or interest related to the insurance benefits which are the subject matter of the request for examination or reexamination (Article 110 of the Industrial Accident Compensation Insurance Act).
Appellee
- The appellee of a request for examination is the Korea Workers' Compensation & Welfare Service which has made the decision, etc. on insurance benefits which are the subject matter of the request for examination (Article 17 (1) of the Administrative Appeals Act and Article 111 (3) of the Industrial Accident Compensation Insurance Act).
Filing Requests for Examination
Subject matters of requests for examination
- Any person who is dissatisfied with a decision, etc. made by the Korea Workers' Compensation & Welfare Service which falls under any of the following subparagraphs (hereinafter referred to as "decision, etc. on insurance benefits") may file a request for examination with the Service (Article 103 (1) of the Industrial Accident Compensation Insurance Act):
1. A decision on insurance benefits;
2. A decision on medical expenses;
3. A decision on medicinal expenses;
4. A measure, etc. to change a medical treatment plan;
5. A decision to make a lump-sum payment of insurance benefits;
6. Measures for preventing and controlling complications, etc.;
7. A decision on collection of unjust gains;
8. A decision on subrogation of the entitlement to insurance benefits.
Methods of requests for examination
- A request for examination shall be filed with the Korea Workers' Compensation & Welfare Service through a branch office of the Service (hereinafter referred to as "regional headquarters or branch") which has made the decision, etc. on insurance benefits (Article 103 (2) of the Industrial Accident Compensation Insurance Act).
- A request for examination shall be filed in a document specifying the following (hereinafter referred to as "written request for examination") (Article 96 (1) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act):
· Name and address of the requester (if such requester is a corporation, the name and location of such corporation and the name of its representative);
· Details of decision or measures on insurance benefits (hereinafter referred to as “decisions on insurance benefits, etc.”)
· Date on which the requester attains the knowledge of the decision, etc. on insurance benefits;
· Purport of and grounds for the request for examination;
· Whether the request for examination is notified, and the contents of the notification.
- If the requester for examination is not the worker suffering from an accident (excluding requests for examination related to a decision on medical expenses and medicine expenses stated above), the following shall be specified in the written request for examination in addition to those referred to above (Article 96 (2) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act):
· Name of the worker suffering from the accident;
· Name and location of the business to which the worker belonged at the time of the accident;
· If the request for examination is filed by an appointed representative or agent, the name and address of the appointed representative or agent shall be specified in the written request for examination in addition to those referred to above (Article 96 (3) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act).
- A written request for examination shall be signed or sealed by the requester for examination or their agent (Article 96 (4) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act).
Period of requests for examination
- A request for examination shall be filed within 90 days after the decision, etc. on insurance benefits is informed (Article 103 (3) of the Industrial Accident Compensation Insurance Act).
Request for corrections of requests for examination and dismissals
- If a request for examination is filed after the expiration of the period of requests for examination or violates the formalities as prescribed by statutes to the point of being uncorrectable, or fails to be corrected within the period prescribed by the Korea Workers' Compensation & Welfare Service, the Service shall decide to dismiss it (Article 97 (1) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act).
- Even though a request for examination violates the legal formalities, if it is possible to correct such violation, the Korea Workers' Compensation & Welfare Service may call on the requester for examination to correct it within a reasonable period of time (The main sentence of Article 97 (2) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act).
※ If matters to be corrected are insignificant, the Korea Workers' Compensation & Welfare Service may make that correction by virtue of its authority (The proviso to Article 97 (2) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act).
Suspension of Execution of Decision, etc. on Insurance Benefits
Suspension of execution of decision, etc. on insurance benefits
- A request for examination shall not suspend the execution of a decision, etc. on the insurance benefits concerned (The main sentence of Article 98 (1) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act).
※ If it is deemed urgently needed to avoid grave losses to be caused by the execution, the Korea Workers' Compensation & Welfare Service may suspend the execution (The proviso to Article 98 (1) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act).
- If the Korea Workers' Compensation & Welfare Service suspends an execution of a decision, etc. on the insurance benefits, the Service shall promptly notify this to the requester for examination in a document specifying the following (Article 98 (2) and (3) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act):
· Title of the case involving the request for examination;
· Decision, etc. on the insurance benefits subject to the suspension of execution, and the details of the suspension of execution;
· Name and address of the requester for examination;
· Reasons for the suspension of execution.
Decisions on Requests for Examination
Decisions on requests for examination
- A decision on a request for examination shall be made in a document specifying the following (Article 101 (1) and (2) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act).
1. Number and title of the case;
2. Name and address of the requester for examination (if the requester for examination is a corporation, the name and location of the corporation and the name of its representative);
3. Name and address of the appointed representative or agent (limited to a request for examination filed by an appointed representative or agent);
4. If the requester for examination is not the worker suffering from an accident, the name and address of the worker suffering from an accident;
5. Main text;
6. Purport of the request for examination;
7. Reasons;
8. Date of decision.
Sending, etc. of an original of the written decision on examination
- When the Korea Workers' Compensation & Welfare Service has decided on a request for examination, it shall send an original of the written decision on examination to the requester for examination (Article 101 (3) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act).
- When the Korea Workers' Compensation & Welfare Service makes a decision, etc. on insurance benefits or a decision on a request for examination, it shall inform the other party or the requester for examination of whether they can file a request for examination or reexamination with regard to the decision, etc. on insurance benefits or the decision on the request for examination, and of the request procedures and period if they files a request (Article 101 (4) of the Enforcement Decree of the Industrial Accident Compensation Insurance Act).