South Korea's COMWEL faces record litigation failures, prompting calls to revise conservative accident recognition standards

South Korea's Workers' Compensation and Welfare Service (COMWEL) is facing increased scrutiny as its administrative litigation failure rate for industrial accident denials reached a six-year high in 2024, standing at 23%. This marks a significant increase from 13.1% in 2020, indicating a growing disconnect between the agency's decisions and judicial outcomes. The majority of these lawsuits, over 96%, involve claims for industrial accident insurance benefits filed by injured workers or their families.

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The agency is applying more narrow medical standards in approving industrial accidents than the courts.

The core issue appears to stem from COMWEL's conservative approach to recognizing industrial accidents, particularly occupational diseases like pneumoconiosis, musculoskeletal disorders, and cardiovascular conditions. While COMWEL often relies on specific criteria such as exceeding the 52-hour workweek for overwork cases, courts tend to adopt a broader perspective, considering factors like overall work-related stress. This divergence in interpretation is highlighted by the fact that over half of COMWEL's litigation losses in 2024 were attributed to 'differences in legal interpretation,' a shift from previous years where 'differences in judgment of facts and evidence' were the primary cause.

Labor attorney Kwon Dong-hee points out that COMWEL applies narrower medical standards than the courts. He advocates for broadening the scope of review processes to include legal experts alongside medical professionals and for a comprehensive revision of the recognition standards. Furthermore, the effectiveness of COMWEL's appeals after losing first-instance rulings has significantly diminished. The rate at which higher courts overturn decisions in favor of COMWEL has plummeted from the 20% range between 2020-2023 to just 6% last year, underscoring the weak basis of many of the agency's appeals.

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The agency is applying more narrow medical standards in approving industrial accidents than the courts. There is a need to expand the scope of participation in the deliberation and advisory process to include legal experts beyond medical professionals and to revise the relevant standards.

In response, COMWEL acknowledges the differing approaches, stating that it focuses on medical causality while courts consider the social security aspect of industrial accident insurance. The agency claims it is working to improve its industrial accident recognition and work processing standards by analyzing key court precedents and loss cases. However, the persistent high failure rate and the shift in reasons for litigation loss suggest that a more substantial overhaul of COMWEL's recognition criteria may be necessary to ensure fair compensation for affected workers and their families.

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The agency tends to judge the work-relatedness based on medical causality, while the court tends to judge it normatively and comprehensively, considering the social security aspect of industrial accident insurance.