Useful Info

Re-treatment under workers' compensation insurance refers to the treatment required when a worker, after suffering a work-related injury, receiving treatment as industrial accident care, being fully cured or having symptoms stabilized and treatment concluded, subsequently experiences a recurrence of the original condition, onset of complications, or needs re-surgery such as removal of internal fixation pins. The eligibility for re-treatment is determined based on the 'medically reasonable causal relationship between the original condition and the condition applied for re-treatment' and the 'expectation of treatment effectiveness.'
Cases where re-treatment is recognized include:
① For general conditions, where a medically reasonable causal relationship is acknowledged between the original condition and the condition applied for re-treatment, and there is a medical opinion that treatment effectiveness can be expected through re-treatment
② Cases where removal of internal fixation devices such as metal pins inserted during internal fixation surgery is necessary
③ Cases where re-surgery on the amputation site is deemed necessary for prosthetic fitting. To apply for re-treatment, submit the re-treatment application form to the Workers' Compensation and Welfare Service Agency (KCOMWEL) branch that handled the initial treatment decision or the final treatment medical institution. The agency will consult with a consulting physician or the attending physician of the worker regarding symptom progression and clinical results, and within 7 days from the receipt date, decide and notify the applicant of the re-treatment eligibility.
If the agency finds it difficult to decide on re-treatment eligibility, it must have the worker examined at a medical institution designated by the agency and decide based on the results. (2005.04.01. Seoul Administrative Court 2003gu-dan 8626): The plaintiff, due to an injury from a roof fall accident in a mine, suffered from intervertebral disc herniation between the 4th and 5th lumbar vertebrae, received treatment, and concluded it. About 13 years later, pain in the lumbar region and radiating leg pain began to appear. This pain and radiating leg pain occurred because the intervertebral disc area between the 4th and 5th lumbar vertebrae, herniated due to the injury, swelled due to degenerative changes, narrowing the nerve space and compressing the nerve roots. As a treatment method, discectomy can be considered, and the intervertebral disc area damaged by trauma can accelerate the progression of degenerative changes. Therefore, it can be deemed that there is a causal relationship between the plaintiff's current lumbar pain and radiating leg pain and the injury in this case, and there is also a necessity for discectomy treatment. Thus, the plaintiff's 4th-5th lumbar intervertebral disc herniation has worsened compared to the condition at the time of treatment conclusion, qualifying for re-treatment where treatment effectiveness can be expected.