ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 1 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 1 04WC 38121 VANDERVOORT, DON OLINGER TRANSPORT, INC 05/27/04 THOMAS R LICHTEN QUINTAIROS PRIETO WOOD & BOY 2 05WC 31501 CARDINAL, VICTORIA CADBURY ADAMS 04/22/05 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 3 07WC 44057 EICKHORST, SALLY ST OF IL DEPARTMENT OF @ 05/02/06 BLACK & JONES ASSISTANT ATTORNEY GENERAL 4 07WC 55626 NOVAK, DAMIEN CHRYSLER LLC 09/25/07 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 5 08WC 51717 MURRAY, DANNA STREANWOOD BEHAVORAL HEAL 08/05/08 BLACK & JONES RIPES, NELSON, BAGGOT & 6 09WC 08213 19B DAHL, JAY D HIGHLAND CHEMICAL INC 10/23/08 GREG TUITE & ASSOC CAPUANI, FRANK S 7 09WC 37829 DEWEY, DANIEL IL DEPT OF TRANSPORTATION @ 05/27/09 BLACK & JONES ASSISTANT ATTORNEY GENERAL 8 10WC 06374 MC NEELY, ANNETTE CHRSLER LLC 10/21/09 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 11WC042282 -C CHRYSLERLLC 9 10WC 10404 REPPUHN, DANIEL CADBURY ADAMS 01/26/10 BLACK & JONES WIEDNER & MCAULIFFE LTD 10 10WC 19643 VIENS, MARONDA J CHRYSLER GROUP LLC 09/03/08 GREG TUITE & ASSOC WIEDNER & MCAULIFFE LTD 10WC019644 -C 10WC019645 -C 12WC031226 -C 12WC031227 -C 11 10WC 33260 OLSEN, DANIEL ACELL TRANSPORATION 01/02/10 STRONG LAW OFFICE RUSIN & MACIOROWSKI LTD 12 10WC 39505 BROWN, MARLEAN WINNEBAGO COUNTY 06/28/10 DWORKIN AND MACIARIELLO WILLIAMS MCCARTHY LLP 13 10WC 48895 WILLIAMS, TAMMY OFS ST ANTHONY HOSPITAL 09/24/10 BLACK & JONES HINSHAW & CULBERTSON 14 11WC 18514 JONES, GREGORY O NISSON FORKLIFT CORP 11/05/10 ALEXANDER, PETER LTD. WIEDNER & MCAULIFFE LTD 11WC018515 -C 15 11WC 19946 LANGERUD, MARY J FAIRHAVEN CHRISTIAN HOME 12/14/10 GREG TUITE & ASSOC PERRY GENTILE 16 11WC 45894 REPPUHN, DANIEL CADBURY ADAMS 11/20/11 BLACK, JIM LAW OFFICE WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 2 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 17 11WC 47641 BROWN, EDITH TESTORS CORP 08/01/11 BLACK & JONES 18 12WC 01307 LYNDE, CHARLES CITY OF LOVES PARK POLICE 08/15/08 HANNIGAN & BOTHA, LTD NYHAN BAMBRICK KINZIE & LOWR 19 12WC 11779 ORTIZ, JOSEPH SYNCREON 02/16/12 KATZ FRIEDMAN EAGLE ET AL GAROFALO SCHREIBER STORM GRA 14WC004881 -C 14WC004882 -C 14WC008163 -C 20 12WC 16966 FLORENTINE, FRANK WIRTZ BEVERAGE IL 08/01/11 SHELDON I MINKOW & ASSOCIA NYHAN BAMBRICK KINZIE & LOWR 12WC016967 -C 12WC016968 -C 13WC001652 -C 13WC017108 -C 21 12WC 32023 BRYANT, ROBERTA GENERAL MILLS 03/30/12 BLACK & JONES COZZI & GOGGIN-WARD 14WC005609 -C 22 12WC 33843 FALZONE, JOHN A DOUG'S PLOWING & GROUNDS W 06/22/12 ALEXANDER, PETER LTD. 23 12WC 35443 SPRAY, MICHAEL LOWE'S DISTRIBUTION CENTE 04/18/12 CAPRON & AVGERINOS PC INMAN & FITZGIBBONS 14WC018064 -C 24 12WC 37527 HUEY, SARAH ON BEHALF OF ST OF IL DEPT OF SINGER 10/03/11 BLACK & JONES ASSISTANT ATTORNEY GENERAL 13WC004313 -C SINGER STATE OF IL 13WC030281 -C 25 12WC 44534 JEFFERSON, TASHA R INTERNATIONAL AUTOMOTIVE 10/09/12 ANESI OZMON RODIN NOVAK KO GANAN & SHAPIRO 26 13WC 03675 NEWMAN, MICHAEL CARLSON HEATING, COOLING 06/19/12 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 17WC027890 -C 27 13WC 03843 LOZDOSKI, STEVEN T WOODWARD GOVERNOR COMPANY 12/10/12 GREG TUITE & ASSOC HINSHAW & CULBERTSON 15WC001087 -C 28 13WC 04020 DELAROSA, TAMMY T CHRYSLER, LLC 07/24/12 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 29 13WC 10337 19B MEDWED, DAVE CHEMTOOL INC 06/30/12 GESMER & REYNOLDS PC LAW OFFICES JOSEPH MARCINIAK 30 13WC 11898 RIVERA, OFELIA JOB NETWORK 01/28/13 GESMER LAW OFFICES, PC LEAHY EISENBERG & FRAENKEL

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 3 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 31 13WC 19767 LOPEZ, BERTHA R & H LAUNDROMAT & DRY 05/13/13 GREG TUITE & ASSOC RUSIN & MACIOROWSKI LTD 32 13WC 35730 JORDAN, LISA MONDELEZ INTERNATIONAL 08/23/13 BLACK & JONES WIEDNER & MCAULIFFE LTD 33 13WC 36816 BRASHER, DANA STREAMWOOD BEHAVIORAL HEA 08/05/08 BLACK & JONES RIPES NELSON BAGGOT KALOBRAT 34 14WC 06757 STINSON, BRANDFORD A & B FREIGHT LINE, INC 07/31/13 DWORKIN AND MACIARIELLO RIPES NELSON BAGGOT KALOBRAT 35 14WC 10844 WHITMORE, JOANNA M BYRON SCHOOL DISTRIC #226 01/30/14 OWENS & LAUGHLIN LLC NYHAN BAMBRICK KINZIE & LOWR 18WC016475 -C 36 14WC 16969 RICHARDSON, MARIA BERGSTROM INC 04/21/14 BLACK & JONES WOLFE & JACOBSON, LTD 37 14WC 19734 NGUYEN, HA HAMILTON SUNDSTRAND 08/01/13 BLACK & JONES MACIOROWSKI SACKMANN & ULRIC 38 14WC 21577 PICHE, KAYCEE PACKAGING COORDINATORS IN 06/10/14 GREG TUITE & ASSOC HEYL ROYSTER VOELKER & ALLEN 14WC021578 -C 14WC021579 -C 39 14WC 21924 HAHN, NICOLE GENERAL MILLS INC 03/03/14 BLACK & JONES PAUL A COGHLAN & ASSOC 40 14WC 22069 SELOVER, MARTIN GKN ROCKFORD INC 08/09/11 KATZ FRIEDMAN EAGLE ET AL RIPES NELSON BAGGOT KALOBRAT 41 14WC 22540 CADWELL, JOHN E UNIVERSITY OF ILLINOIS 02/28/14 GREG TUITE & ASSOC HEYL ROYSTER VOELKER & ALLEN 42 14WC 25421 ROSS, JAMIE CHRYSLER CORP 07/01/13 BLACK & JONES WIEDNER & MCAULIFFE LTD 14WC025422 -C 15WC018315 -C 43 14WC 25429 GARCIA, MARISELA ERIE FOODS INTERNATIONAL 12/26/13 BLACK & JONES HOLECEK & ASSOCIATES 44 14WC 25554 MORRIS, THERESA (WIDOW PETRO TECH HAULING INC # 03/20/06 NASH LAW OFFICE PC EVANS & DIXON

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 4 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 45 14WC 26708 MENDOZA, JOSE METALS USA 01/22/14 BOTTO GILBERT GEHRIS POULOS & DIBENEDETTO LAW 16WC017946 -C 46 14WC 29364 STAHL, DALE GATEHOUSE MEDIA 07/15/14 THOMAS L NASH PC WIEDNER & MCAULIFFE LTD 14WC042607 -C GATE HOUSE MEDIA D/B/A 47 14WC 32156 CLARK, TIMOTHY IV CHRYSLER LLC 03/05/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 15WC025967 -C 15WC025968 -C 48 14WC 33249 PRINNER, ROBIN UPS FREIGHT SERVICES 02/17/14 GESMER & REYNOLDS PC ASA LAW GROUP 17WC009405 -C 49 14WC 34212 IRVIN, KELLY BREAKERS SALOON & EATERY 06/25/12 BLACK & JONES 50 14WC 36592 BUNTON, LLONA BLAIN'S FARM & FLEET 08/03/14 BLACK & JONES RIPES NELSON BAGGOT KALOBRAT 51 14WC 37539 RINGEL, MICHAEL M MID STATES CONCRETE INDUS 09/04/14 ANESI OZMON RODIN NOVAK KO GAROFALO SCHREIBER STORM GRA 52 14WC 39511 FLETCHER, JAMES WINNEBAGO COUNTY HWY DEPT 02/28/14 BLACK & JONES WILLIAMS MCCARTHY LLP 53 14WC 40690 CUPLIN, STEVEN R CHRYSLER LLC 10/15/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE 54 14WC 42628 FIELDS, WADE E CASSENS TRANSPORT 10/09/14 FRANKS, GERKIN & MCKENNA P KNAPP, OHL & GREEN 14WC042629 -C 55 14WC 43138 CACCIATORE, JENNIFER L ILLINOIS DCFS @ 02/21/14 CACCIATORE, WILLIAM T ASSISTANT ATTORNEY GENERAL 15WC019992 -C STATE OF IL, DEPT OF 56 14WC 43334 MANUEL, NIEVES AEROTEK 11/17/14 JAMES ELLIS GUMBINER & ASS LITCHFIELD CAVO 57 15WC 00689 POWELL, MARK LOU BACHRODT AUTO MALL 09/04/13 BLACK & JONES RUSIN & MACIOROWSKI LTD 58 15WC 05202 CENTENO, JUDITH ARAMARK 12/11/14 CACCIATORE, WILLIAM T WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 5 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 59 15WC 07267 JENNINGS, MICHAEL ROEHL TRANSPORT 12/28/14 DAVID W MARTAY CACCHILLO LAW GROUP LLC 60 15WC 07925 POHLMAN, STACY FIRST STUDENT 10/01/13 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 15WC007926 -C 61 15WC 08316 LEBER, JONATHAN F CARRIER COMMERCIAL 05/15/13 GREG TUITE & ASSOC MACIOROWSKI SACKMANN & ULRIC 15WC038479 -C 62 15WC 09361 LUKE, CAROL STATE OF IL-DORS @ 02/17/15 BLACK & JONES ASSISTANT ATTORNEY GENERAL 63 15WC 09415 MCALLISTER, CINDY ELGIN MENTAL HEALTH CENTE 01/19/15 BLACK & JONES ASSISTANT ATTORNEY GENERAL 64 15WC 09940 HERBST, CINDY HAMILTON-SUNDSTRAND UTC 02/19/15 KATZ FRIEDMAN EAGLE ET AL MACIOROWSKI SACKMANN & ULRIC 65 15WC 10169 CHRISTIANSEN, WANDA J UNITED TECHNOLOGIES CORP 08/22/13 FRANCINE B WHITE MACIOROWSKI SACKMANN & ULRIC 15WC010170 -C 16WC017527 -C 66 15WC 14200 MARQUEZ, TONYA EMERY AIR INC 12/12/13 BLACK & JONES COZZI & GOGGIN-WARD 67 15WC 15789 CRABB, DEBORHA L HELP AT HOME 01/23/15 KATZ FRIEDMAN EAGLE ET AL COZZI & GOGGIN-WARD 68 15WC 17272 DE VLIEGER, LAURIE A ROCKFORD MASS TRANSIT DIS 05/06/15 GREG TUITE & ASSOC WILLIAMS MCCARTHY LLP 69 15WC 17504 SEVERSON, PAUL NORTHWEST PALLETT SUPPLY 12/10/14 BLACK & JONES HEYL ROYSTER VOELKER & ALLEN 70 15WC 17636 GILMORE, TOYA LATRICE CHRYSLER LLC 05/04/15 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 71 15WC 17951 KULJANIN, MILOMIR MEGA EXPRESS 11/20/13 BLACK & JONES SCOPELITIS GARVIN LIGHT 72 15WC 17952 ROBLES TRETO, NOEL JESSICA FARTH GARCIA D/B/ W 03/12/15 BLACK & JONES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 6 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 73 15WC 18273 JAMES, JIMMY A STERLING FARM & FLEET INC 05/03/14 GREG TUITE & ASSOC WOLFE & JACOBSON, LTD 74 15WC 19177 TIDWELL, JOSEPH ROCKFORD MEMORIAL HOSPITA 05/21/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 15WC019178 -C 16WC007078 -C 16WC007079 -C 75 15WC 20523 CHANTHAPHONE, SONENALINH CITY OF ROCKFORD FIRE DEP 12/05/14 REESE & REESE HEYL ROYSTER VOELKER & ALLEN 15WC022058 -C 16WC009683 -C 17WC014266 -C 76 15WC 22443 GALBO, JASON GILLS FREEPORT DISPOSAL 01/08/15 CULLEN HASKINS NICHOLSON NYHAN BAMBRICK KINZIE & LOWR 77 15WC 23194 SANDERS, SCOTT LIEBOVICH CUSTOM FABRICAT 09/03/14 GESMER & REYNOLDS PC POULOS & DIBENEDETTO LAW 78 15WC 24249 HADUCA-DIECKHOUS, PREDICA ROCKTON SCHOOL DISTRICT 1 05/07/14 SCHWEICKERT & GANASSIN LAW OFFICES JOSEPH MARCINIAK 79 15WC 25221 BILLINGSLEY, BARBRA CHRYSLET LLC 06/12/15 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 80 15WC 25606 19B CROOK, RICHARD II CON-WAY FREIGHT 11/21/14 KROL BONGIORNO & GIVEN LTD RUSIN & MACIOROWSKI LTD 81 15WC 26402 STEVENS, LAKRISHA IAC MANAGEMENT, LLC 12/17/14 BLACK & JONES GANAN & SHAPIRO 82 15WC 26559 WESLEY, FELICIA DANFOSS DRIVES 05/03/14 BLACK & JONES HENNESSY & ROACH PC 83 15WC 27340 PITTAWAY, JASON SWEDISH AMERICAN HOSPITAL 11/15/12 GESMER & REYNOLDS PC WILLIAMS MCCARTHY LLP 84 15WC 28563 MC GUIRE, CHARLES L. ROCKFORD BOARD OF EDUCATI 07/28/15 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 85 15WC 29216 MARTIN, DANIEL T CITY OF ROCKFORD 07/21/15 THOMAS W DUDA HEYL ROYSTER VOELKER & ALLEN 86 15WC 29470 ARTEAGA, CLAUDIO MODERN SUSPENSION SYSTEMS 02/14/14 GESMER LAW OFFICES, PC HENNESSY & ROACH PC 87 15WC 33863 NEVAREZ, XHAVIER OAKLEY SUB ASSEMBLY 05/26/15 MARTIN V KUGIA 88 15WC 34186 HOLLIMAN, ROSE M ANDROID INDUSTRIES 09/10/15 DWORKIN AND MACIARIELLO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 7 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 89 15WC 34772 VERVINCK, SAMANTHA MCDONALDS 03/26/15 GESMER LAW OFFICES, PC 90 15WC 35746 KLOSOWSKI, KARL J HIGHLAND PARK CVS, LLC 08/13/15 GESMER & REYNOLDS PC HINSHAW & CULBERTSON 91 15WC 36548 WILCOX, MILTON WOODS EQUIPMENT CO 05/20/14 WOODRUFF & JOHNSON COZZI & GOGGIN-WARD 92 15WC 36592 LIEBER, STACY HEALTHPORT 08/28/15 BLACK & JONES THOMAS & PORTELA 15WC036593 -C 93 15WC 37802 LEDDY, NICK ROCKFORD ICE HOGS 11/25/12 GORDON LAW OFFICES LTD HENNESSY & ROACH PC 94 15WC 39327 SHELTON, JAMES C PEARL CITY ELEVATOR CO-OP 07/09/13 BLACK & JONES CAPUANI, FRANK S 95 15WC 41706 MICHALSEN, JULIE CITY OF ROCKFORD 12/01/14 GESMER & REYNOLDS PC HEYL ROYSTER VOELKER & ALLEN 96 15WC 41709 JOHNSON, JONNY BARNES INTERNATIONAL 10/02/14 BLACK & JONES 97 15WC 42452 GUTIERREZ, JESUS NORTHWEST PALLET SUPPLY 12/16/15 DWORKIN AND MACIARIELLO HEYL ROYSTER VOELKER & ALLEN 98 16WC 01458 SEAS, SHARLEEN ILLINOIS STATE POLICE @ 04/27/15 RIDGE & DOWNES ASSISTANT ATTY GENERAL 99 16WC 02567 HARDWICK, ELLIOTT GET FRESH PRODUCE 01/21/16 COSTA IVONE LLC EVANS & DIXON 100 16WC 04134 STRONG, JOHN METALS USA 11/14/15 BLACK & JONES POULOS & DIBENEDETTO LAW 101 16WC 05206 CARTER, HENRY GE AVIATION SYSTEMS LLC 03/25/15 MARKS INJURY LAW MACIOROWSKI SACKMANN & ULRIC 102 16WC 05807 MESSINK, CYNTHIA KUMMER AMERICA CORP 01/19/16 GESMER & REYNOLDS PC LAW OFFICES JOSEPH MARCINIAK 103 16WC 06089 GRAHAM, CHARLENE BCBS OF IL 03/27/15 BLACK & JONES LAW OFFICES STEPHEN CARTER 16WC025257 -C 104 16WC 06213 FRANK, RICKY II CHRYSLER LLC 08/24/15 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 105 16WC 06717 GRIFFIN, THOMAS A TOMERMO INC 02/03/16 TUITE LAW ROSARIO CIBELLA 106 16WC 07104 LAWSON-ROSS, BECKY PACKAGING COORDINATORS IN 10/23/15 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 8 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 107 16WC 07179 PEYTON, CARA IAC BELVIDERE CROSSLINK A 10/14/15 WOODRUFF & JOHNSON GANAN & SHAPIRO 108 16WC 09513 OSTRANDER, SEAN GRUPO ANTOLIN 03/04/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 109 16WC 09540 SANCHEZ, DONNELL NVUS METALS, INC. 02/17/16 RICHARD O. GREENFIELD THOMAS & PORTELA 110 16WC 11953 MENDEZ, CASSIE F SWEDISH AMERICAN HOSPITAL 07/22/15 ANKIN LAW OFFICE WILLIAMS MCCARTHY LLP 111 16WC 13448 RODRIGUEZ, MARY A ROSECRANCE HEALTH NETWORK 02/01/14 THE ROMAKER LAW FIRM POWER & CRONIN LTD 112 16WC 13571 TOBIN, ROBERT (BEHALF OF PREMIUM TRANSP. STAFFING 03/10/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 16WC013575 -C 113 16WC 13837 VISENTIN, MARK ROCKFORD ICE HOGS 01/22/16 FLOYD LAW FIRM HENNESSY & ROACH PC 114 16WC 14317 SHEPARD, TIMOTHY AIM DISTRIBUTION INC 04/08/16 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 115 16WC 14696 LOFT, JOHN STATE OF ILLINOIS @ 10/06/14 VANDERGINST LAW PC ASSISTANT ATTY GENERAL 116 16WC 15424 GREEN, PAULA STATE OF IL DORS 04/18/16 BLACK & JONES ASSISTANT ATTY GENERAL 117 16WC 16129 MCWILLIAMS, WILLIAM T. ROCKFORD MASS TRANSIT DIS 04/06/16 LEE, MARK N LAW OFFICE 118 16WC 16622 JOHNSON, MEGAN F. DEAN FOODS DBA ICE CREAM 05/21/15 TUITE LAW BRADY CONNOLLY & MASUDA PC 119 16WC 16830 CROPPER, ROBERT FISCHER EXCAVATING INC 03/27/11 GESMER & REYNOLDS PC 120 16WC 17569 DAVIS, OKIE SWEDISH AMERICAN 07/02/15 NEWLAND & NEWLAND WILLIAMS MCCARTHY LLP 121 16WC 19022 PFAFF, TERESA WALMART 08/19/15 TUITE LAW QUINTAIROS PRIETO WOOD & BOY 122 16WC 19030 JONES, RICHARD SYNCREON NORTH AMERICA 03/31/16 BLACK & JONES GAROFALO SCHREIBER STORM GRA 123 16WC 20440 WYNER, ERIC J LOU BACHRODT CHEVROLET 07/17/15 RICHARD E ALEKSY GANAN & SHAPIRO 124 16WC 20453 GENANDT, SUSAN CORNERSTONE CREDIT UNION 02/16/16 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 9 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 125 16WC 20559 FRESCAS, ALEJANDRO ANDROID INDUSTRIES 11/26/15 KATZ FRIEDMAN EAGLE ET AL SMITH AMUNDSEN LLC 126 16WC 20636 PRESLEY, COURTNEY CITY OF ROCKFORD POLICE D 03/31/15 NASH LAW OFFICE PC HEYL ROYSTER VOELKER & ALLEN 127 16WC 20884 GRIFFIN, EDWYNNE M ARAMARK UNIFORM & 02/26/16 TUITE LAW WIEDNER & MCAULIFFE LTD 128 16WC 21176 JIMENEZ, LUIS R FIAT CHRYSLER AUTOMOBILES 06/28/14 JACOBSON & SCHIEFELBEIN WIEDNER & MCAULIFFE LTD 129 16WC 21513 LARSON, ROBBY SYCREON 04/25/16 GESMER & REYNOLDS PC GAROFALO SCHREIBER STORM GRA 16WC023091 -C SYNCREON 130 16WC 21539 PARHAM, STUDGE GRUPO ANTOLIN 06/16/16 KATZ FRIEDMAN EAGLE ET AL 131 16WC 22243 FOAT, KATASHA APAC 10/04/15 CHASE & WERNER LTD HENNESSY & ROACH PC 132 16WC 22452 GONZALEZ, MARIA ARAMARK UNIFORM SERVICES 04/08/16 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 133 16WC 22519 RENTON, MICHAEL ROCKFORD MASS TRANSIT DIS 03/04/16 LEE, MARK N LAW OFFICE POWER & CRONIN LTD 134 16WC 22567 BROWN, TONYA MENARDS 10/05/15 BLACK & JONES CHILTON YAMBERT PORTER LLP 135 16WC 22589 KUZIORA, TOMASZ FCA US LLC 04/11/16 WOODRUFF & JOHNSON WIEDNER & MCAULIFFE LTD 16WC022590 -C 136 16WC 22593 SINGLETON, CHERYL L ANDROID INDUSTRIES 07/09/16 KATZ FRIEDMAN EAGLE ET AL 137 16WC 23352 STAFFORD, ADAM J ILLINOIS TOOL WORKS INC 06/21/16 TUITE LAW HENNESSY & ROACH PC 138 16WC 24036 HILL, COLLEEN DEPARTMENT OF HUMAN SERVI 05/06/15 BLACK & JONES ASSISTANT ATTY GENERAL 139 16WC 24066 RYLATT, JULIE A. STATE OF ILLINOIS DEPT. O @ 07/22/16 TUITE LAW 140 16WC 24934 GONZALEZ, MARIA ARAMARK UNIFORM SERVICES 05/29/15 GESMER & REYNOLDS PC 141 16WC 24936 RILEY, MICHAEL B CITY OF ROCKFORD 08/04/16 THOMAS W DUDA HEYL ROYSTER VOELKER & ALLEN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 10 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 142 16WC 25839 MOORE, WILLIAM J ABLE BUILDING MAINTENANCE 10/27/15 ALEXANDER, PETER LTD. 143 16WC 26546 WATTS, WILLIAM B WESLEY WILLOWS CORPORATIO 05/27/16 TUITE LAW NYHAN BAMBRICK KINZIE & LOWR 17WC005040 -C 144 16WC 26559 MOLL, JANE E FREEPORT HEALTH NETWORK 04/12/16 GAROFALO SCHREIBER STORM GRA 145 16WC 28090 BRUCE, JEROME GUNITE CORPORATION 01/19/15 TUITE LAW RUSIN & MACIOROWSKI LTD 146 16WC 28098 STORM, GRAIL L CONSERV FS, INC 12/30/15 TUITE LAW HEYL ROYSTER VOELKER & ALLEN 147 16WC 28594 JOINER, FELICIA MAPLE CREST CARE CENTER 08/25/16 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 18WC001539 -C NORTHWOODS NURSING HOME 148 16WC 29813 NEWHAUFEN, BEVERLY HENREY GENERAL MILLS 04/29/16 MARTIN V KUGIA PAUL A COGHLAN & ASSOC 16WC031283 -C 149 16WC 29950 PARRA, LETICIA EBERSPAECHER 08/28/15 KATZ FRIEDMAN EAGLE ET AL RUSIN & MACIOROWSKI LTD 150 16WC 30222 READER, ROBERT L WINNEBAGO COUNTY HIGHWAY 04/04/16 TUITE LAW 151 16WC 30425 HOMAN, SONYA THE DEPOT 09/10/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 152 16WC 30449 DRIVER, JENNIFER DEPT OF REHAB SVC @ 09/09/14 GESMER LAW OFFICES, PC HELEN LOZANO 153 16WC 30523 PETSCH, JOSEPH LANE'S AUTO SERVICE, INC 09/09/16 GESMER & REYNOLDS PC ROSARIO CIBELLA 154 16WC 31447 GONZALEZ-GARIBAY, PEDRO GRJ TRUCKING 05/12/16 GESMER & REYNOLDS PC 155 16WC 31836 MORRIS, TENNES R JR SYNCREON 08/13/16 BLACK & JONES GAROFALO SCHREIBER STORM GRA 156 16WC 32659 PHILLIPS, VANESSA ALDI 06/10/16 MARTIN V KUGIA BRADY CONNOLLY & MASUDA PC 17WC022018 -C 157 16WC 33205 GUSTAFSON, JEFFREY R CITY OF ROCKFORD 04/05/16 THOMAS W DUDA HEYL ROYSTER VOELKER & ALLEN 158 16WC 34032 COKE, JONATHAN NATIONAL TECHNICAL SYSTEM 10/20/15 RUSIN & MACIOROWSKI LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 11 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 159 16WC 34136 MCNAB, SEAN NOODLES & COMPANY 10/25/16 DWORKIN AND MACIARIELLO 160 16WC 34591 STOREY, RHONDA AJ KENT, INC D/B/A 09/17/13 TUITE LAW HENNESSY & ROACH PC 161 16WC 35243 BOONE, D'EVYRON CITY OF ROCKFORD POLICE D 07/24/16 NASH LAW OFFICE PC HEYL ROYSTER VOELKER & ALLEN 162 16WC 35416 FERRIERO, BENN ST LOUIS BLUES 01/24/15 WOLFE LAW PC HENNESSY & ROACH PC 163 16WC 36472 RICE, LEON TITAN TIRE 10/17/16 BLACK & JONES MICHAEL JASPER 164 16WC 38031 MATTI, ALIN OCEAN BLUE TRUCKING INC 11/21/16 DWORKIN AND MACIARIELLO 165 16WC 38129 SALLIS, SUMMER IAC 11/10/16 BLACK & JONES 166 16WC 38809 ROBINSON, RODNEY CLIFFBREAKERS RIVERSIDE H 04/18/15 DWORKIN AND MACIARIELLO EVANS & DIXON 167 16WC 38898 JONES, LASAONYA, ROCKFORD SCHOOL DIST 205 08/18/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 168 17WC 01204 MOORE, JANICE M MONDELEZ GLOBAL LLC 11/20/14 TUITE LAW WIEDNER & MCAULIFFE LTD 169 17WC 01382 MACK, JOHN FOLKERTS MANUFACTURING 11/07/16 170 17WC 01847 GUSTAFSON, JULIE ROCKFORD HEALTH SYSTEM 06/12/15 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 171 17WC 02223 STALLWORTH, DENNIS DELICATE PLASTICS, INC. 12/01/16 BLACK & JONES 172 17WC 02302 VAZQUEZ, JOHNNY CITY OF ROCKFORD POLICE D 10/23/16 THOMAS L NASH PC HEYL ROYSTER VOELKER & ALLEN 173 17WC 02314 GROGAN, JOHN SYNCREON 12/12/16 KATZ FRIEDMAN EAGLE ET AL SMITH AMUNDSEN LLC 174 17WC 02342 KEHOE, ELAISOIN YALE ENFORCEMENT @ 12/10/16 MARSZALEK AND MARSZALEK HOLECEK & ASSOCIATES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 12 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 175 17WC 02533 JONES, BRENDA HERITAGE WOODS 12/28/16 BLACK & JONES POWER & CRONIN LTD 176 17WC 02733 MOLINA, MARCO COLON'S RESALE SHOP 11/25/16 177 17WC 03530 LOWE, EMANUEL METRO STAFFING 11/21/16 BLACK & JONES 178 17WC 03841 TAYLOR, KATHLEEN FCA US LLC 05/07/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 179 17WC 04929 MITCHELL, JOHN HEIR OF BR CHERRY VALLEY SIGN COMPAN # 09/21/16 BARRICK SWITZER LONG ET AL WIEDNER & MCAULIFFE LTD 180 17WC 04989 ALVAREZ, FRANCISCO R&D THIEL 07/04/16 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 181 17WC 05057 BRAUER, TAMRA K MEIJER 01/15/17 GESMER & REYNOLDS PC KOPKA, PINKUS DOLIN, PC 182 17WC 05619 HEADLEY, ORVILLE MR ORVILLE HEADLY 02/06/17 BLACK & JONES HENNESSY & ROACH PC 183 17WC 06608 ALEXANDER, MATTHEW QPS EMPLOYMENT GROUP, INC 10/28/16 DEPAOLO ZADEIKIS GORE WOLFE & JACOBSON, LTD 184 17WC 07073 GARCIA, RUBEN MID-STATE CONCRETE INDUST 01/17/14 BLACK & JONES GAROFALO SCHREIBER STORM GRA 17WC007074 -C 185 17WC 07789 HERNANDEZ, MARTINA ND INDUSTRIES, INC 02/21/17 GESMER & REYNOLDS PC HENNESSY & ROACH PC 186 17WC 08194 HALL, BRENETTA PRESENCE ST JOSEPH CTR 11/15/16 BLACK & JONES BRADY CONNOLLY & MASUDA PC 187 17WC 08197 RASMUSSEN, ANDREW THOMPSON LINEAR 02/20/17 BLACK & JONES GILDEA & COGHLAN 188 17WC 08581 NACHAMPSSACK, KINGKAMONE TESTORS CORPORATION 01/09/17 KATZ FRIEDMAN EAGLE ET AL EVANS & DIXON 189 17WC 08686 COLLINS, RITA LOWE'S DISTRIBUTION CENTE 11/14/16 BLACK & JONES KEEFE CAMPBELL & ASSOC LLC 190 17WC 09086 JARRELL, ROBERT J CONCORDIA WIRELESS/TRIAD 02/16/17 MARK E MORELAND RIPES NELSON BAGGOT KALOBRAT 191 17WC 09694 MANRIQUEZ, REBECCA LANDSTAR INWAY INC 07/29/16 BLACK & JONES COZZI & GOGGIN-WARD 192 17WC 10851 CRUZ, RUBIN ALDEN DEBES REHABILITATIO 04/01/17 STRONG LAW OFFICE LAW OFFICES FRANCESCA LARSEN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 13 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 193 17WC 10965 NIELSEN, LESLIE MR STEVE DORNICK 10/18/15 BLACK & JONES GILDEA & COGHLAN 194 17WC 13162 GOMEZ, JESUS BL WELLWOOD SERVICES 04/25/17 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 19WC013454 -C 195 17WC 14174 MILLER, SUSAN L SWEDISH AMERICAN, A DIVIS 01/16/17 CACCIATORE, WILLIAM T WILLIAMS MCCARTHY LLP 196 17WC 14363 AURAND, LORI A SCHNUCKS MARKETS, INC 06/01/15 TUITE LAW LEMP & MURPHY 17WC014366 -C 18WC022331 -C 197 17WC 14681 RICHARDSON, THOMAS A ROCKFORD PUBLIC SD #205 01/30/17 TUITE LAW WIEDNER & MCAULIFFE LTD 198 17WC 15977 FLORES RAMOS, JOSE MANUEL FORREST PALLET SERVICES, 04/04/17 WOODRUFF & JOHNSON CHILTON YAMBERT PORTER LLP 199 17WC 16100 THORSEN, GERALD ANDREW M. NELSON DBA ANDR 04/04/17 STROW LAW LLC CLARK FROST 200 17WC 16371 CROSS, FARREN PCI PAHRMA SERVICES 05/11/17 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 201 17WC 16492 RAIH, PATRICIA ADDUS HEALTHCARE 12/13/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 202 17WC 16689 HUGHES, KIM SYNCREON AUTOMOTIVE 11/29/16 O'CONNOR & NAKOS KEEFE CAMPBELL & ASSOC LLC 17WC016690 -C 203 17WC 17741 STANTON, ASHLEY CARDINAL STAFFING SERVICE 02/06/17 BLACK & JONES THOMAS MAMER & HAUGHEY 204 17WC 18018 MATHESON, ROBERT L JR ROCKFORD MEMORIAL HOSPITA 03/23/15 TUITE LAW WIEDNER & MCAULIFFE LTD 205 17WC 18637 CLAY, RAVEN MILESTONE 09/01/16 BLACK & JONES ACCIDENT FUND HOLDINGS 206 17WC 18640 RUNDBERG, TORI GENRAL MILLS, INC 01/15/17 BLACK & JONES BRYCE DOWNEY & LENKOV LLC 17WC030596 -C GENERAL MILLS INC 207 17WC 18752 ELLIOTT, BRANDON P HOME DEPOT USA, INC. 05/29/17 TUITE LAW ADELSON TESTAN BRUNDO 208 17WC 18839 MARTINEZ, ANTONIO STEEL CUTTERS, INC. 11/19/16 BLACK & JONES GAROFALO SCHREIBER STORM GRA 209 17WC 18899 CEBUHAR, MICHELLE ILLINOIS LOTTERY 04/07/16

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 14 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 210 17WC 19249 CHIPMAN, PAMELA GE AVIATION 06/01/17 KATZ FRIEDMAN EAGLE ET AL MACIOROWSKI SACKMANN & ULRIC 211 17WC 19306 SALDANA, PEDRO G BRYNOLF MANUFACTURING INC 03/07/17 TUITE LAW GAROFALO SCHREIBER STORM GRA 212 17WC 19319 MARKS, CHELSEA ROCKFORD PARK DISTRICT 06/01/17 MC HARGUE & JONES HENNESSY & ROACH PC 213 17WC 19455 JOHNSON, TANISHA HELP AT HOME 02/27/17 GESMER LAW OFFICES, PC 214 17WC 19642 OLTHOFF, RONALD FIRE AND SAFETY EQUIPMENT 06/06/17 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 215 17WC 19747 LEGAULT, DEANNA M ROCKFORD PUBLIC SCHOOL @ 09/06/16 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 216 17WC 20156 FLOETER, MACKENZIE CHEMTOOL INC 06/23/17 BLACK & JONES MACIOROWSKI SACKMANN & ULRIC 217 17WC 20828 FREET, MICHAEL S WINNEBAGO COUNTY SHERIFFS 05/05/17 STROW LAW LLC WILLIAMS MCCARTHY LLP 218 17WC 21126 KEEDI, MIRNA ROCKFORD SCHOOL DISTRICT 02/06/17 CLARK FROST WIEDNER & MCAULIFFE LTD 219 17WC 21129 MC ELYEA, VESTLE RAY JR ADVANCED DISPOSAL 02/22/17 BLACK & JONES INMAN & FITZGIBBONS 220 17WC 21293 BLACKWELL, KEITH GUSTAVE A LARSON COMPANY 04/26/17 HORWITZ HORWITZ & ASSOC NOBLE & ASSOC 221 17WC 21409 GERMAIN, RENEE L FREEPORT HEALTH NETWORK 01/26/17 TUITE LAW GAROFALO SCHREIBER STORM GRA 222 17WC 21713 HART, MARGARET FCA US, LLC 07/02/17 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 223 17WC 21817 LEON, MARICELA EVOLUTION STAFFING INC 05/11/17 TUITE LAW HENNESSY & ROACH PC 224 17WC 22173 RAMOS, JOHANN QPS EMPLOYMENT GROUP 07/22/17 COSTA IVONE LLC 225 17WC 22241 FUNK, DAVID HAMILTON-SUNDSTRAND UTC 01/25/17 KATZ FRIEDMAN EAGLE ET AL MACIOROWSKI SACKMANN & ULRIC 226 17WC 22816 LUX, CONSTANCE BON TON DISTRIBUTION CENT 06/08/17 GESMER & REYNOLDS PC 227 17WC 23056 MCLESTER, RAMONA LUCRAMARE, INC DBA 07/10/17 THOMAS J STIBERTH LAW OFFI

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 15 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 228 17WC 23063 THOMAS, QUENTIN DR PEPPER SNAPPLE GROUP 01/25/17 BLACK & JONES GAROFALO SCHREIBER STORM GRA 229 17WC 23178 BARNHART, MICHAEL CITY OF ROCKFORD DEPT 05/09/17 REESE & REESE HEYL ROYSTER VOELKER & ALLEN 230 17WC 23446 CRUZ, JAVIER COMCAST CORPORATION 01/22/16 GESMER LAW OFFICES, PC POWER & CRONIN LTD 231 17WC 23799 ARTEAGA, CLAUDIO MODERN SUSPENSION SYSTEMS 12/16/13 BLACK & JONES HENNESSY & ROACH PC 232 17WC 24294 PHILLIPS, ANEATER ROCKFORD RESCUE MISSION 03/28/17 NASH LAW OFFICE PC WILLIAMS MCCARTHY LLP 233 17WC 24339 MESCH JR, DARYL MWTS 03/13/17 SCHWEICKERT & GANASSIN 234 17WC 24857 SCHULTZ, DAVID BRIDGEWAY 06/28/17 GESMER LAW OFFICES, PC PERRY GENTILE 235 17WC 25103 PETSCH, JOSEPH LANE'S AUTO SERVICE, INC 01/11/17 GESMER & REYNOLDS PC ROSARIO CIBELLA 236 17WC 25513 ALLEN, KURT E BALLARD ELECTRIC DIVISION 05/27/16 ALEXANDER, PETER LTD. HOLECEK & ASSOCIATES 237 17WC 25738 RUSH, BRIAN J MEIBORG BROS INC 06/14/17 FRANKS, GERKIN & MCKENNA P WOLFE & JACOBSON, LTD 238 17WC 25761 STARK, JAMES FRANKLIN TOWNSHIP CEMETER 06/26/17 GESMER & REYNOLDS PC JAMES M KELLY 239 17WC 25860 GIBBONS, JENNIFER SWEDISH AMERICAN HOSPITAL 08/26/17 GESMER & REYNOLDS PC GAROFALO SCHREIBER STORM GRA 240 17WC 26437 CLARK, EMMANUEL OAKLEY SUB ASSEMBLY 04/14/16 MARTIN V KUGIA 17WC026438 -C 241 17WC 26458 FISCHER, RAYMOND TRI-DIM FILTER CORP 08/01/17 BLACK & JONES 242 17WC 26837 MADRIGAL, ALICIA STAFF ON SITE UNITED INC 08/10/16 HERRERA LAW CENTER QUINTAIROS PRIETO WOOD & BOY 243 17WC 27128 PETERSON, DENISE (DIANE) DOLLAR TREE 04/10/17 BLACK & JONES 244 17WC 27210 GIOPPO, LISA LOWE'S COMPANIES, INC 07/18/17 GESMER & REYNOLDS PC KEEFE CAMPBELL & ASSOC LLC 245 17WC 27519 LILLY, BRIAN QPS EMPLOYMENT 07/28/17 DWORKIN AND MACIARIELLO WOLFE & JACOBSON, LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 16 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 246 17WC 27688 GOBER, MELISSA FCA US, LLC 05/21/17 BLACK & JONES WILLIAMS MCCARTHY LLP 247 17WC 27849 FINN-SCHAIBLE, KELLI ABLE HOME HEALTH, LLC 09/04/17 BARRICK SWITZER LONG ET AL PERRY GENTILE 248 17WC 27884 FLORES, ALFREDO TH FOODS 08/09/17 KATZ FRIEDMAN EAGLE ET AL QUINTAIROS PRIETO WOOD & BOY 19WC001096 -C 249 17WC 28051 GOODWIN, ZACHARY REITZEL ROOFING INC 11/11/16 BLACK & JONES RIPES NELSON BAGGOT KALOBRAT 250 17WC 28228 KEHOE, ELAISOIN SUNNY ISLAND RV 08/21/17 MARSZALEK AND MARSZALEK ANCEL GLINK DIAMOND BUSH & E 251 17WC 28771 JENKINS, RICHARD YRC WORLDWIDE 07/20/17 BLACK & JONES HENNESSY & ROACH PC 252 17WC 29716 MAY, OTTO JR FCA US, LLC 08/04/17 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 253 17WC 29739 HOLAWAY, JEFFREY FCA US, LLC 05/19/17 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 254 17WC 29748 SCHUTT, ELIZABETH BEST BUY 07/15/16 GESMER & REYNOLDS PC HENNESSY & ROACH PC 255 17WC 29787 ALMS, GARY S MR BUILTS, INC 05/19/16 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 256 17WC 30344 BURKI, STEVEN STATELINE FOUNDRIES 04/26/17 BLACK & JONES KEEFE CAMPBELL BIERY & ASSOC 257 17WC 30502 RODRIGUEZ, GUSTAVO TAYLOR COMPANY CARRIOR CO 08/11/17 TUITE LAW MACIOROWSKI SACKMANN & ULRIC 258 17WC 30621 INGRAM, LANEKTA ALDEN DEBES REHAB & 09/26/17 KATZ FRIEDMAN EAGLE ET AL 259 17WC 30757 DRUMMER, CODY ROCK RIVER DISPOSAL 11/09/15 COPLAN & CRANE, LTD 260 17WC 30894 O'BRIEN, LAURA ROCKFORD BOARD OF EDUCATI 11/21/16 ALEXANDER, PETER LTD. WIEDNER & MCAULIFFE LTD 261 17WC 31143 ZIMMERMAN, JOHN PAYNECREST ELECTRIC, INC 01/15/17 GESMER LAW OFFICES, PC CLAYBORNE SABO & WAGNER 262 17WC 31749 VANCE, JOHN ATLAS COMPONENT 04/01/17 DWORKIN AND MACIARIELLO NOBLE & ASSOC 263 17WC 32269 AVILA, TIFFANY S UNITED PARCEL SERVICE 09/21/17 TUITE LAW NYHAN BAMBRICK KINZIE & LOWR

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 17 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 264 17WC 32508 VAN BARRIGER, JOSEPH R BAY VALLEY FOODS 04/16/16 GESMER LAW OFFICES, PC KEEFE CAMPBELL BIERY & ASSOC 265 17WC 32665 ALBANK, AHMED JAMCO PRODUCTS 07/18/17 GESMER & REYNOLDS PC HENNESSY & ROACH PC 266 17WC 33747 STOVALL, BRENT ROCKFORD BOARD OF EDUCATI 09/16/17 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 267 17WC 34024 HANSON, MICHELLE ORTHO ILLINOIS SURGERY CE 09/19/17 BLACK & JONES GANAN & SHAPIRO 268 17WC 34070 GARCIA, ANGELA COURTYARD MARRIOTT 10/15/17 DWORKIN AND MACIARIELLO GANAN & SHAPIRO 269 17WC 34956 WALLACE, SANDRA MAXIM HEALTHCARE SERVICES 09/25/17 DWORKIN AND MACIARIELLO RUSIN & MACIOROWSKI LTD 270 17WC 35441 SMITH, DEWAYNE LAKESIDE INTERNATIONAL TR 04/25/17 GESMER & REYNOLDS PC GAROFALO SCHREIBER STORM GRA 271 17WC 35776 BURCHARD, JUDY L CONCENTRIC ROCKFORD INC 04/20/17 TUITE LAW BRADY CONNOLLY & MASUDA PC 272 17WC 35797 LAMB, LARRY TQ LOGISTICS 06/26/17 CLARK FROST 273 17WC 35814 RAFAEL, C DELIA MAGNA INT'L INC 09/25/17 BAUM RUFFOLO & MARZAL LTD POWER & CRONIN LTD 274 17WC 35972 MACLIN, IVA FCA US LLC 10/08/17 BLACK & JONES WIEDNER & MCAULIFFE LTD 275 17WC 36414 HERNADEZ, MARTINA ND INDUSTRIES,INC 02/18/15 GESMER & REYNOLDS PC 276 17WC 36467 LIPSCOMB, LORENZO QPS EMPLOYMENT GROUP 10/24/17 GESMER & REYNOLDS PC WOLFE & JACOBSON, LTD 277 17WC 36493 SAUCEDO, ROXANA TITAN PERSONNEL W 10/11/17 BLACK & JONES 278 17WC 36551 ROSSI, JASON COUNTY OF WINNEBAGO 03/16/17 CLARK FROST WILLIAMS MCCARTHY LLP 279 17WC 36638 GONZALEZ, LOYD JR. DIDIER GREENHOUSE, INC. 03/17/17 CLARK FROST 280 17WC 36751 DEWITT, SUSAN, ESTATE OF THE CITY OF ROCKFORD 11/15/17 GESMER & REYNOLDS PC HEYL ROYSTER VOELKER & ALLEN 281 17WC 36866 MONROE, ALEXA PINNACLE LOGISTICS 12/01/17

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 18 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 282 17WC 37102 ALVARADO, MARTIN ALTER TRADING 12/02/16 BOTTO GILBERT MCBREARTY, BRIAN K 283 17WC 37479 MORRIS, JOHN II THOMPSON PRESSURE PIPE 09/01/17 GESMER LAW OFFICES, PC ROSARIO CIBELLA 284 17WC 37619 SPEICHER, MARIANNE THE CLOTHES BIN 11/07/17 BLACK & JONES CASSANO & ASSOCIATES 285 17WC 37751 MALY, CHRISTEN N ROCKFORD PUBLIC SCHOOL 10/23/17 TUITE LAW WIEDNER & MCAULIFFE LTD 286 17WC 37900 HILL, DEXTER FCA US LLC 02/07/15 GESMER & REYNOLDS PC WILLIAMS MCCARTHY LLP 287 18WC 00032 KUYKENDALL, DOSS QPS EMPLOYMENT GROUP 10/23/17 BLACK & JONES WOLFE & JACOBSON, LTD 19WC011052 -C 288 18WC 00576 WILSON, TRAVIS BERNER FOODS INC 07/30/17 BLACK & JONES HOLECEK & ASSOCIATES 289 18WC 00728 LOGEMANN, MICHELE KOLB-LENA INC 04/30/15 MARKS INJURY LAW KEEFE CAMPBELL BIERY & ASSOC 290 18WC 00900 ALLEN, WALTER FURST STAFFING 12/18/17 BLACK & JONES ACCIDENT FUND HOLDINGS 291 18WC 01077 DELAROSA, TAMMY T FCA US, LLC 01/05/15 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 292 18WC 01505 TOMLINSON, JAMES W AEROTEK INC 10/24/17 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 293 18WC 01861 BOWERS, MATTHEW QUICK DELIVERY SERVICE, I 06/01/16 BLACK & JONES JAMES M KELLY 294 18WC 01873 JOHNSON, CONRAD TAYLOR/UNITED TECHNOLOGIE 11/14/17 GESMER LAW OFFICES, PC MACIOROWSKI SACKMANN & ULRIC 295 18WC 02317 STEINHABLE, JASON TRADESMEN INTERNATIONAL 10/25/17 DWORKIN AND MACIARIELLO EVANS & DIXON 296 18WC 02883 KINGERY, DONALD A OFFICE SYSTEMS INSTALLATI 08/23/17 PIGNATELLI & ASSOCIATES HENNESSY & ROACH PC 297 18WC 03168 LAMM, RONI R FREEPORT SCHOOL DIST #145 05/10/17 TUITE LAW LAWRENCE COZZI - LAW OFFICES 298 18WC 03281 TOBLER, CHRISTINA DOLLAR TREE STORES 01/04/18 BLACK & JONES BRYCE DOWNEY & LENKOV LLC 299 18WC 03381 HOLTE, CANDICE ANAM MEMORY CARE 12/29/17 BLACK & JONES RUSIN & MACIOROWSKI LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 19 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 300 18WC 03591 SLEZAK, DAVID ESTWING MANUFACTURING 01/23/17 BRASSFIELD KRUEGER & RAMLO 301 18WC 03611 GAREY, MARK FOREST CITY GEAR 12/18/17 GESMER & REYNOLDS PC RIPES NELSON BAGGOT KALOBRAT 302 18WC 03640 RIVERA, MARIA BLANCO KELCE & COMPANY 05/17/17 BLACK & JONES 303 18WC 04568 COATES, STEVEN FCA US LLC 07/25/17 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 304 18WC 04586 MCNEIL, MARK ROCKFORD ICE HOGS 11/22/15 GORDON LAW OFFICES LTD 305 18WC 04849 STEVENS, LAKRISHA RESOURCE MFG 09/13/17 BLACK & JONES SPIEGEL & CAHILL, PC 306 18WC 05017 THIBEDEAU, JOHN MONDELEZ INTERNATIONAL 11/16/17 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 307 18WC 05229 BEDARD, CHARLES CITY OF ROCKFORD 11/08/17 FOOTE MIELKE CHAVEZ & O'NE HEYL ROYSTER VOELKER & ALLEN 308 18WC 05242 BRAUER, TINA LOOSE SCREW BAR & GRILL 07/26/15 BLACK & JONES DERANGO & CAIN 309 18WC 05422 AGUILAR, MIGUEL A HAMPTON PROPERTIES 12/01/17 TUITE LAW FRIEDRICH LAW LLC 310 18WC 05596 BUCHHOLZ, BRIAN K RAYNOR GARAGE DOORS, INC 10/30/17 MERTES & MERTES PC 311 18WC 05995 VAUGHAN, JULIE SWEDISH AMERICAN HOSPITAL 12/21/17 GESMER & REYNOLDS PC WILLIAMS MCCARTHY LLP 312 18WC 06188 NICHOL, SHANNON FCA US, LLC 11/13/17 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 313 18WC 06474 MARTUCCI, LAWRENCE CONTEMPORARY HAMMER WORKS 12/21/17 CLARK FROST 314 18WC 06485 HOOKS, STEVE CURTIS METAL FINISHING 02/19/18 BLACK & JONES HENNESSY & ROACH PC 315 18WC 06527 BARRAGAN, ALONSO J&M PLATING 08/28/14 BLACK & JONES HOLECEK & ASSOCIATES 316 18WC 06602 SISLER, NICO L POINT ROCK INVESTMENTS IN 10/07/17 PIGNATELLI & ASSOCIATES 317 18WC 06784 HORSTMAN, KEN RYDER INTEGRATED LOGISTIC 01/17/18 GESMER & REYNOLDS PC HEYL ROYSTER VOELKER & ALLEN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 20 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 318 18WC 06898 DOWTHARD, KAYONNA GRUPO ANTOLIN 12/04/17 BLACK & JONES WIEDNER & MCAULIFFE LTD 319 18WC 06940 CAHILL, SANDRA FHN MEMORIAL HOSPITAL 09/14/17 BLACK & JONES GAROFALO SCHREIBER STORM GRA 320 18WC 06943 CASEY, THERESA FCA US LLC 05/11/17 BLACK & JONES WIEDNER & MCAULIFFE LTD 321 18WC 07043 RIOS-MAPPE, JULIO C ROCKFORD MASS TRANSIT DIS 12/12/17 GOLDBERG WEISMAN & CAIRO L 322 18WC 07095 HALL, JEFFRY A COUNTY OF WINNEBAGO 09/16/14 TUITE LAW WILLIAMS MCCARTHY LLP 323 18WC 07170 LARSON, TRESEA MERCY HEALTH CORPORATION 08/24/16 BLACK & JONES 324 18WC 07396 GREGG, KEVIN J BOZEMAN ENTERPRISES 11/08/17 CULLEN HASKINS NICHOLSON BRADY CONNOLLY & MASUDA PC 325 18WC 07466 CRAM, TERESA KELLEY WILLIAMSON MOBIL 12/24/17 BLACK & JONES RIPES NELSON BAGGOT KALOBRAT 326 18WC 07521 RICHTER, RONALD HINCKLEY SPRINGS WATER 02/13/17 TURNER & SACKETT LLC CHILTON YAMBERT PORTER LLP 327 18WC 07690 JOHNSON, VERNE LOWE'S DISTRIBUTION CENTE 01/09/18 DWORKIN AND MACIARIELLO 328 18WC 07803 GUSE, DAVID BLACK DIAMOND PLUMBING & 12/27/17 NASH LAW OFFICE PC BRYCE DOWNEY & LENKOV LLC 329 18WC 07863 RANDECKER, NORMA M STATE OF IL 11/13/17 TUITE LAW ASSISTANT AT0TORNEY GENERAL 330 18WC 07908 PEREZ, MELISSA ARAMARK UNIFORM SVCS 09/18/17 BLACK & JONES WIEDNER & MCAULIFFE LTD 331 18WC 08170 MUNOZ, ANGELA UNITED CONTINENTAL HOLDIN 07/28/17 GRAUER & KRIEGEL LLC 332 18WC 08258 POUNCY, TERRY METRO STAFF, INC 11/21/16 STRONG LAW OFFICE WIEDNER & MCAULIFFE LTD 333 18WC 08519 WYCKSTANDT, SHAWN GUNITE CORPORATION 01/03/18 MARKS INJURY LAW RUSIN & MACIOROWSKI LTD 334 18WC 08553 KING, GEORGE PINNACLE LOGISTICS 03/12/18 DWORKIN AND MACIARIELLO 335 18WC 08782 DENNIS, MELISSA RIVER BLUFF NURSING HOME 03/07/18 GESMER & REYNOLDS PC WILLIAMS MCCARTHY LLP

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 21 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 336 18WC 08889 RASNER, VICTORIA FCA US, LLC 02/28/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 337 18WC 08900 GIARDONO, ANITA SNAK KING CORP 02/22/18 BLACK & JONES LEAHY EISENBERG & FRAENKEL 338 18WC 09090 PARKS, BRADLEE YMCA ROCK RIVER VALLEY 03/15/18 BLACK & JONES RUSIN & MACIOROWSKI LTD 339 18WC 09302 ELIZONDO, WILLIAM SYNCREON 10/15/17 KATZ FRIEDMAN EAGLE ET AL KEEFE CAMPBELL BIERY & ASSOC 340 18WC 09485 DAVIS, DARLENE M COMMUNITY CARE SYSTEMS, I 09/17/17 BLACK & JONES LIVINGSTONE MUELLER ET AL 341 18WC 09602 MCNIECE, DOMINIK ROCKFORD POLICE DEPARTMEN 11/28/17 GESMER & REYNOLDS PC 342 18WC 10394 SCHMOLDT, TRACY A CARRIER CORPORATION 05/12/17 TUITE LAW MACIOROWSKI SACKMANN & ULRIC 343 18WC 10512 GALLAGHER, PAUL P ROCKFORD ILLINOIS POLICE 10/18/16 VITELL & SPITZ LTD HEYL ROYSTER VOELKER & ALLEN 344 18WC 10617 DERUS, RICHARD FEDERAL EXPRESS 10/17/17 CAPRON & AVGERINOS PC WIEDNER & MCAULIFFE LTD 345 18WC 10664 SUTHERLAND, KENNETH AMERICAN EXTRUSION INTERN 03/19/18 GESMER & REYNOLDS PC RIPES NELSON BAGGOT KALOBRAT 346 18WC 10858 ZARATE, MIGUEL JUAN HERRERA 03/30/18 BLACK & JONES LAWRENCE COZZI - LAW OFFICES 347 18WC 10866 JONES, T J YANGFENG AUTOMOTIVE INTER 03/02/18 BLACK & JONES HENNESSY & ROACH PC 348 18WC 11009 WAINWRIGHT, QUENTIN MIKE HARRIS MASONRY CONTR 03/05/18 HORWITZ HORWITZ & ASSOC NYHAN BAMBRICK KINZIE & LOWR 349 18WC 11072 NEMENSKI, PHILLIP R MIDSTATES CONCRETE INDUST 12/05/17 SOSTRIN AND SOSTRIN PC GAROFALO SCHREIBER STORM GRA 350 18WC 11244 SMITH, RAY ESTWING 11/16/17 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 351 18WC 11316 NIETO, ETHELVINA YANFENG US AUTO INTERIOR 03/03/18 GESMER & REYNOLDS PC 352 18WC 11374 VIEL, KELLY MCDONALD'S 12/17/17 BLACK & JONES BRYCE DOWNEY & LENKOV LLC 353 18WC 11466 PARR, KYLE CITY OF ROCKFORD 02/23/18 GESMER & REYNOLDS PC HEYL ROYSTER VOELKER & ALLEN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 22 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 354 18WC 11831 JACOBS, TINA DASCO PRO 03/13/18 MARTIN V KUGIA WOLFE & JACOBSON, LTD 355 18WC 11844 YOUNG, DAVID MORING DISPOSAL 03/06/18 GESMER & REYNOLDS PC RIPES NELSON BAGGOT KALOBRAT 356 18WC 11997 MCCLESKEY, BRIANNE T SWEDISH AMERICAN HOSP ASS 11/05/16 TUITE LAW WILLIAMS MCCARTHY LLP 357 18WC 12173 ZNOY, ROBERT ROPER WHITNEY 04/09/18 REESE & REESE HOLECEK & ASSOCIATES 358 18WC 12189 KJELLGREN, ROXANNE WINNEBAGO COUNTY 02/15/18 BARRICK SWITZER LONG ET AL WILLIAMS MCCARTHY LLP 359 18WC 12468 THOMPSON, BILLY GREENLEE TEXTRON INC 03/11/18 DWORKIN AND MACIARIELLO GAROFALO SCHREIBER STORM GRA 360 18WC 12518 KRAUSE, GARRY NICHOLSON ELECTRIC INC 02/27/18 GOLDBERG WEISMAN & CAIRO L MACIOROWSKI SACKMANN & ULRIC 361 18WC 12546 ZALUCKYJ, BROOKE FCA US LLC 01/07/18 KAT0Z FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 362 18WC 12691 LEWIS, LEROY HOLLAND 01/06/18 BLACK & JONES HENNESSY & ROACH PC 18WC037273 -C USF HOLLAND 363 18WC 12785 SHOULDER, MARLOES MCLAIN FOOD SERVICES 03/13/18 BLACK & JONES KEEFE CAMPBELL BIERY & ASSOC 364 18WC 12940 BLUNT, MARVA ROCKFORD PUBL SCHOOL DIST 09/25/17 MARKS INJURY LAW WIEDNER & MCAULIFFE LTD 365 18WC 12947 POWELL, JOHN SR. FCA US LLC 06/01/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 366 18WC 13226 QUICK, MATTHEW YANGFENG AUTOMOTIVE INTER 04/22/18 BLACK & JONES HENNESSY & ROACH PC 367 18WC 13477 GRIFFETH, JARED MIKE HARRIS MASONRY CONTR 05/01/17 HORWITZ HORWITZ & ASSOC NYHAN BAMBRICK KINZIE & LOWR 18WC013478 -C 368 18WC 13540 MALLEK, EDWARD US MESSENGER & LOGISTICS 04/18/18 FRANCIS J DISCIPIO LAW OFF MACIOROWSKI SACKMANN & ULRIC 369 18WC 13743 SCHUTT, ALAN IPSEN INC 06/26/16 KATZ FRIEDMAN EAGLE ET AL GAROFALO SCHREIBER STORM GRA 370 18WC 13907 MEGGENBERG, RICHARD ANDROID INDUSTRIES 10/01/16 KATZ FRIEDMAN EAGLE ET AL 371 18WC 14094 SMOLINSKI, TIMOTHY ILLINOIS WATER TECHNOLOGI 04/11/18 GESMER & REYNOLDS PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 23 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 372 18WC 14320 GUMS, WANDA SAVENCIA CHEESE LLC 03/19/15 DWORKIN AND MACIARIELLO KEEFE CAMPBELL BIERY & ASSOC 373 18WC 14793 MARTIN, EDWARD BUCKSHOT RIDGE FARMS & 05/07/18 DWORKIN AND MACIARIELLO JAMES M KELLY 374 18WC 15105 DACH, RICHARD CROWN MACHINE 05/11/18 BLACK & JONES JOSEPH MARCINIAK 375 18WC 15125 DISMUKE, CARLETTIA GALAPAGOS ROCKFORD CHARTE 05/08/18 DWORKIN AND MACIARIELLO HEHEHAN, DONOVAN & ISAACSON 376 18WC 15595 BANKES, ROBERT ARCO MACHINERY MOVERS LLC 04/09/18 BLACK & JONES GANAN & SHAPIRO 377 18WC 15705 LE, LOAN WOODWARD INC 06/09/14 CLARK FROST HINSHAW & CULBERTSON 378 18WC 15772 SELL, COURTNEY FCA US LLC 04/17/18 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 379 18WC 15897 WILLIAMS, KERRY O MIKE HARRIS MASONRY CONTR 03/05/18 HORWITZ HORWITZ & ASSOC NYHAN BAMBRICK KINZIE & LOWR 380 18WC 15911 DANIELS, ERICA UPS 01/30/18 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 381 18WC 16095 SUMMERS, JULIE MONDELEZ INTERNATIONAL IN 03/30/17 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 382 18WC 16388 GONZALEZ, MOISES CAMBRON FOREST CITY FRAMERS INC 01/09/18 SALK, STEVEN B & ASSOC LTD WIEDNER & MCAULIFFE LTD 383 18WC 16575 ROBINSON, RACHEL SUNRISE TRANSPORTATION 03/23/18 BLACK & JONES FRANCESCA LARSEN 384 18WC 16585 FLUKER, ONDREA FCA US LLC 10/01/17 BLACK & JONES WILLIAMS MCCARTHY LLP 385 18WC 16742 GARRISON, SEAN M BULT'S, INC 01/01/18 MC HARGUE & JONES WIEDNER & MCAULIFFE LTD 18WC016743 -C 386 18WC 16894 ALANBAQY, AHMED ARAMARK UNIFORM SERVICES 05/16/17 TUITE LAW MICHAEL COHEN 387 18WC 16965 TORRES, DAMIEN TRUE BLUE/ 11/24/17 ADRIAN MURATI BRADY CONNOLLY & MASUDA PC 388 18WC 17088 COLLINS, CHARLES T ROCKFORD AREA 08/02/17 ALEXANDER, PETER LTD. HENNESSY & ROACH PC 389 18WC 17251 ALLEN, SWAHILI FCA US LLC 04/05/18 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 24 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 390 18WC 17348 DIETMEIER, MICHAEL L FURST-MCNESS COMPANY 07/10/17 TUITE LAW CAPUANI, FRANK S 391 18WC 17376 MOYA, EDGAR FCA US LLC 05/19/18 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 392 18WC 17691 BROWN, PHILLIP UPS 05/31/18 COSTA IVONE LLC ASA LAW GROUP 393 18WC 17760 CARMACK, MARY FCA US LLC 05/23/18 BLACK & JONES WILLIAMS MCCARTHY LLP 394 18WC 17763 HARNISH, DAVID TAYLOR COMPANY 05/11/18 BLACK & JONES MACIOROWSKI SACKMANN & ULRIC 395 18WC 17766 SALINAS, HUMBERTO UNIVERSAL HOSPITAL SVCS 04/12/18 BLACK & JONES 18WC017767 -C 396 18WC 17769 HERNANDEZ, ALEJANDRA HELP AT HOME 05/14/18 BLACK & JONES INMAN & FITZGIBBONS 397 18WC 17826 MAZZERI, GIOVANNA FEDEX 05/24/18 DWORKIN AND MACIARIELLO 398 18WC 18052 RIBARICH, RHONDA TAYLOR FREEZER 10/26/15 REESE & REESE MACIOROWSKI SACKMANN & ULRIC 399 18WC 18148 LOUIS, ANTHONY ROCKFORD ICE HOGS 09/28/17 GORDON LAW OFFICES LTD 400 18WC 18406 BARRON, JEAN FCA US LLC 06/18/18 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 18WC018407 -C 401 18WC 18511 KOSIER, MARK POOLCORP 03/06/18 GESMER & REYNOLDS PC GAROFALO SCHREIBER STORM GRA 402 18WC 18515 MAY, GERALD IAC 05/04/15 BLACK & JONES GANAN & SHAPIRO 403 18WC 18520 JETER, JAMES HENNIG INC 05/07/18 BLACK & JONES HENNESSY & ROACH PC 404 18WC 18992 SHARP, VICTORIA K ROCKFORD MEMORIAL HOSPITA 11/22/16 JOHN J CASTANEDA WIEDNER & MCAULIFFE LTD 405 18WC 19021 KENT, CLARK RYDER INTEGRATED LOGISTIC 01/20/17 BLACK & JONES HEYL ROYSTER VOELKER & ALLEN 406 18WC 19158 FRALEY, TODD L ED ETNYRE & CO 01/25/18 TUITE LAW CLARK FROST 407 18WC 19314 WURM, BRADLEY TITAN TIRE 03/11/15 HAUSER LAW LLC KEEFE CAMPBELL BIERY & ASSOC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 25 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 408 18WC 19466 COOPER, COLLIES GUNITE CORP 06/09/18 HETHERINGTON KARPEL BOBBER RUSIN & MACIOROWSKI LTD 409 18WC 19569 FAVRETTO, ALMA PCI PHARMA SERVICES 04/16/18 MARK N LEE HOLECEK & ASSOCIATES 410 18WC 19673 WILSON, DENISE INNOVATIVE FIXTURE SOLUTI 05/08/18 BLACK & JONES HENNESSY & ROACH PC 411 18WC 19746 GETTY, CHARLENE CITY OF ROCKFORD POLICE D 04/13/18 GESMER & REYNOLDS PC HEYL ROYSTER VOELKER & ALLEN 412 18WC 19819 EDMONDS, GREGORY R EAST DUBUQUE NITROGEN 01/01/18 HAUSER LAW LLC EVANS & DIXON 413 18WC 20060 THOMPSON, CHRIS KELLENBERGER TECHNOLOGY 06/08/18 GOLDBERG WEISMAN & CAIRO L 414 18WC 20125 LOOMIS, JODI E WOODS EQUIPMENT CO 02/27/18 PIGNATELLI & ASSOCIATES 415 18WC 20145 GORS, COURTNEY E BURR CHEMICAL COMPANY, IN 01/08/18 TUITE LAW INMAN & FITZGIBBONS 416 18WC 20281 MCDONALD, NANCY CITY OF FREEPORT 03/14/18 GESMER & REYNOLDS PC 417 18WC 20289 VOLKEY, DON LIEBOVICH BROTHERS INC 04/28/14 BLACK & JONES HENNESSY & ROACH PC 418 18WC 20615 CAVINESS, DONTAY D MOVING ANGELS OF ILLINOIS 06/22/18 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 419 18WC 21083 VOLKEY, DON LIEBOVICH BROTHERS INC 12/10/16 BLACK & JONES HENNESSY & ROACH PC 420 18WC 21115 AGUIRRE, MARITZA ALDEN ALMA NELSON DEBES 08/04/17 BLACK & JONES FRANCESCA LARSEN 421 18WC 21217 GOMEZ, ALMA VALLI PRODUCE 06/06/18 BLACK & JONES GANAN & SHAPIRO 422 18WC 21236 KING, ROGER FHN MEMORIAL HOSPITAL 01/31/18 DWORKIN AND MACIARIELLO GAROFALO SCHREIBER STORM GRA 423 18WC 21506 BOUQUOT, ROXANE SYNCREON 05/14/18 GESMER & REYNOLDS PC 424 18WC 21640 ELLINGSON, DAVID G CITY OF BELVIDERE A MUNIC 09/24/17 BOYD, SCOTT M POWER & CRONIN LTD 425 18WC 21744 O'DONELL, BRIAN NEWPORT INDUSTRIES INC 11/06/17 BRASSFIELD KRUEGER & RAMLO CACCHILLO LAW GROUP LLC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 26 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 426 18WC 21823 PFILE, DEAN W STAR MANUFACTURING COMPAN 07/15/17 TUITE LAW CAPUANI, FRANK S 427 18WC 22194 GOMEZ, FABIAN FIAT CHRYSLER 04/12/18 MC HARGUE & JONES WILLIAMS MCCARTHY LLP 428 18WC 22380 MOORE, TIMMERI RESOURCE/MFG 06/15/18 BLACK & JONES QUINTAIROS PRIETO WOOD & BOY 429 18WC 22674 GARAS, SHAWNNE L MERCY HEALTH SYSTM CORPOR 06/30/18 ANKIN LAW OFFICE 430 18WC 22719 HOCKMUTH, MICHAEL J O'REILLY AUTO AENTERPRISE 10/30/17 TUITE LAW HENNESSY & ROACH PC 431 18WC 22785 DUELLMAN, TYMISSA PCI PHARMA SERVICES 04/06/18 BLACK & JONES HOLECEK & ASSOCIATES 432 18WC 23063 HORNA, JEREMY INTERNATIONAL PAPER 07/19/18 FRANKS, GERKIN & MCKENNA P GOLDBERG SEGALLA LLC 433 18WC 23220 WOODY, JOHN ADAPT PLASTICS, INC 12/05/16 GESMER & REYNOLDS PC GANAN & SHAPIRO 434 18WC 23256 ASPRILLA, ANDRES CANDELO SECURE STAFFING 06/07/18 BLACK & JONES HENNESSY & ROACH PC 435 18WC 23259 MORIARITY, PATRICK FURST STAFFING 07/27/18 BLACK & JONES 436 18WC 23291 MARTINEZ, JAVIER ROSEWOOD CARE CENTER 02/26/18 BOTTO GILBERT 437 18WC 23373 JOHNSON, MITCHELL A BRISTOL-MYERS SQUIB COMPA 08/14/15 TUITE LAW RUSIN & MACIOROWSKI LTD 438 18WC 23475 JONES, PAIGE MAGNA SERVICE OF AMERICA 01/24/18 DWORKIN AND MACIARIELLO POWER & CRONIN LTD 439 18WC 23973 HAIL, L.C KOLB-LENA, INC 06/02/18 TUITE LAW KEEFE CAMPBELL BIERY & ASSOC 440 18WC 24375 HUGHES, MARK GKN ROCKFORD 03/15/17 BLACK & JONES RIPES NELSON BAGGOT KALOBRAT 441 18WC 24378 THOLIN, JARRED SAM'S CLUB 08/15/15 BLACK & JONES GANAN & SHAPIRO 442 18WC 24513 MARTINEZ, NICOLE JIMMY JOHN'S W 05/30/18 BLACK & JONES 443 18WC 24690 BUSE, JEREMY RYAN INCORPORATED CENTRAL 05/01/18 FRANKS, GERKIN & MCKENNA P CHILTON YAMBERT PORTER LLP

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 27 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 444 18WC 24830 HOLLEY, JAY THE BOLDT COMPANY 06/20/18 GREGORIO & MARCO RUSIN & MACIOROWSKI LTD 445 18WC 25192 CASTLE, ANTHONY AEROTEK 08/10/18 GESMER & REYNOLDS PC HENNESSY & ROACH PC 446 18WC 25688 WILLIAMS, AMBREA SYNCREON 08/08/18 HORWITZ HORWITZ & ASSOC KEEFE CAMPBELL BIERY & ASSOC 447 18WC 25864 POST, SHERRI EAST DUBUQUE HIGH SCHOOL 02/06/18 GOLDBERG WEISMAN & CAIRO L WIEDNER & MCAULIFFE LTD 448 18WC 25899 BLAKELY, VIRGINIA ROCKFORD MASS TRANSIT 07/28/18 MARK N LEE 449 18WC 25963 KEIL, ADAM MIDWEST PACKAGING 08/03/18 MICHELLE L. LANDON LLC LAWRENCE COZZI - LAW OFFICE 450 18WC 26136 SWANSON, BERNICE J KINNIKINNICK CCSD #131 05/08/17 TUITE LAW 451 18WC 26183 WILSON, MARY ANDROID INDUSTRIES 02/01/18 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 18WC026184 -C 452 18WC 26195 FEHR, DOUG FCA US LLC 04/05/18 BLACK & JONES WILLIAMS MCCARTHY LLP 453 18WC 26230 WHITEHORN, MARCUS ROCKFORD TOOLCRAFT, INC 08/06/18 DWORKIN AND MACIARIELLO NYHAN BAMBRICK KINZIE & LOWR 454 18WC 26818 WATSON, NICHOLE LOWES DISTRIBUTION 04/10/18 BLACK & JONES KEEFE CAMPBELL BIERY & ASSOC 455 18WC 26917 HOLBERT, JOSEPH J.L. CLARK 08/23/18 BLACK & JONES SPIEGEL & CAHILL, PC 456 18WC 26923 CULLINS, ERIC GUNITE CORP 04/01/18 BLACK & JONES RUSIN & MACIOROWSKI LTD 457 18WC 26946 ROECKER, JOSHUA UNITED TECHNOLOGIES CORP 04/17/18 MACIOROWSKI SACKMANN & ULRIC 458 18WC 27046 GILL, EARL AEROTEK 08/05/18 GESMER & REYNOLDS PC 459 18WC 27097 FAVRETTO, ALMA PCI PHARMA SERVICES 08/20/18 MARK N LEE 460 18WC 27413 SKOGSBERG, JEFF PRAIRIE FARMS DAIRY/ 07/17/17 HENNESSY & ROACH PC 461 18WC 27471 CLAXTON, ROBERT EXELON WEST 06/07/16 HENNESSY & ROACH PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 28 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 462 18WC 27533 BOYCE, THOMAS COLLIER RV CENTER INC 05/09/17 ROSARIO CIBELLA 463 18WC 27799 SLAUGHTER, TANIKA CHRYSLER 08/03/18 DONALD FOHRMAN & ASSOC WILLIAMS MCCARTHY LLP 464 18WC 27830 CORDER, JEFFREY W ILLINOIS TOOL WORKS, INC 01/10/17 TUITE LAW NYHAN BAMBRICK KINZIE & LOWR 465 18WC 27850 CASSARO, CHARLES S AIM DISTRIBUTION, INC 08/23/18 TUITE LAW RIPES NELSON BAGGOT KALOBRAT 466 18WC 28160 WISNIOWSKI, ANDRZEJ GERBER COLLISION & GLASS 08/20/18 RICHARD E ALEKSY HOLECEK & ASSOCIATES 18WC028161 -C 467 18WC 28396 GONZALEZ, ARACELIS ILLINOIS CENTRAL 09/13/18 DWORKIN AND MACIARIELLO GILDEA, COGHLAN & REGAN LTD. 468 18WC 28442 LOPEZ-AVILA, ERNESTO PAPER RECOVERY 07/25/18 DERANGO & CAIN GAROFALO SCHREIBER STORM GRA 469 18WC 28655 CASTANON, PAULINA ANDROID INDUSTRIES 06/19/18 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 470 18WC 28699 BATLEY, LINDA M WALMART STORES, INC 07/28/18 TUITE LAW QUINTAIROS PRIETO WOOD & BOY 471 18WC 28825 ALLEN, CRAIG SPEEDWAY AUTO MALL 07/09/18 GOLDBERG WEISMAN & CAIRO L RUSIN & MACIOROWSKI LTD 472 18WC 28995 HOWARD, PATRICIA ANCHOR HARVEY COMPONENT 03/27/18 KATZ FRIEDMAN EAGLE ET AL HENNESSY & ROACH PC 473 18WC 29127 LOMAS, SAM HAMILTON SUNDSTRAND 07/20/17 BLACK & JONES MACIOROWSKI SACKMANN & ULRIC 474 18WC 29180 RAMIREZ, LUIS A NORTHERN ILLINOIS 02/07/17 EVANS & DIXON 475 18WC 29221 ROBINSON, GLORIA FCA US LLC 03/01/18 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 476 18WC 29672 POWELL, JOHN SR. FCA US LLC 02/13/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 477 18WC 29685 WHITAKER, DECAMERON FCA ASSEMBLY PLANT 09/11/18 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 478 18WC 29763 GRAHAM, MARILYN L COMMUNITY CARE SYSTEMS 09/11/18 DWORKIN AND MACIARIELLO 479 18WC 29943 DIEHL, STEPHANIE YANFENG AUTOMOTIVE INTERI 01/04/18 KATZ FRIEDMAN EAGLE ET AL HENNESSY & ROACH PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 29 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 480 18WC 30013 KASAPOVIC, ZLATKO ON SITE WOODWORK CORP. 08/13/18 TUITE LAW EVANS & DIXON 481 18WC 30025 LEIGH, ANDREW ZENTZ AND ASSOCIATES, INC 09/04/18 TUITE LAW 482 18WC 30042 GARVEY, TOM A FCA US, LLC 08/26/18 GESMER & REYNOLDS PC WILLIAMS MCCARTHY LLP 483 18WC 30221 SWANSON, GINGER WAL-MART STORES, INC 11/12/17 QUINTAIROS PRIETO WOOD & BOY 484 18WC 30304 JOHNSON, COREY UNITED PARCEL SERVICE 04/27/18 BRUSTIN & LUNDBLAD LTD NYHAN BAMBRICK KINZIE & LOWR 485 18WC 30408 LAPASTORA, JOSE GKN ROCKFORD, INC 09/22/18 KATZ FRIEDMAN EAGLE ET AL RIPES NELSON BAGGOT KALOBRAT 486 18WC 30611 TOMLINSON, JAMES ROCKFORD TOOLCRAFT, INC 10/08/18 DWORKIN AND MACIARIELLO INMAN & FITZGIBBONS 487 18WC 30670 SANCHEZ JOSE BARNES INTERNATIONAL INC 07/15/17 HOLECEK & ASSOCIATES 488 18WC 30797 DAVIS STEVE KWCC, INC KENARD CONSTRUC 02/16/18 CAPRON & AVGERINOS PC GILDEA, COGHLAN & REGAN LTD. 489 18WC 30811 O'HAVER, TRAVIS TITAN TIRE CORPORATION 10/26/17 SANDMAN LEVY & PETRICH 490 18WC 31091 CARDENAS, SANDRA FERNANDE ANDROID INDUSTRIES 11/19/17 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 491 18WC 31215 VERHAGEN, LESTER FCA US LLC 09/13/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 492 18WC 31253 WEST, KRISTINE SPIDER COMPANY, INC 06/21/18 BLACK & JONES CAPUANI, FRANK S 493 18WC 31276 JOHNSON, SHARON KELLY WILLIAMSON COMPANY 06/14/18 GESMER & REYNOLDS PC RIPES NELSON BAGGOT KALOBRAT 494 18WC 31299 DAWSON, DAVID FIRST ELECTRIC CO 02/21/18 BRADY CONNOLLY & MASUDA PC 495 18WC 31426 SMITH, JEFFREY TH FOODS INC 07/09/18 BLACK & JONES EVANS & DIXON 496 18WC 31552 MERRIT, DAVID YES STAFFING 10/06/18 DAVID W MARTAY SLAVIN & SLAVIN 497 18WC 31614 CABRERA, LOUIS JR WARNER'S FURNITURE W 09/17/18 BLACK & JONES HINSHAW & CULBERTSON

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 30 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 498 18WC 31658 GRAY, ROBERTA ROCKFORD HOUSING AUTHORIT 03/07/18 GESMER & REYNOLDS PC GILDEA, COGHLAN & REGAN LTD. 499 18WC 31705 EDGESTON, JULIUS PHELPS INDUSTRIES 12/06/17 BLACK & JONES WIEDNER & MCAULIFFE LTD 500 18WC 31736 SORENSON, MARK D CITY OF ROCKFORD POLICE D 10/02/18 REESE & REESE HEYL ROYSTER VOELKER & ALLEN 501 18WC 31800 WEST, KRISTINE SPIDER COMPANY, INC 09/19/18 BLACK & JONES 502 18WC 31942 STRATTON, MARYL D MILESTONE, INC 11/22/17 TUITE LAW BRYCE DOWNEY & LENKOV LLC 503 18WC 31960 SARRELS, KELLY D O'HAVER TRANSPORATION, IN 10/03/18 TUITE LAW QUINTAIROS PRIETO WOOD & BOY 504 18WC 32195 NOREK, JOSHUA BOONE COUNTY FIRE DISTRIC 07/27/18 GESMER & REYNOLDS PC POWER & CRONIN LTD 505 18WC 32210 ROSTAMO, KIMBERLY SKYWEST AIRLINES INC. 09/20/17 BLACK & JONES GANAN & SHAPIRO 506 18WC 32213 JOHNSON, JEREMY SPHERION STAFFING SERVICE 09/26/18 BLACK & JONES 507 18WC 32374 NEWSOME, THEO TREEHOUSE FOODS 08/11/18 BLACK & JONES KEEFE CAMPBELL BIERY & ASSOC 508 18WC 32414 BROWN, MICKEY L R&R TRANSPORTATION 09/03/18 JAMES RUPPERT LEAHY EISENBERG & FRAENKEL 509 18WC 32667 VOSS, RODNEY SCHNEIDER NATIONAL 01/31/18 BLACK & JONES HENNESSY & ROACH PC 510 18WC 32688 MENDOZA, CRISTINA GUERILLA GRAFFIX 06/19/18 GESMER & REYNOLDS PC 511 18WC 32874 LAUER, BRADLEY R CITY OF ROCKFORD POLICE D 10/17/18 REESE & REESE HEYL ROYSTER VOELKER & ALLEN 512 18WC 33002 PADRON, JEANETTE COMPASS GROUPS 10/05/18 MORETTI LAW PC MACIOROWSKI SACKMANN & ULRIC 513 18WC 33036 SLOCUM, JOSEPH JR. JB HUNT 01/06/17 DWORKIN AND MACIARIELLO 514 18WC 33098 KOPP, CHAD GUNITE CORP 01/22/18 RUSIN & MACIOROWSKI LTD 515 18WC 33175 JORDAN, LISA CHRYSLER, LLC 03/03/18 KRETMAR BEATTY SANDZA WILLIAMS MCCARTHY LLP

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 31 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 516 18WC 33244 ROBERTS, STEPHANIE A1 CLEANERS & LAUNDROMAT 04/01/17 BLACK & JONES 517 18WC 33275 RAWHOOF, KELLI ROCKFORD BANK & TRUST COM 01/15/15 HOLECEK & ASSOCIATES 518 18WC 33381 WAGNER, CLINT M CITY OF ROCKFORD 07/17/18 BARRICK SWITZER LONG HEYL ROYSTER VOELKER & ALLEN 519 18WC 33461 FERNANDEZ CARDENAS, SANDR ANDROID INDUSTRIES 09/20/18 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 520 18WC 33479 BEERS, BRYAN EVOLUTION STAFFING LLC 03/27/17 HENNESSY & ROACH PC 521 18WC 33737 TAYLOR, JOSHUA COMBINED ROOFING, INC 10/02/18 ANKIN LAW OFFICE 522 18WC 33754 HOLZE, HENRY BLOUNT INTERNATIONAL 10/03/16 BLACK & JONES WOLFE & JACOBSON, LTD 523 18WC 33780 SMITH, ALLEN J.P. CULLEN & SONS, INC 04/20/18 GREGORIO & MARCO 524 18WC 33933 ANGER, LEEANN SYNCREON 10/07/18 KATZ FRIEDMAN EAGLE ET AL GAROFALO SCHREIBER STORM GRA 525 18WC 34021 HILLYER, ANDREW PINNACLE LOGISTICS 11/03/18 DWORKIN AND MACIARIELLO BRYCE DOWNEY & LENKOV LLC 526 18WC 34289 STOCKER, KIMBERLY FCA US, LLC 07/15/18 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 527 18WC 34369 TORRES, DAVID J SNAK KING CORP 07/16/18 O'CONNOR & NAKOS WIEDNER & MCAULIFFE LTD 528 18WC 34489 ELLIS, JAYMES PIERCE DISTRIBUTION 09/04/18 DWORKIN AND MACIARIELLO WOLF LAW LTD 529 18WC 34648 SENATRE, CARLA B PISTON AUTOMOTIVE BELVIDE 11/13/18 DWORKIN AND MACIARIELLO ACCIDENT FUND HOLDINGS 530 18WC 34774 STRONG, AMBER BYRON DRAGWAY, INC. 06/24/18 LAWRENCE COZZI - LAW OFFICE 531 18WC 35303 KING, NANCY ROCKFORD SUPPORTIVE LIVIN 11/15/18 MC HARGUE & JONES 532 18WC 35572 ORTEGA, JOSE S THE MIDDLEBY CORPORATION 09/10/18 TUITE LAW MACIOROWSKI SACKMANN & ULRIC 533 18WC 35650 DU BREE, MICHAEL SPEEDEE DELIVERY 01/10/18 DWORKIN AND MACIARIELLO BRADY CONNOLLY & MASUDA PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 32 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 534 18WC 35702 IVY, DOUGLAS D CITY OF ROCKFORD POLICE D 10/20/18 REESE & REESE HEYL ROYSTER VOELKER & ALLEN 535 18WC 35782 TILLMAN, THOMAS CHRYSLER ASSEMBLY PLANT 10/17/18 ANKIN LAW OFFICE WIEDNER & MCAULIFFE LTD 536 18WC 35895 SHARP, KEVIN INGENIUM AEROSPACE 08/14/18 VRDOLYAK LAW GROUP LLC 537 18WC 36015 WEBSTER, BRAXTON ANDROID INDUSTRIES 06/29/18 GESMER & REYNOLDS PC 538 18WC 36042 CONRO, SUSAN M FAMILY DOLLAR, INCORP. 10/01/18 TUITE LAW 539 18WC 36104 ROSENFELD, LISA THE EQUITY GROUP INC 06/05/18 CLARK FROST 540 18WC 36258 BUSKER, TONI CITY OF FREEPORT 06/17/18 BLACK & JONES RUSIN & MACIOROWSKI LTD 541 18WC 36450 HARPER, JOY MONDELEZ INTERNATIONAL 11/07/18 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 542 18WC 36486 HARKINS, PATRICIA ROCKFORD BOARD OF EDUCATI 10/15/18 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 543 18WC 36615 JOHNSON, JAIME SUNRISE TRANSPORTATION 01/08/18 BLACK & JONES 544 18WC 36795 HERRMANN, STEVE TITAN TIRE 12/14/17 BLACK & JONES KEEFE CAMPBELL BIERY & ASSOC 545 18WC 36847 HERNANDEZ, ANGELES SAUCED SNAK KING CORP 11/06/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 546 18WC 36930 DAVIS, KELLIE SPX FLOW 08/07/18 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 547 18WC 36968 SELLERS, LATASHA FHN MEMORIAL HOSPITAL 01/30/18 BLACK & JONES GAROFALO SCHREIBER STORM GRA 548 18WC 36978 PEREZ, BRENDA FEDEX GROUND 06/18/18 GESMER & REYNOLDS PC KOPKA, PINKUS DOLIN, PC 549 18WC 37006 DOLAN, JUSTINA STEPHENSON COUNTY PROBATI 10/19/18 SEIDMAN MARGULIS & FAIRMAN 550 18WC 37059 HARKINS, PATRICIA ROCKFORD BOARD OF EDUCATI 10/17/18 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 551 18WC 37137 METZGER, ANNETTE SNAK KING 06/04/18 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 33 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 552 18WC 37148 LAGRONE, CRAIG SPX FLOW, INC 05/22/18 BLACK & JONES 553 18WC 37159 DEAN, MARIA BERGSTROM 10/01/18 BLACK & JONES WOLFE & JACOBSON, LTD 554 18WC 37385 CHADDERDON-LUEPKES, JUSTI HIAWATHA CUSD 426 07/31/18 HANNIGAN & BOTHA, LTD WIEDNER & MCAULIFFE LTD 555 18WC 37448 JACKSON, CYNTHIA ARAMARK 11/26/18 GESMER & REYNOLDS PC INMAN & FITZGIBBONS 556 18WC 37585 WILLIAMS, BRIAN USF HOLLAND 06/12/18 BLACK & JONES HENNESSY & ROACH PC 557 18WC 37590 BARBARY, JAMESETTA YANGFENG AUTOMOTIVE INTER 11/17/18 DWORKIN AND MACIARIELLO HENNESSY & ROACH PC 558 18WC 37853 LESURE, AKILIA PINNACLE LOGISTICS 12/13/18 WOODRUFF JOHNSON 559 18WC 38089 QUIST, PAM NORTHWOODS CARE CENTRE 02/09/18 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 560 18WC 38279 CLAYPOOL, STEVE SNELSON COMPANIES, INC 12/08/18 SCHWEICKERT & GANASSIN RUSIN & MACIOROWSKI LTD 561 18WC 38352 MITCHELL, LAWRENCE MCDONALD'S CORP 10/07/18 DWORKIN AND MACIARIELLO HENNESSY & ROACH PC 562 18WC 38395 RODGERS, TIMOTHY USF HOLLAND 11/17/17 JOHN C SERKLAND 563 19WC 00134 GUSTAFSON, DENNIS FCA US LLC 10/26/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 564 19WC 00190 CHIPMAN, PAMELA GE AVIATION AIR MANAGEMT 11/28/18 KATZ FRIEDMAN EAGLE ET AL MACIOROWSKI SACKMANN & ULRIC 565 19WC 00798 CORTEZ, PRIMITIVO THOMPSON PIPE GROUP 11/05/18 ADRIAN MURATI WIEDNER & MCAULIFFE LTD 566 19WC 01115 KIELY, GARY CITY OF ROCKFORD 09/14/18 GESMER & REYNOLDS PC HEYL ROYSTER VOELKER & ALLEN 567 19WC 01456 LORD, CLARISSA WIDOW OF AUTOGYRO, USA, INC. # 10/30/18 CAPRON & AVGERINOS PC BRADY CONNOLLY & MASUDA PC 568 19WC 01638 OLSON, PATRICK G SWAN LAKE LLC, D/B/A 09/20/18 TUITE LAW 569 19WC 01642 BAHR, BOBBIE J KEMPEL ENTERPRISES, INC 11/24/18 TUITE LAW EVANS & DIXON

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 34 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 570 19WC 02001 SAN MIGUEL CASTILLO, VICT MAGNA EXTERIORS 12/28/18 BLACK & JONES POWER & CRONIN LTD 571 19WC 02011 AGUILERA, ELIZABETH DUNKIN DONUTS 11/30/18 GESMER & REYNOLDS PC LAWRENCE COZZI - LAW OFFICE 572 19WC 02027 TAYLOR, ANDREA SEWARD SCREW PRODUCTS 11/02/18 BLACK & JONES HOLECEK & ASSOCIATES 573 19WC 02053 WOODS, ROBERT J LOWE'S HOME CENTERS LLC 12/12/18 TUITE LAW KEEFE CAMPBELL BIERY & ASSOC 574 19WC 02106 STALLWORTH, LENA MARIE ALDEN ALMA NELSON DEBES 08/10/17 BLACK & JONES 575 19WC 02111 QUATRANO, ROBIN SENIOR HELPERS 01/06/19 DWORKIN AND MACIARIELLO HENNESSY & ROACH PC 576 19WC 02186 EASTON, CARL WIESE USA, INC 09/06/18 SCHWEICKERT & GANASSIN 577 19WC 02359 GARNICA, ARMANDO SPECTRUM PREFERRED MEATS 12/20/18 JOHN S. ELIASIK RUSIN & MACIOROWSKI LTD 578 19WC 02582 STEELE, DARLENE J FURST STAFFING 10/03/18 PIGNATELLI & ASSOCIATES ACCIDENT FUND HOLDINGS 579 19WC 02605 GRAHAM, JOHNNY S CHRYSLER CORPORATION 11/08/17 REESE & REESE WILLIAMS MCCARTHY LLP 580 19WC 02632 THORNTON, PARTENIA MCDONALDS 09/01/18 BLACK & JONES ASA LAW GROUP 581 19WC 02635 HAVENS, KAREN STANDARD FORWARDING 08/01/18 BLACK & JONES HENNESSY & ROACH PC 582 19WC 02830 GOTHNER, THERESA UNITED PARCEL SERVICE 05/15/18 GOLDBERG WEISMAN & CAIRO L NYHAN BAMBRICK KINZIE & LOWR 583 19WC 02969 SAXBY, RONDA J PRESENCE LIFE CONNECTIONS 11/26/18 TUITE LAW 584 19WC 02974 HERRON, JOSEPH FCA US LLC 10/01/17 BLACK & JONES WILLIAMS MCCARTHY LLP 585 19WC 02977 RIO, JEFFREY GENERAL MILLS INC 12/12/18 BLACK & JONES BRYCE DOWNEY & LENKOV LLC 586 19WC 03099 JENSEN, LUANN ORTHO ILLINOIS SURGERY CE 11/22/17 GESMER & REYNOLDS PC ROSARIO CIBELLA 587 19WC 03160 ROSS, BRIAN A POPLAR GROVE PACEMAKER LL 04/01/16 TUITE LAW

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 35 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 588 19WC 03183 ROSS, BRIAN A PACEMAKER COUNTRYSIDE 09/13/18 TUITE LAW EVANS & DIXON 589 19WC 03271 CARDOSO, ENRIQUE JOSE ANTONIO MURILLO 10/24/18 GESMER & REYNOLDS PC 590 19WC 03361 STUDIER, JOSHUA RUSSCO MFG, INC 11/16/18 TUITE LAW GANAN & SHAPIRO 591 19WC 03409 LARSEN, TED LIEBOVICH BROTHERS INC 02/01/18 BLACK & JONES POULOS & DIBENEDETTO LAW 592 19WC 03476 SMITH, REBECCA FCA US LLC 08/23/18 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 19WC003477 -C 593 19WC 03508 BRIDGES, TIMOTHY HUGHS RESOURCES 12/19/18 DUDLEY & LAKE LLC SLAVIN & SLAVIN 594 19WC 03687 BURMEISTER, CATHERINE BURMEISTER FARM EQUIPMENT 07/17/18 GANAN & SHAPIRO 595 19WC 04495 SPEIGLE, DONALD ROGERS ELECTRIC 08/10/18 HORWITZ HORWITZ & ASSOC 596 19WC 04514 RUSSELL, JUDY FIRST STUDENT INC 01/27/19 GOLDBERG WEISMAN & CAIRO L 597 19WC 04764 WORSHAM, ALANE GARDA WORLD 02/01/19 ANGELINI & ORI LLC KEEFE CAMPBELL BIERY & ASSOC 598 19WC 04813 JONES, ANNETTE PINNACLE LOGISTICS 02/14/19 DWORKIN AND MACIARIELLO 599 19WC 04959 BEASLEY, RYAN ELITE FASTENERS INC 02/01/19 DWORKIN AND MACIARIELLO GAROFALO SCHREIBER STORM GRA 600 19WC 05090 WIEBENGA, LEE NORTHERN PLAINS DISTRIBUT 01/15/19 DERANGO & CAIN 601 19WC 05240 TRIMBLE, CHARLES HEELS AND HARDHATS CONTRA 08/31/17 BLACK & JONES GAROFALO SCHREIBER STORM GRA 602 19WC 05243 MILROY, CARRIE ROCKFORD PUBLIC SCHOOLS 09/20/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 603 19WC 05254 LONG, ZACHARY CARDINAL STAFFING 11/18/18 BLACK & JONES POWER & CRONIN LTD 604 19WC 05303 CASE, MICHAEL STATE OF ILLINOIS LOTTERY 01/22/19 LAW OFFICE OF LAURA A CHIL ASSISTANT ATTORNEY GENERAL 605 19WC 05441 WESTENBERG, SUSAN HARLEM SCHOOL DISTRICT #1 05/01/17 GESMER & REYNOLDS PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 36 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 606 19WC 05567 JACKSON, NICHOLAS MORSE ELECTRIC INC. 02/11/18 KATZ FRIEDMAN EAGLE ET AL 607 19WC 05655 DREW, ALICE CINTAS CORP 06/01/18 BLACK & JONES POWER & CRONIN LTD 608 19WC 05658 CURRY, SHEILA TH FOODS, INC 03/01/18 BLACK & JONES 609 19WC 05676 FLORES, PATRICK MACLELLAN INTEGRATED SERV 12/16/18 GESMER & REYNOLDS PC 610 19WC 05679 KEELING, KYLE LOWES DISTRIBUTION 01/07/19 BLACK & JONES KEEFE CAMPBELL BIERY & ASSOC 611 19WC 05690 WUBBEN, RONALD STAR MANUFACTURING 08/09/17 BLACK & JONES CAPUANI, FRANK S 612 19WC 05871 LOVE, CEDRIC MACIELLAN INTEGRATED SERV 01/28/19 DWORKIN AND MACIARIELLO KNELL LAW LLC 613 19WC 05888 SIMMONS, RAMARIO FCA US LLC 07/23/18 BLACK & JONES WILLIAMS MCCARTHY LLP 614 19WC 05994 LEMBKE, SANDRA MAGNA EXTERIORS 01/22/19 BLACK & JONES POWER & CRONIN LTD 615 19WC 06017 REEDY, CHAZZ GUNITE CORP 07/08/18 BLACK & JONES RUSIN & MACIOROWSKI LTD 616 19WC 06056 JASPERS, MICHELLE HEARTLAND HOSPICE 02/01/19 BLACK & JONES 617 19WC 06099 LANDRETH, SYLVIA ROCKFORD SCHOOL DISTRICT 02/06/19 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 618 19WC 06140 DALL, KURT ABF FREIGHT SYSTEM INC. 11/13/18 DEPAOLO & ZADEIKIS 619 19WC 06265 GREENIG, JILL ROCKFORD SCHOOL DISTRICT 01/01/18 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 620 19WC 06516 GARCIA, CESAR CANO CARPENTER CONTRACTORS 02/12/19 COSTA IVONE LLC WIEDNER & MCAULIFFE LTD 621 19WC 06704 WEKENMANN, MARY PCI PHARMA SERVICES 09/27/18 NASH LAW OFFICE PC HOLECEK & ASSOCIATES 622 19WC 06809 ELLESON, STEPHANIE M UTC AEROSPACE SYSTEMS 02/02/19 GESMER & REYNOLDS PC MACIOROWSKI SACKMANN & ULRIC 623 19WC 06839 CAPITOSTI, DEANNA PACCAR PARTS 01/16/19 BLOCK, KLUKAS & MANZELLA P BRADY CONNOLLY & MASUDA PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 37 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 624 19WC 06868 NUNEZ, ISABEL YANFENG AUTOMOTIVE 01/09/19 GESMER & REYNOLDS PC HENNESSY & ROACH PC 625 19WC 06968 HERNANDEZ, ADOLFO QPS EMPLOYMENT 02/27/19 DWORKIN AND MACIARIELLO WOLFE & JACOBSON, LTD 626 19WC 07051 MABIE, KEVIN FCA US LLC 04/03/17 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 627 19WC 07191 COLLINS, GERALD BELVEDERE USA LLC 08/10/18 JOSEPH J LOSS PC RUSIN & MACIOROWSKI LTD 19WC007192 -C 628 19WC 07298 TOBLER, CHRISTINA DOLLAR TREE 02/10/19 BLACK & JONES BRYCE DOWNEY & LENKOV LLC 629 19WC 07329 WANSTROM, ROCK ANDROID INDUSTRIES 02/28/19 KATZ FRIEDMAN EAGLE ET AL 630 19WC 07503 BROWN, CAPRISHA CSL PLASMA 02/21/19 GESMER & REYNOLDS PC HOLECEK & ASSOCIATES 631 19WC 07529 PAGAN, JUAN WINNEBAGO FOUNDRY INC 07/31/18 LIPKIN & HIGGINS LAW OFFIC 632 19WC 07624 TUCKER, LASHAWNDA SYNCREON 01/08/19 GESMER & REYNOLDS PC 633 19WC 07663 MARTINEZ, MAXIMILIANO E LEWIS TREE SERVICE 03/04/19 EPSTEIN, JACK R LAW OFFICE 634 19WC 07674 OLSEN, DENNIS KRAUTER FOREST PRODUCTS, 09/15/17 GESMER & REYNOLDS PC 635 19WC 07689 EMIGHOLZ, MATT STATE OF ILLINOIS-CMS @ 02/22/19 MARK N LEE ASSISTANT ATTORNEY GENERAL 636 19WC 07739 FLORES, PATRICK MACLELLAN INTERGRATED SER 12/16/18 GESMER & REYNOLDS PC KNELL LAW LLC 637 19WC 07846 BANKS, JOHN SOUTHERN REFRIGERATED 03/07/19 DWORKIN AND MACIARIELLO GOLDBERG SEGALLA LLC 638 19WC 07938 HEATH, ALESHA AXIUM FOODS 03/13/19 ANGELINI & ORI LLC 639 19WC 08037 JONES, FRED COUNTY OF WINNEBAGO 12/06/18 CLARK FROST WILLIAMS MCCARTHY LLP 640 19WC 08174 RIPORTELLA, RYAN BREAKTHRU BEVERAGE 01/07/19 GESMER & REYNOLDS PC NYHAN BAMBRICK KINZIE & LOWR 641 19WC 08423 RAYLOR, TAMLA ARAMARK ROCKFORD SCHOOL 01/28/19 SHELDON I MINKOW & ASSOCIA WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 38 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 642 19WC 08498 DENNIS, MELISSA RIVER BLUFF NURSING HOME 02/16/19 GESMER & REYNOLDS PC WILLIAMS MCCARTHY LLP 643 19WC 08553 ALLEN, LASHAUNDA GUNITE CORP/ACCURIDE 06/01/18 RUSIN & MACIOROWSKI LTD 644 19WC 08660 SHEFFIELD, PHYLLIS HARLEM SCHOOL DISTRICT 12 01/15/19 NASH LAW OFFICE PC 645 19WC 08732 ANDERSON, PAUL SHEET METAL CONNECTORS, I 08/06/18 ANCEL GLINK PC 646 19WC 08833 BURRIS, JANICE K MALCOLM EATON ENTERPRISES 01/10/19 TUITE LAW WIEDNER & MCAULIFFE LTD 647 19WC 08889 HERMANS, JODI PCI PHARMA SERVICES 04/19/17 GESMER & REYNOLDS PC JOSEPH MARCINIAK 648 19WC 08965 MCWILLIAMS, LAURIE YANGFENG AUTOMOTIVE INTER 11/27/17 BLACK & JONES HENNESSY & ROACH PC 649 19WC 08972 SMITH, MICHAEL R MECHANICAL INC 05/01/18 BLACK & JONES 650 19WC 09484 MOORE, JONATHAN MEIJER 02/14/19 NASH LAW OFFICE PC KOPKA, PINKUS DOLIN, PC 651 19WC 09514 CAPITOSTI, DEANNA PACCAR PARTS 01/16/19 BLACK & JONES BRADY CONNOLLY & MASUDA PC 652 19WC 09548 ANTIS, WILLIAM J RYDER INTERGRATED LOGISTI 11/29/18 RUBIN LAW GROUP 653 19WC 09631 CONNORS, SHAWN M CTY OF ROCKFORD ROCKFORD 09/23/17 TUITE LAW 654 19WC 09792 RAMOS, LIZANDRO QPS EMPLOYMENT GROUP 03/13/19 BLACK & JONES WOLFE & JACOBSON, LTD 655 19WC 09867 MEEHAN, PATRICK LAWN CARE BY WALTER 02/10/19 BLACK & JONES 656 19WC 09870 KALEN, SCOTT VIKING CHEMICAL CO 12/01/18 BLACK & JONES HENNESSY & ROACH PC 657 19WC 09899 PETERS, STEVEN T WILSON ELECTRIC 11/08/18 REESE & REESE 658 19WC 09907 SMITH, KERMIT BERBER FOOD & BEVERAGE 02/01/19 GESMER & REYNOLDS PC 659 19WC 09931 WALSTON, DENNIS RMTD 03/12/19 GESMER & REYNOLDS PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 39 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 660 19WC 09940 COSTA, TIMOTHY BLOUNT INTERNATIONAL INC 02/05/19 GESMER & REYNOLDS PC 661 19WC 10112 HAWKINS, JANICE ROCKFORD PUBLIC SCHOOLS 08/24/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 662 19WC 10133 WRIGHT, KAREN HARLEM SCHOOL DIST 122 02/11/19 GOLDBERG WEISMAN & CAIRO L 663 19WC 10311 DELEON, REBECCA UTC AEROSPACESYSTEMS 01/22/19 KATZ FRIEDMAN EAGLE ET AL MACIOROWSKI SACKMANN & ULRIC 664 19WC 10373 ALLEN, LAURELL FCA US LLC 02/12/15 BLACK & JONES 665 19WC 10535 SCACE, JUSTIN SAVERY TRANSPORT INC 11/16/18 BLACK & JONES 666 19WC 10568 HERNANDEZ, ROBERT JOSEPH SQUARE RESTORATION, INC 09/13/18 BRADY CONNOLLY & MASUDA PC 667 19WC 10582 LAMB, RONALD CINTAS CORP 02/06/19 BLACK & JONES POWER & CRONIN LTD 668 19WC 10685 GAY, KRISTOPHER CHERRY VALLEY FIRE PROTEC 01/22/19 BLACK & JONES RUSIN & MACIOROWSKI LTD 669 19WC 10688 BRINKMEYER, DOUG ALL TRUCKS USA INC W 04/24/18 BLACK & JONES 670 19WC 10713 JURING, ANGELA FCA US LLC 01/10/18 KATZ FRIEDMAN EAGLE ET AL 671 19WC 10733 BROWN, WILLIAM G JR. ROCKFORD SCHOOL DISTRICT 07/16/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 672 19WC 10839 CASSELL, JON L PACCAR INC 02/18/19 TUITE LAW BRADY CONNOLLY & MASUDA PC 673 19WC 11007 BROCK, KRISTINE FCA US LLC 09/10/18 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 674 19WC 11039 SCHNEIDER, MICHAEL THE CITY OF ROCKFORD 08/03/18 HEYL ROYSTER VOELKER & ALLEN 675 19WC 11363 EKQUIST, WILLIAM WOODS EQPMNT A/K/A BLOUNT 03/07/19 PIGNATELLI & ASSOCIATES WOLFE & JACOBSON, LTD 676 19WC 11538 RAMSEY, MARCI OSF HEALTHCARE 03/11/19 CAPRON & AVGERINOS PC HINSHAW & CULBERTSON 677 19WC 11638 HEAVIN, VARNON R IMAGE PROS ASPHALT MNTNCE 08/18/18 WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 40 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 678 19WC 11747 HERNANDEZ, EDUARDO WASTE CONNECTIONS, INC 02/07/19 STROW LAW LLC 679 19WC 11818 REIMANN, DAVID AEROTEK 11/14/18 GESMER & REYNOLDS PC 680 19WC 11890 NEWHAUSEN, MERLE A A & B FREIGHT LINE 11/27/18 MARTIN V KUGIA LEAHY EISENBERG & FRAENKEL 681 19WC 11939 SUNDELL, DOMINIC NEBLOCK INC. 07/01/18 BLACK & JONES FRIEDRICH LAW LLC 682 19WC 12042 GONZALEZ MELENDEZ, LUIS A J&L HOME IMPROVEMENT 02/02/19 JAMES URTIS 683 19WC 12167 BRITO LARA, BRENDA C DASCO PRO, INC 03/20/17 TUITE LAW WOLFE & JACOBSON, LTD 684 19WC 12250 ROSTAMO, JOEL UNITED PARCEL SERVICE 01/04/18 CLARK FROST NYHAN BAMBRICK KINZIE & LOWR 685 19WC 12358 KOZUCH, KATHY MERCY HEALTH HOSP-RIVERSI 02/24/19 BLACK & JONES WIEDNER & MCAULIFFE LTD 686 19WC 12370 CABALLERO SALGADO, ALEJAN DSI CORPORATION 08/15/18 BLACK & JONES ACCIDENT FUND HOLDINGS 687 19WC 12390 NOBLE, KENDALE KOLB LENA CHEESE 04/13/19 GESMER & REYNOLDS PC KEEFE CAMPBELL BIERY & ASSOC 688 19WC 12729 LUN, CING KHAN TH FOODS, INC. 03/14/19 COLLISON LAW OFFICES 689 19WC 12760 SCHMIDT, NICOLE CARDINAL STAFFING SRVS 02/18/18 BLACK & JONES 690 19WC 12763 MCWILLIAMS, LAURIE YANGFENG AUTOMOTIVE INTER 04/16/19 BLACK & JONES HENNESSY & ROACH PC 691 19WC 12766 RODRIGUEZ, LETICIA GRANITE DESIGNERS 03/14/19 BLACK & JONES 692 19WC 12897 MILLER, MARK MARK MILLER CONSTRUCTION 04/08/19 DWORKIN AND MACIARIELLO 693 19WC 12973 FREEMAN, ANDRE ROCKFORD SECONDARY CO 02/26/19 CULLEN HASKINS NICHOLSON 694 19WC 13099 WICKWIRE, JENNIFER, WIDOW ALTER TRADING CORPORATION # 10/03/18 GESMER & REYNOLDS PC LANE & WATERMAN 695 19WC 13140 LOCHNER, CHELSEY E CITY OF ROCKFORD POLICE D 02/27/19 REESE & REESE HEYL ROYSTER VOELKER & ALLEN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 41 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 696 19WC 13143 SAGE, TERRY ALPHA SOURCE 11/12/18 BLACK & JONES 697 19WC 13178 MATHIS, KIMBERLY QPS 02/08/19 GESMER & REYNOLDS PC WOLFE & JACOBSON, LTD 698 19WC 13251 RODRIGUEZ, HANNAH ROCKFORD POWER TRAIN 04/16/19 KATZ FRIEDMAN EAGLE ET AL RIPES NELSON BAGGOT KALOBRAT 699 19WC 13279 LEYVA, ALBERTO DAVILA AMERICAN ALUMINUM EXTRUSI 03/16/18 COSTA IVONE LLC 700 19WC 13423 MARTIN, MARGARET GARDEN HOTEL & CONFERENCE 12/01/18 BLACK & JONES 701 19WC 13446 BONDS, MICHAEL ACCURATE METALS OF ILLINO 01/01/17 BLACK & JONES BRADY CONNOLLY & MASUDA PC 702 19WC 13449 PEAK, SHAUNNA ESTWING 12/21/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 703 19WC 13510 EDWARDS, CHERYL FCA US LLC 04/18/19 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 704 19WC 13593 NIHELLS, JACOB P CHERRY VALLEY FIRE PROTEC 04/18/19 THOMAS W DUDA 705 19WC 13809 ROACH, CHRISTOPHER NED DICKEY & ASSOCIATES 05/07/19 DWORKIN AND MACIARIELLO 706 19WC 14195 FIORENZA, ZACH COLLIER RV 04/30/19 BLACK & JONES CASSANO & ASSOCIATES 707 19WC 14355 SCHACTNER, NICOLE GOLDIE B FLOBERG CENTER 02/26/19 BLACK & JONES NOBLE & ASSOC 708 19WC 14361 MANDUJANO, ADAM MIKE HARRIS MASON CONTRAC 11/01/18 BLACK & JONES GANAN & SHAPIRO 709 19WC 14364 JONES, JOYCE ROCKFORD PUBLIC SCHOOLS 04/24/19 BLACK & JONES WIEDNER & MCAULIFFE LTD 710 19WC 14434 YOUNG, MERRY A DOLLAR TREE STORES, INC 04/17/19 TUITE LAW NYHAN BAMBRICK KINZIE & LOWR 711 19WC 14574 ALLEN, JOHN PORTILLO'S HOT DOGS LLC 04/26/19 GESMER & REYNOLDS PC HOLECEK & ASSOCIATES 712 19WC 14666 HANSBERRY, MARK PCI PHARMA SERVICES 02/12/18 MC HARGUE & JONES HOLECEK & ASSOCIATES 713 19WC 14828 SPENCER, FRANKIE FCA US LLC 11/29/18 BLACK & JONES WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 42 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 714 19WC 14971 ERICKSON, STEVE SCP POOL CORP 04/15/19 BLACK & JONES GAROFALO SCHREIBER STORM GRA 715 19WC 14976 ANDERSON, LARRY ESTWING MANUFACTURING CO 01/06/19 BLACK & JONES WIEDNER & MCAULIFFE LTD 716 19WC 14980 MAUERMAN, EDWARD PINNACLE LOGISTICS 10/07/18 BLACK & JONES 717 19WC 14996 OWEN, MONICA HARLEN SCHOOL DIST 122 03/18/19 DWORKIN AND MACIARIELLO 718 19WC 15139 HERNANDEZ, ADELA QPS EMPLOYMENT GROUP 02/26/19 GESMER & REYNOLDS PC WOLFE & JACOBSON, LTD 719 19WC 15181 KNIFFEN, DAVID WINNEBAGO COUNTY SHERIFF' 04/30/19 REESE & REESE 720 19WC 15257 KELBEY, CAMERON T WOODWARD INC 04/03/19 TUITE LAW HINSHAW & CULBERTSON 721 19WC 15374 REESE, MATTHEW C UPS 04/04/19 REESE & REESE ASA LAW GROUP 722 19WC 15535 WILSON, SHAYLA N ECOLAB PRODUCTION LLC 04/04/19 TUITE LAW KEEFE CAMPBELL BIERY & ASSOC 723 19WC 15666 NEAL, JOANNE ROCKFORD MEMORIAL HOSPITA 04/11/19 BLACK & JONES 724 19WC 15671 LEWIS, ANDREA BERNER FOODS INC 05/01/19 BLACK & JONES HOLECEK & ASSOCIATES 725 19WC 15676 ROBERTS, SETH ELITE FASTENERS 01/07/19 BLACK & JONES GAROFALO SCHREIBER STORM GRA 726 19WC 15797 VULGAMOTT, CYNTHIA S JESSICA'S RESTAURANT 09/30/18 REESE & REESE 727 19WC 15921 ROCK, MELISSA K TRINITY LUTHERAN CHURCH/S 12/14/17 LUCY T. UNGER 728 19WC 15967 SEAWOOD, GREGORY W HIRSCHBACH MOTOR LINES, I 02/15/19 GESMER & REYNOLDS PC BETTY NEUMAN & MCMAHON 729 19WC 16011 MAY, OTTO JR. FCA US LLC 02/20/19 GESMER & REYNOLDS PC 730 19WC 16188 DIMAGGIO, CHRISTOPHER FCA US LLC 02/28/19 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 731 19WC 16306 CURRY, ALBERT FCA US LLC 04/23/18 BLACK & JONES WILLIAMS MCCARTHY LLP

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 43 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 732 19WC 16309 SIMMONS, RAMARIO FCA US LLC 07/23/18 BLACK & JONES 733 19WC 16363 GRANT, KENYAH ROSEWOOD CARE CENTER 05/24/19 DWORKIN AND MACIARIELLO 734 19WC 16454 JOHNSON, DENNIS SLIDEMATIC 04/25/19 GESMER & REYNOLDS PC JOSEPH MARCINIAK 735 19WC 16495 GOMEZ, JUAN E ESTWING MANUFACTURING 02/26/18 WIEDNER & MCAULIFFE LTD 736 19WC 16535 TALLARD, TAYLOR GENERAL MILLS, INC 07/27/18 FRANKS, GERKIN & MCKENNA P BRYCE DOWNEY & LENKOV LLC 737 19WC 16891 D'ANGELO, ROBERT SUNSET CARTAGE INC 03/27/19 ACCIDENT FUND HOLDINGS 738 19WC 17021 CARRISON, JOHN W SUGAR RIVER MACHINE SHOP 02/19/19 TUITE LAW BRADY CONNOLLY & MASUDA PC 739 19WC 17055 KOMAR, EVA MAGNA INTERNATIONAL 05/28/19 KATZ FRIEDMAN EAGLE ET AL POWER & CRONIN LTD 740 19WC 17140 BROOKS, SHAREN GENERAL MILLS INC 02/22/19 BLACK & JONES BRYCE DOWNEY & LENKOV LLC 741 19WC 17148 EZOP, JENNIFER THE FIRST STEP DAYCARE 06/08/18 BLACK & JONES JOSEPH MARCINIAK 742 19WC 17214 FAGAN, KEVIN IL DEPT OF TRANSPORTATION @ 12/21/18 FRANKS, GERKIN & MCKENNA P ASSISTANT ATTORNEY GENERAL 743 19WC 17473 DISMUKE, BELUNN FCA US LLC 02/01/19 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 744 19WC 17634 GOWAN, SAMMANTHA ROCKFORD HOUSIGN AUTHORIT 02/16/18 GILDEA, COGHLAN & REGAN LTD. 745 19WC 17786 RUSSELL, JAYSEN COCA-COLA 11/07/18 KROL BONGIORNO & GIVEN LTD 746 19WC 17885 VIRTUE, PATTY HARTIG DRUG 12/26/18 CAPRON & AVGERINOS PC GANAN & SHAPIRO 747 19WC 17955 MARTIN, FELICIA SPX FLOW, INC 03/01/19 BLACK & JONES WIEDNER & MCAULIFFE LTD 748 19WC 17960 NORWOOD, BERNARD FCA US, LLC 03/16/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 749 19WC 17963 CENICEROS, JESUS MIDCOR SUPPLY 05/14/19 BLACK & JONES ACCIDENT FUND HOLDINGS

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 44 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 750 19WC 17967 LOPEZ, ABEL AZZ GALVANIZING 11/23/18 BLACK & JONES 751 19WC 17974 SOWELL, STEWART ANDROID INDUSTRIES 03/09/19 BLACK & JONES WIEDNER & MCAULIFFE LTD 752 19WC 17977 THOMPSON, SHAWN INGERSOLL MACHINE TOOLS 06/15/16 BLACK & JONES 753 19WC 17980 KLEINDL, DIANNA ACUMENT GLOBAL TECHNOLOGI 03/14/19 BLACK & JONES HOLECEK & ASSOCIATES 754 19WC 18095 RUDNY, BRIAN M SYNERGY PEO, LLC 11/05/18 TUITE LAW KEEFE CAMPBELL BIERY & ASSOC 755 19WC 18252 WHITMORE-SMITH, DEBORAH SYNCREON 05/16/19 DWORKIN AND MACIARIELLO 756 19WC 18393 SCHUTT, CHARANNA FCA US LLC 05/31/19 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 757 19WC 18540 ELLIOTT, GEORGE WANEK TRUCKING 03/18/19 TURNER & SACKETT LLC 758 19WC 18611 JOHNSON, KEITH D FURST STAFFING SRVS, INC 07/25/16 TUITE LAW 759 19WC 18789 LEMBKE, JAMES A HERITAGE CARPENTRY, INC 12/12/18 TUITE LAW KOPKA, PINKUS DOLIN, PC 760 19WC 18941 NELSON, DEBRA ROCKFORD SCHOOL DIST #205 04/17/18 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 761 19WC 18951 WREN, JENNIFER ROCKFORD BALL SCREW 05/23/19 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 762 19WC 18954 DEVOE, JEROME AUTOZONE 06/13/19 BLACK & JONES GILDEA, COGHLAN & REGAN LTD. 763 19WC 18966 PEYTON, WILLIAM D QPS 01/16/19 GESMER & REYNOLDS PC WOLFE & JACOBSON, LTD 764 19WC 19099 BUCHNER, CASEY OSF HOME HEALTH & HOSPICE 10/16/18 DWORKIN AND MACIARIELLO 765 19WC 19140 GREINER, GERALDINE WIDOW FRENTRESS LAKE MARINE # * 05/17/02 EDWARD J. KOZEL 766 19WC 19335 GUY, SHAWN JONES NATURALS HOLDINGS 01/02/19 GANAN & SHAPIRO 767 19WC 19378 STAAB, MICHAEL SYNCREON 01/31/19 KATZ FRIEDMAN EAGLE ET AL GAROFALO SCHREIBER STORM GRA

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 45 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 768 19WC 19382 LINDSTROM, ELIZABETH MERCY HEALTH CORP 03/17/17 WIEDNER & MCAULIFFE LTD 769 19WC 19439 STAVER, DANIEL TEMPORARAY EXCAVATING 02/14/19 THOMAS A MORRISSEY 770 19WC 19521 VARGAS, DAVID AMERICAN ALUMINUM EXTRUSI 06/20/19 ERIC H CHECK, LAW OFFICES 771 19WC 19633 BURTON, JEREMY AXIUM FOODS 02/08/19 BLACK & JONES WARMOUTH LAW PC 772 19WC 19636 TROUT, THERESA JACK WOLFE CHRYSLER 11/27/18 BLACK & JONES 773 19WC 19641 TRUCKENMILLER, DARRYL STEPHENSON SERVICE CO 06/12/19 BLACK & JONES HEYL ROYSTER VOELKER & ALLEN 774 19WC 19778 WOMACK, MICHAEL VIVINT SOLAR 06/19/19 MARKHAM M JEEP & ASSOCIATE 775 19WC 19810 SALAZAR, ROGER PINNACLE LOGISTICS 07/01/19 REESE & REESE 776 19WC 19816 HADIE, TROY C ROCKFORD HOUSING AUTHORIT * 01/16/18 GILDEA, COGHLAN & REGAN LTD. 777 19WC 19894 HAWKINS, MICKEAL CONCENTRIC AB * 04/20/19 DWORKIN AND MACIARIELLO 778 19WC 20007 MOSES, KENDRA KADON PRECISION MACHINING * 06/24/19 DWORKIN AND MACIARIELLO RUSIN & MACIOROWSKI LTD 779 19WC 20185 RIMINGTON, LINDA A ROLLING HILLS PROGRESS CT * 04/23/19 HAUSER LAW LLC 780 19WC 20380 KREWER, MICHAEL DISTINCTIVE ROOFING, INC. * 05/24/18 MARTIN V KUGIA WOLF & LAUDICINA LTD 781 19WC 20431 HAYNES, BENJAMIN PREMIUM TRANSPORTATION * 01/24/19 DWORKIN AND MACIARIELLO 782 19WC 20491 HENDRICKSON, MARY KAY JOHNSON OIL CO EXPRESS LA * 06/19/18 O'CONNOR & NAKOS 783 19WC 20743 LEON, CRISTOBAL CREATIVE LANDSCAPING * 06/04/19 SEIDMAN MARGULIS & FAIRMAN BRADY CONNOLLY & MASUDA PC 784 19WC 20987 SOPCZAK, JOSH PORTER INSTALLATIONS * 01/21/19 ADRIAN MURATI HENNESSY & ROACH PC 785 19WC 21136 GARCIA-FERREYRA, MARIO OAKLEY INDUSTRIES * 06/17/19 MARTIN V KUGIA

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 46 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 786 19WC 21147 FLEMING, KERRY ROCKTON SCHOOL DISTRICT # * 02/15/18 CLARK FROST 787 19WC 21277 HARNISCH, DENNIS GLENDENNING BROTHERS * 06/01/19 BLACK & JONES JAMES M KELLY 788 19WC 21280 BRIGGS, KRISTI MERCYHEALTH JAVON BAE HOS * 06/24/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 789 19WC 21535 ROLLINS, BEVERLY A HELP AT HOME * 04/03/19 HAUSER LAW LLC 790 19WC 21700 JENNINGS, DAMARIO UPS * 07/24/19 DWORKIN AND MACIARIELLO 791 19WC 21796 BANKES, ROBERT ARCO MACHINERY MOVERS * 04/09/18 BLACK & JONES GANAN & SHAPIRO 792 19WC 21832 CAMACHO, JAVIER A&O FRAMING, INC * 11/19/18 BLACK & JONES 793 19WC 21835 COLLIER, KYM FCA US, LLC * 04/15/19 BLACK & JONES WILLIAMS MCCARTHY LLP 794 19WC 21873 NELSON, DENNIS WASTE CONNECTIONS INC * 04/16/18 DOUGLAS RALLO PC 795 19WC 21881 MARTINEZ, AMY UPS CUSTOMER CENTER * 06/20/19 BLACK & JONES 796 19WC 21942 HOLM, MARK FRANCHESCO'S RISTORANTE * 05/29/19 MARKS INJURY LAW 797 19WC 21990 LANCASTE, JEREMY MBI * 06/27/19 TURNER & SACKETT LLC WIEDNER & MCAULIFFE LTD 798 19WC 22030 ABERNATHY, OPAL A GRACE HOSPICE * 02/08/19 DWORKIN AND MACIARIELLO 799 19WC 22133 COBOS, SUSAN M YANFENG AUTOMOTIVE INTERI * 08/30/18 PIGNATELLI & ASSOCIATES 800 19WC 22190 FISHER, ALEXANDER UPS * 06/30/19 BLACK & JONES LAWRENCE COZZI - LAW OFFICE 801 19WC 22329 DAVIS, TIMOTHY AMERICOLD LOGISTICS, LLC * 06/28/19 GESMER & REYNOLDS PC 802 19WC 22534 JUSUFI, NAZIM THE PEPPER MILL * 01/22/19 TUITE LAW 803 19WC 22628 WEST, KAREN MCCLEARY, INC * 04/16/19 CAPRON & AVGERINOS PC HENNESSY & ROACH PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 47 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 804 19WC 22704 SALINAS, TAMMY INTEGRATED LABEL CORP * 02/15/19 DWORKIN AND MACIARIELLO ACCIDENT FUND HOLDINGS 805 19WC 22892 ALMANZA, LUIS TAYLOR COMPANY * 04/19/17 MACIOROWSKI SACKMANN & ULRIC 806 19WC 22991 MILLER, RHONDA FCA US, LLC * 12/13/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 807 19WC 22994 MORIARITY, PATRICK PETERSON CLEANING * 07/22/19 BLACK & JONES WIEDNER & MCAULIFFE LTD 808 19WC 23006 HOLMES, JAMES MAGNA SERVICES OF AMERICA * 06/08/18 BLACK & JONES POWER & CRONIN LTD 809 19WC 23009 PYZYNSKI, EMELITA TH FOODS INC * 01/28/19 BLACK & JONES 810 19WC 23012 SPENCER, FRANKIE FCA US LLC * 11/29/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 811 19WC 23018 PELLEY, TYRAN RAYNER COVERING SYSTEMS I * 10/18/18 BLACK & JONES 812 19WC 23044 RENTON, CHAD CORE-MARK INTERNATIONAL, * 07/26/19 GESMER & REYNOLDS PC 813 19WC 23821 GONZALEZ, RUBEN MICHEL ROCKNEL FASTENER, INC * 07/18/19 BLACK & JONES 814 19WC 23824 WILSON, LINVAL MODERN PLATING * 02/01/17 BLACK & JONES HOLECEK & ASSOCIATES 815 19WC 23910 FLORES, JUAN CARLOS QVEST SANITATION * 05/31/19 PIGNATELLI & ASSOCIATES 816 19WC 23933 HALL, JEFFRY A COUNTY OF WINNEBAGO ILLIN * 04/30/19 TUITE LAW 817 19WC 23997 CANTU, GUY RUG DOCTOR, LLC * 04/15/19 CORBOY & DEMETRIO PC 818 19WC 24091 SHORES, BRIAN CAVO COMMUNICATIONS * 06/01/19 DWORKIN AND MACIARIELLO QUINTAIROS PRIETO WOOD & BOY 819 19WC 24661 WALLIS, MICHAEL ROCKFORD BALL SCREW * 05/09/19 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 820 19WC 24666 HICKS, RICKY MACLELLAN INTEGRATED SERV * 07/25/18 BLACK & JONES KNELL LAW LLC 821 19WC 24675 MAUERMAN, BRITTANY BLAIN'S FARM & FLEET * 07/16/19 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 48 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 822 19WC 24678 DALSANTO, NORA SWEDISH AMERICAN HOSPITAL * 08/05/19 BLACK & JONES 823 19WC 24786 RODRIGUEZ, XZENA TMI HOSPITALITY MANAGMT D * 07/05/19 LAWFIRST 824 19WC 24898 STENSRUD, PATRICIA L G4S SECURE SOLUTIONS USA * 11/23/18 TUITE LAW 825 19WC 24918 LOMAX JR, GEORGE O MEYERS INDUSTRIES INC. * 05/02/19 TUITE LAW 826 19WC 25071 ERICKSON, BRYCE FCA US LLC * 03/14/19 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 827 19WC 25314 KELLER, THERESA MILESTONES * 10/13/18 DWORKIN AND MACIARIELLO HEYL ROYSTER VOELKER & ALLEN 828 19WC 25472 KROMPART, STACIE HOLLYWOOD RESTAURANT * 08/05/19 BLACK & JONES MCANANY VANCLEVE & PHILLIPS 829 19WC 25474 BURFOOT, SCOTT ROCKFORD PARK DIST 05/19/19 BLACK & JONES HENNESSY & ROACH PC 830 19WC 25527 GERVASIO, LUCIO PET SMART * 07/09/18 CRONIN PETERS & COOK 831 19WC 25541 DELAROSA, TAMMY FCA US, LLC * 08/12/19 GESMER & REYNOLDS PC 832 19WC 25598 HOLAWAY, JEFFREY FCA US LLC * 08/15/19 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 833 19WC 25661 STOCKER, KIMBERLY FCA US, LLC * 02/05/19 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 834 19WC 25896 ESCALANTE, MICHAEL WOODWARD GOVERNOR CO * 06/20/18 BLACK & JONES 835 19WC 25937 HALCOMB, JUDY UNITED PARCEL SERVICES * 02/04/19 GWC INJURY LAWYERS LLC NYHAN BAMBRICK KINZIE & LOWR 836 19WC 26063 ADDISON, MARIE EASTER SALES * 07/25/19 GESMER & REYNOLDS PC 837 19WC 26103 SCHWARTZ, CLAREISA B J SALSONS, INC. * 11/05/18 FRIEDRICH LAW LLC 838 19WC 26165 BUSH, JEAN YANFENG AUTOMOTIVE INTERI 01/14/19 BLACK & JONES 839 19WC 26169 FERRARESI, MARY US BANK 10/25/18 BLACK & JONES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 49 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 840 19WC 26172 ALLEN, JOHN PORTILLO'S HOT DOGS 10/25/18 BLACK & JONES 841 19WC 26254 FLORES, PATRICK MACLELLAN INTEGRATED SRVS 10/14/18 GESMER & REYNOLDS PC 842 19WC 26800 HOBBS, SHANE ASPEN CONSTRUCTION SYSTEM * 08/17/19 BLACK & JONES BRADY CONNOLLY & MASUDA PC 843 19WC 26804 CASTILLO, JEANETTE MAGNA EXTERIORS * 06/18/19 BLACK & JONES POWER & CRONIN LTD 844 19WC 26807 MADDRELL, SHERRY WALMART * 07/21/19 BLACK & JONES QUINTAIROS PRIETO WOOD & BOY 845 19WC 26843 MEADORS, ERIK J CITY OF LOVES PARK-POLICE * 08/14/19 TUITE LAW 846 19WC 26871 SPRING, SCOTT UTC AEROSPACE SYSTEMS/ * 08/08/19 CLARK FROST MACIOROWSKI SACKMANN & ULRIC 847 19WC 26909 ARAND, TONY B SQUARED CONCRETE * 10/16/18 DWORKIN AND MACIARIELLO 848 19WC 27008 MABRY, KAYLA R MCDONALD'S CORPORATION * 08/20/19 TUITE LAW 849 19WC 27064 CURRY, DENNIS R.L. LEEK INDUSTRIES * 09/03/19 DWORKIN AND MACIARIELLO 850 19WC 27126 TOWNSEND, MICHAEL IPSEN, INC * 06/08/18 BLACK & JONES 851 19WC 27130 SANDERS, CHARMAINE JONE'S NATURAL CHEWS * 07/15/19 BLACK & JONES 852 19WC 27146 MOORE, KAYETTA BERGSTROM * 04/02/19 GESMER & REYNOLDS PC 853 19WC 27164 PRESENDA-TORRES, JAVIER TROY'S LAWN CARE INC * 07/12/19 FRANKS, GERKIN & MCKENNA P 854 19WC 27260 KESSLING, JUSTINA ANDROID INDUSTRIES * 12/10/18 WIEDNER & MCAULIFFE LTD 855 19WC 27319 CLARK, TIMOTHY A ARAMARK * 03/28/19 REESE & REESE 856 19WC 27414 BRAGELMAN, RICHARD ROCKFORD HEAT TREATERS, I * 02/01/19 GAROFALO SCHREIBER STORM GRA 857 19WC 27441 BRYANT, JAMES FCA US LLC * 06/26/18 KATZ FRIEDMAN EAGLE ET AL

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 50 C A S E H E A R I N G S Y S T E M DOHERTY, CAROLYN 027 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/08/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 858 19WC 27514 BEETS, TONYA ROCKFORD BOARD OF * 11/20/18 HORWITZ HORWITZ & ASSOC 859 19WC 27522 STRANG, BRYCE FITZGERALD EQUIPMENT CO I * 06/27/19 RIPES NELSON BAGGOT KALOBRAT 860 19WC 27628 LAKIS, NICHOLAS ILLINOIS STATE POLICE @ * 02/12/19 RIDGE & DOWNES 861 19WC 27758 PIZANA, JUANI NUETRO QUESO * 02/12/18 NYHAN BAMBRICK KINZIE & LOWR 862 19WC 28064 SANDOVAL, ROSIO TRI-DIM FILTER CORPORATIO * 08/15/19 MARC J SHUMAN & ASSOCIATES 863 19WC 28132 JOHNSON, ANTONIO HUGHES RESOURCES * 09/17/19 DWORKIN AND MACIARIELLO 864 19WC 28199 REES, DANIEL L OBERT FARMS LLC. * 11/27/17 TUITE LAW 865 19WC 28266 HYSER, ANTHONY E BEST BUY COMPANY INC * 08/20/19 TUITE LAW 866 19WC 28330 KOESTER, BEVERLY L SCALES MOUND SCHOOL DISTR * 07/10/19 TUITE LAW 867 19WC 28481 SIMPSON, PAMELA IL STATE TOLL HWY AUTHORI @ * 08/27/19 BAUM RUFFOLO & MARZAL LTD 868 19WC 28577 PETRIE, MIKE COLLINS AEROSPACE * 09/09/19 BLACK & JONES 869 19WC 28607 BLAKELY, HERBERT R.L. LEEK INDUSTRIES * 06/01/19 BLACK & JONES 870 19WC 28611 WARREN, LANA MOSAIC * 05/26/19 BLACK & JONES 871 19WC 28661 HARDEN, JIMMIE FCA US LLC * 09/13/19 KATZ FRIEDMAN EAGLE ET AL 872 19WC 28664 CONTRERAS, MARIO FCA US LLC * 09/03/19 KATZ FRIEDMAN EAGLE ET AL