A person left severely disabled after an influenza vaccination can still claim separate reimbursement for medical treatment if the illness recurs or worsens, even after receiving a lump-sum disability compensation payment from the state, South Korea's Supreme Court has ruled. The court found that while the presidential decree barring medical cost payments to recipients of lump-sum disability compensation is itself valid, the government cannot invoke it to reject all medical expense claims.
The Supreme Court's First Division, with Justice Shin Sook-hee as the presiding judge, recently upheld a lower court ruling in favor of a vaccine injury victim identified as A, who had sued the commissioner of the Korea Disease Control and Prevention Agency to overturn the denial of additional medical cost payments.
A received an influenza vaccination at a community health post on Oct. 7, 2014, and was diagnosed with Guillain-Barré syndrome on the 18th of the same month, requiring hospitalization. Guillain-Barré syndrome is a disorder in which the immune system attacks the peripheral nerves, causing muscle weakness and paralysis. In June 2015, A was certified as having a first-degree physical disability.
A applied to the disease control agency for vaccine injury compensation in September 2015 but was rejected. A then filed a separate administrative lawsuit and won a ruling overturning the denial. The agency subsequently paid A a total of 325.78 million won (about $226,000) in May 2021, including roughly 302.66 million won in lump-sum disability compensation, about 9.22 million won in medical costs and 13.9 million won in nursing care expenses.
A requested an additional 136.19 million won in unpaid medical costs incurred between October 2014 and June 2021. The agency rejected the request, citing Article 29 of the enforcement decree of the Infectious Disease Control and Prevention Act, which stipulates that medical costs are not paid to those who have received lump-sum disability compensation. A challenged the decision with another administrative lawsuit.
Both the trial court and the appeals court sided with A. The first-instance court ruled that the decree provision restricting medical cost payments on the grounds of lump-sum compensation was void, finding that it exceeded the scope delegated by the parent statute, unfairly discriminated against recipients of lump-sum payments and infringed on their right to claim compensation.
The Supreme Court also found it unlawful for the agency to issue a blanket denial without distinguishing the nature of the medical costs.
The court held, however, that the decree itself is valid. It said the provision should be read as withholding payment only for medical costs related to conservative treatment arising after the lump-sum disability compensation is paid. Medical costs incurred before the lump-sum payment cannot be excluded from compensation, the court ruled. Even after the lump-sum payment, the court said, medical costs must be reimbursed if the vaccination-related illness recurs or worsens and requires active treatment.
A died on June 20, 2024, ahead of the appeals court verdict, raising the question of whether the heirs could take over the case at the Supreme Court. The court ruled that the claim passes to the heirs under the inheritance provisions of the Civil Act even if the victim dies, and that the succession of the lawsuit by A's heirs was lawful.