ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 1 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 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, LTD 2 05WC 10479 SWAN, ALBERT W SJOSTROM & SONS, INC 10/30/03 ANESI OZMON RODIN NOVAK KO BRADY CONNOLLY & MASUDA PC 3 05WC 31501 CARDINAL, VICTORIA CADBURY ADAMS 04/22/05 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 4 06WC 02937 SIHOCKY, JOHN HELANDER MASONRY 12/15/05 HORWITZ HORWITZ & ASSOC THOMAS & ASSOCIATES 5 07WC 08090 FASULA, FRANK J JR WINNEBAGO COUNTY 09/15/04 BLACK & JONES 6 07WC 12454 JACKSON, LISA ROCKFORD HEALTH SYSTEM 09/24/06 GREG TUITE & ASSOC WIEDNER & MCAULIFFE LTD 07WC012455 -C 11WC029199 -C ST OF IL DEPT OF HEALTH CA 7 07WC 20204 SCHUETZ, DENNIS SCHINDLER ELEVATOR CORP 04/03/07 GESMER LAW OFFICES, PC MC ANDREWS & NORGLE LLC 8 07WC 44057 EICKHORST, SALLY ST OF IL DEPARTMENT OF @ 05/02/06 CACCIATORE, WILLIAM T ASSISTANT ATTORNEY GENERAL 9 07WC 55626 NOVAK, DAMIEN CHRYSLER LLC 09/25/07 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 10 08WC 16214 DAILING, ALISA ROCK RIVER WATER 02/12/08 GESMER LAW OFFICE WILLIAMS MCCARTHY LLP 11 08WC 51717 MURRAY, DANNA STREANWOOD BEHAVORAL HEAL 08/05/08 BLACK & JONES RIPES, NELSON, BAGGOT & 12 09WC 08213 19B DAHL, JAY D HIGHLAND CHEMICAL INC 10/23/08 GREG TUITE & ASSOC LAW OFFICE OF CAPUANI & SHIE 13 09WC 24507 GRACEFFA, ANTHONY COUNTY OF WINNEBAGO 07/21/08 GESMER LAW OFFICES, PC WILLIAMS MCCARTHY LLP 14 09WC 34511 RUSSEY, LEE CADBURY ADAMS USA LLC 05/27/09 HETHERINGTON KARPEL BOBBER WIEDNER & MCAULIFFE LTD 15 09WC 37829 DEWEY, DANIEL IL DEPT OF TRANSPORTATION @ 05/27/09 BLACK & JONES ASSISTANT ATTORNEY GENERAL 16 09WC 42260 TRY, NANCY M STATE OF ILLINOIS @ 08/28/09 GREG TUITE & ASSOC ASSISTANT ATTORNEY GENERAL

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 2 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 17 09WC 42809 ELDRIDGE, PATRICIA CITY OF ROCKFORD 08/20/09 FRANCINE B WHITE HEYL ROYSTER VOELKER & ALLEN 18 10WC 06374 MC NEELY, ANNETTE CHRSLER LLC 10/21/09 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 11WC042281 -C CHRYSLER LLC 11WC042282 -C 19 10WC 10404 REPPUHN, DANIEL CADBURY ADAMS 01/26/10 BLACK & JONES WIEDNER & MCAULIFFE LTD 20 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 21 10WC 20746 SWARTWOUT, JANE K BON-TON DISTRIBUTION, INC 07/18/08 GREG TUITE & ASSOC WIEDNER & MCAULIFFE LTD 10WC020747 -C TON-TON DISTRIBUTION, INC 12WC039077 -C BON TON DISTRIBUTION INC 22 10WC 22458 WENDLAND, KENNETH EXCELON SECURITY, LLC 03/15/10 PIGNATELLI & ASSOCIATES RUSIN & MACIOROWSKI LTD 23 10WC 25570 LOVE, LORETTA BERGSTROM, INC 03/31/10 GESMER LAW OFFICES, PC 24 10WC 33260 OLSEN, DANIEL ACELL TRANSPORATION 01/02/10 STRONG LAW OFFICE RUSIN & MACIOROWSKI LTD 25 10WC 39505 BROWN, MARLEAN WINNEBAGO COUNTY 06/28/10 DWORKIN AND MACIARIELLO WILLIAMS MCCARTHY LLP 26 10WC 48895 WILLIAMS, TAMMY OFS ST ANTHONY HOSPITAL 09/24/10 BLACK & JONES HINSHAW & CULBERTSON 27 11WC 03189 HERMANN, SCOTT CHRYSLER LLC 01/03/11 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 13WC005843 -C 28 11WC 13428 HANNERS, JAMES M HOLLAND MOTOR FREIGHT 02/08/11 FRANKS, GERKIN & MCKENNA P HENNESSY & ROACH PC 29 11WC 14485 WALSTON, ROBIN IL DEPT OF REHABILITATIVE @ 11/15/10 JAMES W GREEN, JR MATTHEW LICAVOLI 30 11WC 18514 JONES, GREGORY O NISSON FORKLIFT CORP 11/05/10 ALEXANDER, PETER LTD. WIEDNER & MCAULIFFE LTD 11WC018515 -C

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 3 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 31 11WC 19946 LANGERUD, MARY J FAIRHAVEN CHRISTIAN HOME 12/14/10 GREG TUITE & ASSOC PERRY GENTILE 32 11WC 21605 RAMOS, SYLVIA A FIFTH THIRD BANK 06/30/10 GREG TUITE & ASSOC WIEDNER & MCAULIFFE LTD 33 11WC 23849 JONES, MISTI KOLB LENA CHEESE CO 05/03/10 GREG TUITE & ASSOC RIPES NELSON BAGGOT KALOBRAT 12WC026761 -C KOLB-LENA CHEESE CO 12WC026762 -C 34 11WC 29328 GUERRERO, GREGORIO MIKRON INDUSTRIES, INC 10/15/09 GESMER LAW OFFICES, PC BRADY CONNOLLY & MASUDA PC 35 11WC 30749 WHIPPLE, CHERYL L RIVER BLUFF NURSING HOME 06/01/11 GREG TUITE & ASSOC WILLIAMS MCCARTHY LLP 36 11WC 45894 REPPUHN, DANIEL CADBURY ADAMS 11/20/11 BLACK, JIM LAW OFFICE WIEDNER & MCAULIFFE LTD 37 11WC 47641 BROWN, EDITH TESTORS CORP 08/01/11 BLACK & JONES 38 12WC 01307 LYNDE, CHARLES CITY OF LOVES PARK POLICE 08/15/08 HANNIGAN & BOTHA, LTD NYHAN BAMBRICK KINZIE & LOWR 39 12WC 01433 CRECY, CHARLES NED DICKEY & ASSOC 10/07/11 NASH LAW OFFICE PC STONE & JOHNSON CHARTERED 40 12WC 11779 ORTIZ, JOSEPH SYNCREON 02/16/12 KATZ FRIEDMAN EAGLE ET AL 14WC004881 -C 14WC004882 -C 14WC008163 -C 41 12WC 15998 MESSERSCHMIDT, DAYTON VILLA DI ROMA 12/08/11 BLACK & JONES ASSISTANT ATTORNEY GENERAL 42 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 43 12WC 19066 GUSTAFSON, DENNIS CHRYSLER CORP 01/25/12 BLACK & JONES WIEDNER & MCAULIFFE LTD 44 12WC 22815 GONZALEZ, FRANCISCO BEST PALLET COMPANY LLC 05/30/12 GESMER LAW OFFICES, PC GANAN & SHAPIRO 15WC017695 -C 15WC017696 -C 45 12WC 25244 WRIGHT, DAVE WILLIAMS BROTHERS 06/21/12 HORWITZ HORWITZ & ASSOC KNELL LAW LLC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 4 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 46 12WC 29970 WHIPPLE, CHERYL RIVER BLUFF NURSING HOME 05/30/12 GREG TUITE & ASSOC 47 12WC 30969 FLORES, ABDIEL KELLYS MARKET COMPANY 09/02/12 SALVATO & O'TOOLE EDWARD JANUSZKIEWICZ 48 12WC 31246 LOCKWOOD, RICHARD CINETIC LANDS CORP 06/04/12 BLACK & JONES RUSIN & MACIOROWSKI LTD 49 12WC 32023 BRYANT, ROBERTA GENERAL MILLS 03/30/12 BLACK & JONES COZZI & GOGGIN-WARD 14WC005609 -C 50 12WC 33843 FALZONE, JOHN A DOUG'S PLOWING & GROUNDS W 06/22/12 ALEXANDER, PETER LTD. 51 12WC 34272 LEWIS, MARK CHRYSLER LLC 09/14/12 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 52 12WC 35276 OLSON, DONNA IVENSYS APPLIANCE CONTROL 09/06/12 PIGNATELLI & ASSOCIATES GILDEA & COGHLAN 53 12WC 35443 SPRAY, MICHAEL LOWE'S DISTRIBUTION CENTE 04/18/12 CAPRON & AVGERINOS PC INMAN & FITZGIBBONS 14WC018064 -C 54 12WC 36657 FLORES, JOSE M PALTECH 02/17/12 CULLEN HASKINS NICHOLSON RUSIN & MACIOROWSKI LTD 55 12WC 37527 HUEY, TERESA ST OF IL DEPT OF SINGER 10/03/11 BLACK & JONES ASSISTANT ATTORNEY GENERAL 13WC004313 -C SINGER STATE OF IL 13WC030281 -C 56 12WC 38289 MERCADO, MARTIN ASSOCIATED GENERAL W 06/12/12 DWORKIN AND MACIARIELLO ASSISTANT ATTORNEY GENERAL 57 12WC 41191 DAHLE, STACY CHRYSLER CORP 08/14/12 BLACK & JONES WIEDNER & MCAULIFFE LTD 58 12WC 44534 JEFFERSON, TASHA R INTERNATIONAL AUTOMOTIVE 10/09/12 ANESI OZMON RODIN NOVAK KO GANAN & SHAPIRO 59 13WC 03675 NEWMAN, MICHAEL CARLSON HEATING, COOLING 06/19/12 GALLAGHER, DONALD V 60 13WC 03843 LOZDOSKI, STEVEN T WOODWARD GOVERNOR COMPANY 12/10/12 GREG TUITE & ASSOC HINSHAW & CULBERTSON 15WC001087 -C 61 13WC 04020 DELAROSA, TAMMY T CHRYSLER, LLC 07/24/12 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 62 13WC 06947 MAFFEI, CARMELLA SWEDISH AMERICAN HOSPITAL 11/01/10 BLACK & JONES WILLIAMS MCCARTHY LLP

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 5 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 63 13WC 09077 BOTIC, FATA PBC LINEAR 01/12/13 BLACK & JONES HOLECEK & ASSOCIATES 64 13WC 10372 RUX, FRED STANDARD FORWARDING 04/20/11 BLACK & JONES POWER & CRONIN LTD 65 13WC 11768 GASTON, ARETHA CHRYSLER GROUP LLC 01/12/13 BLACK & JONES WIEDNER & MCAULIFFE LTD 14WC018763 -C 15WC018318 -C FCA US, LLC 15WC018319 -C 15WC018320 -C FCA US, LLC 15WC034559 -C 15WC034560 -C FCA US, LLC 16WC016893 -C 16WC019034 -C FCA US LLC 66 13WC 11898 RIVERA, OFELIA JOB NETWORK 01/28/13 GESMER LAW OFFICES, PC ADELSON TESTAN & BRUNDO 67 13WC 12998 LEHMAN, BRENDA J SWEDISH AMERICAN HOSP ASS 02/04/11 GREG TUITE & ASSOC WILLIAMS MCCARTHY LLP 68 13WC 13034 REUSCH, WALTER CHRYSLER LLC 02/07/13 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 69 13WC 14557 ESTEVEZ, NICHOLAS ROGERS BROTHERS INC 10/01/11 CULLEN HASKINS NICHOLSON HOLECEK & ASSOCIATES 70 13WC 17026 WESLEY, JAMES E MONDELEZ INTERNATIONAL 04/08/13 BLACK & JONES WIEDNER & MCAULIFFE LTD 13WC017027 -C WELSEY, JAMES E 71 13WC 17263 RILEY, ALBERT LEE SR UTC AEROSPACE SYSTEMS 08/27/12 KATZ FRIEDMAN EAGLE ET AL MACIOROWSKI SACKMANN & ULRIC 72 13WC 17588 DIAZ, IMILDA G DANAHER MOTION 12/04/07 BLACK & JONES GILDEA & COGHLAN 73 13WC 19767 LOPEZ, BERTHA R & H LAUNDROMAT & DRY 05/13/13 GREG TUITE & ASSOC RUSIN & MACIOROWSKI LTD 74 13WC 19984 CARTON, ANTHONY M STOCKTON CHEESE INC 02/19/13 HAUSER LAW LLC WIEDNER & MCAULIFFE LTD 13WC029877 -C 75 13WC 24982 CRUM, LEE TAYLOR COMPANY 06/14/13 BLACK & JONES MACIOROWSKI SACKMANN & ULRIC 76 13WC 27638 LE, DUNG SEROLA BIOMECHANICS 05/14/13 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 77 13WC 27772 OLSON, KATHLEEN VALSPAR 06/05/13 BLACK & JONES RUSIN & MACIOROWSKI LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 6 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 78 13WC 30758 MORALES, ALICIA ROCKFORD PROCESS CONTROL 05/29/13 BOTTO GILBERT GEHRIS NYHAN BAMBRICK KINZIE & LOWR 79 13WC 32221 CARLSON, VICKI MINARIKS DRIVES 05/10/13 GESMER LAW OFFICES, PC LAW OFFICES JOSEPH MARCINIAK 80 13WC 32896 MARTIN, MARY ANN MENARDS 08/01/13 BLACK & JONES RODDY LAW LTD 81 13WC 33515 WARD, MICHAEL CHRYSLER LLC 12/22/12 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 82 13WC 34775 EFFLER, JAMIE HORIZON DISTRIBUTION 04/03/12 GOLDBERG WEISMAN & CAIRO L RUSIN & MACIOROWSKI LTD 83 13WC 35730 JORDAN, LISA MONDELEZ INTERNATIONAL 08/23/13 BLACK & JONES WIEDNER & MCAULIFFE LTD 84 13WC 36261 BIGHAM, CRYSTAL WARNER LINEAR 10/11/13 CACCIATORE, WILLIAM T WOLFE & JACOBSON, LTD 85 13WC 36330 WHITNEY, RICHARD PREMIER CDL TRAINING SERV W 03/26/13 BLACK & JONES 86 13WC 36816 BRASHER, DANA STREAMWOOD BEHAVIORAL HEA 08/05/08 BLACK & JONES RIPES NELSON BAGGOT KALOBRAT 87 13WC 37908 PENNING, LYNETTE ADDUS HEALTHCARE 10/30/13 VELLA & LUND, PC HENNESSY & ROACH PC 88 13WC 38301 O'MALLEY, JULIE PILOT TRAVEL CENTERS, LLC 09/09/13 GESMER LAW OFFICES, PC BRADY CONNOLLY & MASUDA PC 89 13WC 40291 SMITH, RAYMOND GENERAL MILLS 06/05/13 JAMES J. GAY PAUL A COGHLAN & ASSOC 90 13WC 40561 TORRES PINEDO, JORGE TRINITY LABOR SERVICE W 05/07/12 BLACK & JONES 91 13WC 40564 CARLON, JOHN SR MASTER DISTRIBUTORS 11/18/13 BLACK & JONES HOLECEK & ASSOCIATES 92 13WC 41394 MAHAVONG, KIMBERLY SYNCREON NORTH AMERICA IN 10/28/13 GREG TUITE & ASSOC HOLECEK & ASSOCIATES 93 13WC 41854 LEWIS, MARK CHRYSLER LLC 11/18/13 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 94 14WC 00471 GOODSON, TRUMAN IMPERIAL PUNCH 07/12/13 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 95 14WC 01764 JOHNSON, FRED CHRYSLER LLC 01/11/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 7 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 96 14WC 02882 OROS, MICHAEL VITRAN EXPRESS NKA CENTRA 11/14/13 GOLDBERG WEISMAN & CAIRO L COZZI & GOGGIN-WARD 97 14WC 03781 HUNTER, ALBERT G LOWE'S HOME CENTERS, INC 07/08/13 GREG TUITE & ASSOC KEEFE CAMPBELL & ASSOC LLC 98 14WC 04483 MILLIGAN, ROBIN DKA DUNAW PACCAR PARTS DIVISION 05/25/12 BLACK & JONES BRADY CONNOLLY & MASUDA PC 14WC004484 -C 99 14WC 04878 FALZONE, JEREMY CAMRYN INDUSTRIES 11/25/13 KATZ FRIEDMAN EAGLE ET AL HENNESSY & ROACH PC 100 14WC 06540 KMIECIK, LORI UNIVERSITY OF ILLINOIS 12/24/13 LAW OFFICE OF KEVIN O'BRIE NYHAN BAMBRICK KINZIE & LOWR 101 14WC 06757 STINSON, BRANDFORD A & B FREIGHT LINE, INC 07/31/13 DWORKIN AND MACIARIELLO RIPES NELSON BAGGOT KALOBRAT 102 14WC 07064 MORGA, TAMMY BON-TON DISTRIBUTION CENT 12/11/13 GREG TUITE & ASSOC WIEDNER & MCAULIFFE LTD 103 14WC 08683 WILLIAMS, MELLYORA CHRYSLER LLC 12/03/12 KATZ FRIEDMAN EAGLE ET AL 104 14WC 08776 FERONE, MARCY CHRYSLER LLC 08/29/12 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 105 14WC 10844 WHITMORE, JOANNA M BYRON SCHOOL DISTRIC #226 01/30/14 OWENS & LAUGHLIN LLC NYHAN BAMBRICK KINZIE & LOWR 106 14WC 11861 RILEY, ALBERT LEE SR UTC AEROSPACE SYSTEMS 01/20/14 KATZ FRIEDMAN EAGLE ET AL MACIOROWSKI SACKMANN & ULRIC 107 14WC 12107 WEBB, FELICIA L BELLTOWER RETIREMENT HOME 09/26/12 THOMAS R LICHTEN GAROFALO SCHREIBER STORM 108 14WC 12714 COX, JOSEPH F PACIFIC BEARING CO 05/14/13 GREG TUITE & ASSOC HOLECEK & ASSOCIATES 109 14WC 13822 SCHMITT, AUSTIN M BOONE COUNTY SHERIFF'S DE 12/27/13 FOHRMAN, DONALD W & ASSOCS ELMAN & EHARDT LTD 14WC013823 -C 15WC021492 -C 17WC015246 -C

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 8 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 110 14WC 14724 MORRISEY, WILLIAM R. JOSEPH A. MORRISEY & ASSO 03/14/14 GESMER LAW OFFICES, PC GANAN & SHAPIRO 111 14WC 15316 ANDERSON, JAMES R G & D INTEGRATED 12/02/13 ANESI OZMON RODIN NOVAK KO HEYL ROYSTER VOELKER & ALLEN 14WC027469 -C 112 14WC 16247 HELTON, VERGIL D ESTWING MANUFACTURING CO 12/06/13 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 113 14WC 16762 WILSON, KENNETH R CHRYSLER LLC 10/01/12 KATZ FRIEDMAN EAGLE ET AL 114 14WC 16856 O'BRIEN, DAVID COM ED 07/28/95 BLACK & JONES RUSIN & MACIOROWSKI LTD 115 14WC 16969 RICHARDSON, MARIA BERGSTROM INC 04/21/14 BLACK & JONES WOLFE & JACOBSON, LTD 116 14WC 17050 HRUSKA, TRAVIS L KEENE TECHNOLOGY INC 11/01/13 GREG TUITE & ASSOC WIEDNER & MCAULIFFE LTD 117 14WC 17377 RALSTON, GAVIN E CHRYSLER LLC 03/20/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 118 14WC 17669 PLOWMAN, MARK D. O'MARA MOVING & STORAGE, 05/30/12 JAMES M KELLY 119 14WC 18862 MARTIN, RONNIE R THE BON TON STORES INC 03/04/14 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 120 14WC 19341 LAWVER, TERRENCE CHRYSLER LLC 04/24/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 121 14WC 19530 ROBINSON, JOYCE HONEYWELL 01/11/12 FRANCINE B WHITE RODDY LAW LTD 14WC019540 -C 14WC019723 -C 122 14WC 19734 NGUYEN, HA HAMILTON SUNDSTRAND 08/01/13 BLACK & JONES MACIOROWSKI SACKMANN & ULRIC 123 14WC 19740 BATES, DOROTHY LOWES DISTRIBUTION 02/22/14 BLACK & JONES KEEFE CAMPBELL & ASSOC LLC 14WC040320 -C 124 14WC 20120 THORNTON, DEBORAH CHRYSLER CORP 03/21/12 BLACK & JONES WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 9 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 125 14WC 20253 MCDONALD, AARON OLD DOMINION FREIGHT LINE 12/24/13 BLACK & JONES RUSIN & MACIOROWSKI LTD 126 14WC 20463 MISKIN, DRAGAN BIG FOOT LOUNGE 01/10/14 SEIDMAN MARGULIS & FAIRMAN WOLFE & JACOBSON, LTD 14WC022800 -C 127 14WC 20754 CARLSON, ANGELA CHRYSLER LLC 10/15/13 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 128 14WC 21227 19B BULLARD, MICHAEL BONNEL HEATING 12/18/13 BLACK & JONES GANAN & SHAPIRO 129 14WC 21577 PICHE, KAYCEE PACKAGING COORDINATORS IN 06/10/14 GREG TUITE & ASSOC HEYL ROYSTER VOELKER & ALLEN 14WC021578 -C 14WC021579 -C 130 14WC 21924 HAHN, NICOLE GENERAL MILLS INC 03/03/14 BLACK & JONES PAUL A COGHLAN & ASSOC 131 14WC 22069 SELOVER, MARTIN GKN ROCKFORD INC 08/09/11 KATZ FRIEDMAN EAGLE ET AL RIPES NELSON BAGGOT KALOBRAT 132 14WC 22447 PONCE-TORRES, MARGARITO CHRYSLER LLC 06/11/14 KATZ FRIEDMAN EAGLE ET AL 133 14WC 22540 CADWELL, JOHN E UNIVERSITY OF ILLINOIS 02/28/14 GREG TUITE & ASSOC HEYL ROYSTER VOELKER & ALLEN 134 14WC 22840 SPAIN, BRIANNA N ANDROID INDUSTRIES 02/28/14 BLACK & JONES WIEDNER & MCAULIFFE LTD 135 14WC 23317 HAMOR, KATHY STOP-N-GO 09/13/13 BLACK & JONES GANAN & SHAPIRO 136 14WC 24865 BRANCECUM, LUGENIA CHRYSLER LLC 07/05/14 KATZ FRIEDMAN EAGLE ET AL 137 14WC 25421 ROSS, JAMIE CHRYSLER CORP 07/01/13 BLACK & JONES WIEDNER & MCAULIFFE LTD 14WC025422 -C 15WC018315 -C 138 14WC 25554 MORRIS, THERESA (WIDOW PETRO TECH HAULING INC # 03/20/06 NASH LAW OFFICE PC RODDY LAW LTD 139 14WC 25969 ESTEVEZ, NICHOLAS ROGERS BROTHERS, INC 06/05/14 CULLEN HASKINS NICHOLSON HOLECEK & ASSOCIATES 140 14WC 26315 WOODSMALL, TABATHA HEIT HEALTHCARE CENTER 05/21/13 BLACK & JONES RUSIN & MACIOROWSKI LTD 141 14WC 26708 MENDOZA, JOSE METALS USA 01/22/14 BOTTO GILBERT GEHRIS

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 10 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 142 14WC 27083 LOY, DOUG FLEET LIFT TRUCK SERVICE 01/02/14 CLARK FROST RUSIN & MACIOROWSKI LTD 143 14WC 27193 WESLEY, FELICIA DANFOSS DRIVERS 05/03/14 BLACK & JONES HENNESSY & ROACH PC 144 14WC 27756 DAVIS, SHATIQUA ACCURIDE 04/04/14 GESMER LAW OFFICES, PC RUSIN & MACIOROWSKI LTD 145 14WC 27963 BURK, PAUL CHRYSLER LLC 05/07/14 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 146 14WC 28129 HAWKINS, SHIRLEY A WINNEBAGO COUNTY RIVER BL 07/12/14 GREG TUITE & ASSOC WILLIAMS MCCARTHY LLP 147 14WC 28371 REWERTS, CHAD BEST BUY 10/07/12 GESMER LAW OFFICES, PC INMAN & FITZGIBBONS 14WC028372 -C 148 14WC 29122 MISKIN, DRAGAN BIG FOOT LOUNGE 01/10/14 SEIDMAN MARGULIS & FAIRMAN WOLFE & JACOBSON, LTD 149 14WC 29364 STAHL, DALE GATEHOUSE MEDIA 07/15/14 THOMAS L NASH PC WIEDNER & MCAULIFFE LTD 14WC042607 -C GATE HOUSE MEDIA D/B/A 150 14WC 29386 ROSER, DEE SENIOR RESOURCE CENTER 02/07/13 BLACK & JONES RUSIN & MACIOROWSKI LTD 151 14WC 29842 DUONG, DE GLEASON CUTTING TOOLS 07/29/14 WOODRUFF & JOHNSON 152 14WC 30092 SORG, LUKE D GUNITE CORPORATION 11/24/13 GREG TUITE & ASSOC RUSIN & MACIOROWSKI LTD 153 14WC 30496 TERRY, LINDA F DAVITA ROXBURY DIALYSIS C 07/05/14 DEPAOLO ZADEIKIS GORE WIEDNER & MCAULIFFE LTD 154 14WC 30668 MARTINEZ, JESUS M. CHRYSLER LLC 06/17/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 155 14WC 31299 PAGE, MICHAEL G WOODWARD, INC. 04/18/13 GREG TUITE & ASSOC HINSHAW & CULBERTSON 156 14WC 31824 CHAVEZ, B ANDY CHEM PROCESSING INC 07/14/14 BLACK & JONES PERRY GENTILE 157 14WC 32156 CLARK, TIMOTHY IV CHRYSLER LLC 03/05/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 15WC025967 -C 15WC025968 -C 158 14WC 33249 PRINNER, ROBIN UPS FREIGHT SERVICES 02/17/14 BLACK & JONES ASA LAW GROUP

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 11 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 159 14WC 33364 MILLIGAN AKA DUNAWAY, ROB PACCAR PARTS DIVISION 10/23/11 BLACK & JONES BRADY CONNOLLY & MASUDA PC 160 14WC 33689 YOUNG, SHAWNA MYLAN INSTITUTIONAL INC 06/20/14 SMOLER LAW OFFICE, PC GRANT & FANNING 14WC036458 -C 161 14WC 34212 IRVIN, KELLY BREAKERS SALOON & EATERY 06/25/12 BLACK & JONES 162 14WC 34320 HAYES, MELISSA OGLE COUNTY SHERIFF'S DEP 09/03/14 BLACK & JONES INMAN & FITZGIBBONS 163 14WC 34518 PUSATERI, GAIL A RIVER RIDGE SCHOOL DIST 2 12/10/13 REESE & REESE ROSARIO CIBELLA 164 14WC 35643 GOODALL, CHRISTOPHER L CHERRY VALLEY DRIVE 07/16/14 THOMAS W DUDA RUSIN & MACIOROWSKI LTD 165 14WC 35661 MONTAGANO, ROBERT SHARI MOTOR SERVICE 07/01/14 CULLEN HASKINS NICHOLSON LEWIS BRISBOIS BISGAARD 166 14WC 35750 OLSON, MICHAEL M DIZZY DOGG INDUSTRIES 04/10/14 BLACK & JONES RODDY LAW LTD 167 14WC 35790 DUONG, DE GLEASON CUTTING TOOLS 10/14/14 WOODRUFF & JOHNSON COZZI & GOGGIN-WARD 168 14WC 36589 JOHNSON, SHERRY BOY SCOUTS OF AMERICA 05/27/14 BLACK & JONES WILSON ELSER 169 14WC 36592 BUNTON, LLONA BLAIN'S FARM & FLEET 08/03/14 BLACK & JONES RIPES NELSON BAGGOT KALOBRAT 170 14WC 36624 TRUMM, KAREN CHRYSLER CORP 01/01/13 THOMAS L NASH PC WIEDNER & MCAULIFFE LTD 171 14WC 36815 RAMIREZ, FERNANDO TORRES CHIPOTLE MEXICAN GRILL 09/01/13 BARRICK SWITZER LONG ET AL HENNESSY & ROACH PC 172 14WC 37162 JOHNSON, GARRETT MOSCATO'S PIZZA 02/13/14 HEYL ROYSTER VOELKER & ALLEN 173 14WC 37539 RINGEL, MICHAEL M MID STATES CONCRETE INDUS 09/04/14 ANESI OZMON RODIN NOVAK KO GAROFALO SCHREIBER STORM 174 14WC 38880 WILLIAMS, MICHAEL J WILLOWLGEN ACADEMY 01/28/14 GREG TUITE & ASSOC HOLECEK & ASSOCIATES 175 14WC 39368 WEBB, TERRY GRUPO ANTOLIN 11/03/14 KATZ FRIEDMAN EAGLE ET AL HEYL ROYSTER VOELKER & ALLEN 176 14WC 39427 JORDON, PAMELA DELTA POWER 11/03/14 GESMER LAW OFFICES, PC 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 DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 177 14WC 39511 FLETCHER, JAMES WINNEBAGO COUNTY HWY DEPT 02/28/14 BLACK & JONES WILLIAMS MCCARTHY LLP 178 14WC 39613 HARDESTY, ADORACIAN WALMART 02/23/14 BLACK & JONES GANAN & SHAPIRO 179 14WC 40690 CUPLIN, STEVEN R CHRYSLER LLC 10/15/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE 180 14WC 40983 COUSINS, MATTHEW CHRYSLER CORP 11/12/14 COHN & COHN WILLIAMS MCCARTHY LLP 181 14WC 41331 ROSINSKI, ARTHUR F CHRYSLER GROUP LLC 08/14/14 GREG TUITE & ASSOC WIEDNER & MCAULIFFE LTD 182 14WC 42582 CHAPMAN, DARLA SWISS COLONY 08/22/14 183 14WC 42628 FIELDS, WADE E CASSENS TRANSPORT 10/09/14 FRANKS, GERKIN & MCKENNA P KNAPP, OHL & GREEN 14WC042629 -C 184 14WC 43138 CACCIATORE, JENNIFER L ILLINOIS DCFS @ 02/21/14 CACCIATORE, WILLIAM T ASSISTANT ATTORNEY GENERAL 15WC019992 -C STATE OF IL, DEPT OF 185 14WC 43169 PRICE, BOB CHRYSLER, LLC 07/28/12 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 15WC000729 -C 15WC000730 -C 186 14WC 43275 HAWKINS, ORTESSA CHRYSLER LLC 01/25/13 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 187 14WC 43334 MANUEL, NIEVES AEROTEK 11/17/14 JAMES ELLIS GUMBINER & ASS LITCHFIELD CAVO 188 15WC 00033 AL-BECHARY, KHALAF DOLLAR DEPOT W 10/29/14 BLACK & JONES 189 15WC 00485 JACKSON, TYUS ARENA FOOTBALL ONE LLC 06/08/13 GORDON LAW OFFICES LTD HOLECEK & ASSOCIATES 190 15WC 00689 POWELL, MARK LOU BACHRODT AUTO MALL 09/04/13 BLACK & JONES RUSIN & MACIOROWSKI LTD 191 15WC 00950 THOMAS, ERICK WILLIAM CHARLES CONSTRUCT 08/07/14 COMPTON LAW GROUP CLARK JUSTEN ZUCCHI

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 13 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 192 15WC 01093 SAVIC, NERMINA WESLEY WILLOWS CORP 11/13/14 GREG TUITE & ASSOC KEEFE CAMPBELL & ASSOC LLC 193 15WC 01526 KIDD, JOHNNY EVOQUA WATER TECHNOLOGIES 11/01/14 HORWITZ HORWITZ & ASSOC RUSIN & MACIOROWSKI LTD 15WC001529 -C 194 15WC 01882 TRUDO, SHANE A GENERAL MILLS INC D/B/A 07/31/13 GREG TUITE & ASSOC PAUL A COGHLAN & ASSOC 195 15WC 02388 PITT, JUAMUEL GKN ROCKFORD 03/31/14 BLACK & JONES RIPES NELSON BAGGOT KALOBRAT 196 15WC 02842 MAYES, COLEMAN STEPPING STONES OF ROCKFO 02/01/12 BRASSFIELD KRUEGER & RAMLO 197 15WC 03122 BREAN, SCOTT GUNITE 11/19/14 BLACK & JONES RUSIN & MACIOROWSKI LTD 198 15WC 03172 STURM, CINDY L NORTH BOONE COMMUNITY 01/23/13 GREG TUITE & ASSOC GAROFALO SCHREIBER STORM 199 15WC 03205 ENFINGER, DEBORAH GRUPO ANTOLIN 08/15/14 WOODRUFF & JOHNSON HEYL ROYSTER VOELKER & ALLEN 15WC003206 -C 200 15WC 03836 POMLEE, FRANKIE CHRYSLER LLC 08/03/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 201 15WC 05202 CENTENO, JUDITH ARAMARK 12/11/14 CACCIATORE, WILLIAM T WIEDNER & MCAULIFFE LTD 202 15WC 05507 ROWELL, ALBERT VILLAGE OF HANOVER 12/22/13 CAPRON & AVGERINOS PC NYHAN BAMBRICK KINZIE & LOWR 203 15WC 05598 ZERGA, CARYLANNE LOWES DISTRIBUTION 01/12/15 BLACK & JONES KEEFE CAMPBELL & ASSOC LLC 204 15WC 06070 ACREE, BRIANNA CHRYSLER CORP 02/12/14 TURNER & SACKETT LLC WILLIAMS MCCARTHY LLP 15WC027300 -C 205 15WC 06302 HALFMAN, DEBORAH KABLE NEWS CO 01/21/15 DWORKIN AND MACIARIELLO HENNESSY & ROACH PC 206 15WC 06380 KNIGHT, GAIL (ESTATE) UPS 02/06/15 GESMER LAW OFFICES, PC NYHAN BAMBRICK KINZIE & LOWR 207 15WC 06490 TURNER, MARK AMIB DELIVERY, INC. 11/25/14 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 208 15WC 07267 JENNINGS, MICHAEL ROEHL TRANSPORT 12/28/14 DAVID W MARTAY CACCHILLO LAW GROUP LLC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 14 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 209 15WC 07610 PARRA, SONIA IAC BELVIDERE CROSSLINK A 11/01/14 WOODRUFF & JOHNSON GANAN & SHAPIRO 210 15WC 07925 POHLMAN, STACY FIRST STUDENT 10/01/13 GESMER LAW OFFICES, PC BRADY CONNOLLY & MASUDA PC 211 15WC 08316 LEBER, JONATHAN F CARRIER COMMERCIAL 05/15/13 GREG TUITE & ASSOC MACIOROWSKI SACKMANN & ULRIC 212 15WC 09357 MAHAVONG, DAVID T SYNCREON NORTH AMERICA IN 02/10/15 GREG TUITE & ASSOC HOLECEK & ASSOCIATES 15WC036129 -C 213 15WC 09361 LUKE, CAROL STATE OF IL-DORS @ 02/17/15 BLACK & JONES ASSISTANT ATTORNEY GENERAL 214 15WC 09415 MCALLISTER, CINDY ELGIN MENTAL HEALTH CENTE 01/19/15 BLACK & JONES ASSISTANT ATTORNEY GENERAL 215 15WC 09940 HERBST, CINDY HAMILTON-SUNDSTRAND UTC 02/19/15 KATZ FRIEDMAN EAGLE ET AL MACIOROWSKI SACKMANN & ULRIC 216 15WC 10169 CHRISTIANSEN, WANDA J UNITED TECHNOLOGIES CORP 08/22/13 FRANCINE B WHITE MACIOROWSKI SACKMANN & ULRIC 217 15WC 10185 PADGETT, JOHN ADVANCE DISPOSAL # 10/24/13 MEYERS & FLOWERS INMAN & FITZGIBBONS 218 15WC 10704 HEARD, KELA ARACHNID 02/05/15 GESMER LAW OFFICES, PC LAW OFFICES JOSEPH MARCINIAK 219 15WC 10904 HOLLENBECK, BRIAN E RUSCO MANUFACTURING CO 03/13/15 GREG TUITE & ASSOC ROBERT L. SMITH 220 15WC 11005 JEVTIC, SVJETLANA ROCK RIVER HALTH CARE 10/28/14 BLACK & JONES KEEFE CAMPBELL & ASSOC LLC 221 15WC 11504 BEACH, BRANDON JOHNSON CONTROLS 08/28/14 GESMER LAW OFFICES, PC RUSIN & MACIOROWSKI LTD 222 15WC 11692 SHANKLIN, EMMANUEL CHRYSLER CORP 03/09/15 BLACK & JONES WILLIAMS MCCARTHY LLP 223 15WC 13833 MACIAS, ALFREDO STATELINE GRAIN AND FEED 11/04/13 BLACK & JONES EDWARD JANUSZKIEWICZ 224 15WC 14200 MARQUEZ, TONYA EMERY AIR INC 12/12/13 BLACK & JONES COZZI & GOGGIN-WARD 225 15WC 14364 LONG, LYNN CULVERS 11/09/14 CLARK FROST KOPKA, PINKUS & DOLIN, PC 226 15WC 14823 GEEN, COLETTE T ROCKFORD BOARD OF EDUCATI 03/05/14 GREG TUITE & ASSOC WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 15 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 227 15WC 15667 KINSEY, RUSSELL CONAGRA FOODS INC 07/30/14 228 15WC 15736 DAVIS, TIMOTHY AMERICOLD LOGISTICS 04/13/15 GESMER LAW OFFICES, PC HENNESSY & ROACH PC 229 15WC 15789 CRABB, DEBORHA L HELP AT HOME 01/23/15 KATZ FRIEDMAN EAGLE ET AL COZZI & GOGGIN-WARD 230 15WC 16107 PONCE-TORRES, MARGARITO CHRYSLER LLC 09/15/12 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 231 15WC 16476 SKELTON, RANDY M JR DAGNON BUILDING & ROOFING 12/03/14 BARRICK SWITZER LONG ET AL 232 15WC 16941 UDELHOFEN, COURTNEY L IAC BELVIDERE, LLC 02/24/14 GESMER LAW OFFICES, PC GANAN & SHAPIRO 233 15WC 17164 KEMP, DUSTIN WES-PAC INC 05/09/12 BLACK & JONES GANAN & SHAPIRO 234 15WC 17272 DE VLIEGER, LAURIE A ROCKFORD MASS TRANSIT DIS 05/06/15 GREG TUITE & ASSOC WILLIAMS MCCARTHY LLP 235 15WC 17504 SEVERSON, PAUL NORTHWEST PALLETT SUPPLY 12/10/14 BLACK & JONES HEYL ROYSTER VOELKER & ALLEN 236 15WC 17636 GILMORE, TOYA LATRICE CHRYSLER LLC 05/04/15 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 237 15WC 17720 CASCIO, JOSEPH A. CITY OF ROCKFORD, A MUNIC 07/03/14 GREG TUITE & ASSOC HEYL ROYSTER VOELKER & ALLEN 15WC018472 -C ROCKFORD, IL FIRE DEPT 15WC020501 -C 238 15WC 17951 KULJANIN, MILOMIR MEGA EXPRESS 11/20/13 BLACK & JONES SCOPELITIS GARVIN LIGHT 239 15WC 17952 ROBLES TRETO, NOEL JESSICA FARTH GARCIA D/B/ 03/12/15 BLACK & JONES 240 15WC 18198 NIMAN, AARON UNITED TECHNOLOGY CORPORA 02/20/14 WILLIAMS MCCARTHY LLP MACIOROWSKI SACKMANN & ULRIC 241 15WC 18273 JAMES, JIMMY A STERLING FARM & FLEET INC 05/03/14 GREG TUITE & ASSOC 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 DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 242 15WC 18445 KITE, NICK TITAN PERSONNEL GROUP 04/24/15 NASH LAW OFFICE PC 243 15WC 19177 TIDWELL, JOSEPH ROCKFORD MEMORIAL HOSPITA 05/21/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 15WC019178 -C 16WC007078 -C 16WC007079 -C 244 15WC 19436 WILLIAMS, DONNA INTERACTIVE HEALTH 03/12/15 DAVID W MARTAY WIEDNER & MCAULIFFE LTD 245 15WC 20212 NASBY, MARY FIRST STUDENT 03/16/15 GESMER LAW OFFICES, PC BRADY CONNOLLY & MASUDA PC 246 15WC 20523 CHANTHAPHONE, SONENALINH CITY OF ROCKFORD FIRE DEP 12/05/14 REESE & REESE HEYL ROYSTER VOELKER & ALLEN 15WC022058 -C 16WC009683 -C 247 15WC 20661 WESLEY, JAMES MONDELEZ INTL * 12/10/14 BLACK & JONES WIEDNER & MCAULIFFE LTD 248 15WC 20854 THOMPSON, LANDON FCA US LLC 07/26/14 BLACK & JONES WIEDNER & MCAULIFFE LTD 16WC005234 -C 249 15WC 20983 MEDINA, NORMA ANCHOR COUPLING 03/20/13 BLACK & JONES GOLDBERG SEGALLA LLC 250 15WC 21479 BUNCH, MICHELLE STATE OF IL DEPT OF CHILD @ 02/23/15 GESMER LAW OFFICES, PC ASSISTANT ATTORNEY GENERAL 251 15WC 22382 FOSTER, ZENA M UNITED TECHNOLOGIES CORP. 04/29/15 FRANCINE B WHITE MACIOROWSKI SACKMANN & ULRIC 252 15WC 22443 GALBO, JASON GILLS FREEPORT DISPOSAL 01/08/15 CULLEN HASKINS NICHOLSON NYHAN BAMBRICK KINZIE & LOWR 253 15WC 23194 SANDERS, SCOTT LIEBOVICH CUSTOM FABRICAT 09/03/14 GESMER LAW OFFICES, PC POULOS & DIBENEDETTO LAW 254 15WC 23228 WHITLOCK, DEWAYNE ROCK RIVER WATER 01/08/14 GESMER LAW OFFICES, PC WILLIAMS MCCARTHY LLP 255 15WC 23584 MC MAHON, LYNN DISCOVERY CENTER MUSEUM 08/09/12 BLACK & JONES BRADY CONNOLLY & MASUDA PC 256 15WC 24249 HADUCA-DIECKHOUS, PREDICA ROCKTON SCHOOL DISTRICT 1 05/07/14 SCHWEICKERT & GANASSIN LAW OFFICES JOSEPH MARCINIAK 257 15WC 24797 CENICEROS, MARIELA IHC HEALTH SOLUTIONS 06/01/15 BLACK & JONES GAROFALO SCHREIBER STORM

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 17 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 258 15WC 24830 ADKINS, KATHY ROCKFORD SCHOOL DISTRICT 03/16/13 KATZ FRIEDMAN EAGLE ET AL 259 15WC 25221 BILLINGSLEY, BARBRA CHRYSLET LLC 06/12/15 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 260 15WC 25289 SOMMERS, NATALIE J. HARLEM SCHOOL DIST. #122 02/13/15 FRANCINE B WHITE WIEDNER & MCAULIFFE LTD 261 15WC 25606 19B CROOK, RICHARD II CON-WAY FREIGHT 11/21/14 KROL BONGIORNO & GIVEN LTD RUSIN & MACIOROWSKI LTD 262 15WC 25757 DAVENPORT, SHANNON CHRYSLER 11/01/13 GESMER LAW OFFICES, PC WILLIAMS MCCARTHY LLP 263 15WC 26241 KOTESKI, SHERRI MOSAIC 07/13/15 GESMER LAW OFFICES, PC 264 15WC 26402 STEVENS, LAKRISHA IAC MANAGEMENT, LLC 12/17/14 MARKS INJURY LAW GANAN & SHAPIRO 265 15WC 26559 WESLEY, FELICIA DANFOSS DRIVES 05/03/14 BLACK & JONES 266 15WC 26695 STAAB, MICHAEL SYNCREON 12/23/14 KATZ FRIEDMAN EAGLE ET AL GAROFALO SCHREIBER STORM 17WC016515 -C 267 15WC 27216 KEHOE, ELAISOIN ALPHASTAFF/ SERVICOM, LLC 05/19/15 MARSZALEK AND MARSZALEK WIEDNER & MCAULIFFE LTD 268 15WC 27340 PITTAWAY, JASON SWEDISH AMERICAN HOSPITAL 11/15/12 GESMER LAW OFFICES, PC WILLIAMS MCCARTHY LLP 269 15WC 27458 ROBERTS, CRYSTAL PRESENCE COR MARIAE CENTE 06/02/15 BURNETT & CARON, LTD KEEFE CAMPBELL & ASSOC LLC 270 15WC 27556 ADAMS, BRYAN CHEMTOOLS INC 02/01/15 BLACK & JONES MACIOROWSKI SACKMANN & ULRIC 271 15WC 27809 REDNER, TERESA ANDROID BELVIDERE II 06/17/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 272 15WC 28563 MC GUIRE, CHARLES L. ROCKFORD BOARD OF EDUCATI 07/28/15 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 18 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 273 15WC 28980 SENTHAVYSOUK, PATTY TAYLOR CO 10/21/14 BLACK & JONES MACIOROWSKI SACKMANN & ULRIC 274 15WC 29384 LEMEK, MELANIE A. HARLEM SCHOOL DISTRICT 12 05/30/13 MARKS INJURY LAW POWER & CRONIN LTD 15WC029385 -C 275 15WC 29567 MARTINGILIO, KATHY OSF SAINT ANTHONY MEDICAL 05/24/15 BLACK & JONES HINSHAW & CULBERTSON 276 15WC 29803 RUSH, CHRISTINA M. EGGSCLUSIVE CAFE 08/08/15 GESMER LAW OFFICES, PC HEYL ROYSTER VOELKER & ALLEN 277 15WC 30114 ZAMMUTO, JENNY C. WINNEBAGO CNTY SHERIFF'S 07/14/15 REESE & REESE HINSHAW & CULBERTSON 278 15WC 30611 HUCKABEE, DEBRA K OTTAWA FARM & FLEET, INC. 08/06/15 GREG TUITE & ASSOC WOLFE & JACOBSON, LTD 279 15WC 30863 HAGEN, YEVETTE CHRYSLER LLC 08/07/15 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 280 15WC 31081 19B RAZIM, KAREN VISION FINANCIAL GROUP 02/19/15 CANDIANO LAW OFFICE PERRY GENTILE 281 15WC 31359 MCCARTHY, CHARLES RAMP MANAGEMENT 09/01/15 BLACK & JONES HOLECEK & ASSOCIATES 282 15WC 32133 NEEDHAM, KAREN E CHRISTOPHER & BANKS CORP. 12/15/14 FRANCINE B WHITE COZZI & GOGGIN-WARD 283 15WC 33132 MANDUJANO, ISABEL MCCLEARY INC. 07/30/15 BLACK & JONES WARMOUTH LAW PC 284 15WC 33180 CUCHIARA, LEONARD DENT WIZARDS 08/25/15 BLACK & JONES GRANT & FANNING 285 15WC 33423 WICKLER, AARON M&M CONCRETE 05/19/15 BLACK & JONES GANAN & SHAPIRO 15WC041067 -C 286 15WC 33735 PERRETT, LARRY USF HOLLAND INC 08/27/15 BLACK & JONES HENNESSY & ROACH PC 287 15WC 33863 NEVAREZ, XHAVIER OAKLEY SUB ASSEMBLY 05/26/15 MARTIN V KUGIA 288 15WC 34186 HOLLIMAN, ROSE M ANDROID INDUSTRIES 09/10/15 DWORKIN AND MACIARIELLO 289 15WC 34421 RIVERA, CARLOS JAMCO PRODUCTS INC 09/25/15 GESMER LAW OFFICES, PC HEYL ROYSTER VOELKER & ALLEN 290 15WC 34648 PETERSON, TERESA CHRYSLER LLC 01/06/15 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 19 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 291 15WC 34772 VERVINCK, SAMANTHA MCDONALDS 03/26/15 GESMER LAW OFFICES, PC 292 15WC 34800 GRAVES, JAQUELINE TDS AUTOMOTIVE 07/31/14 DWORKIN AND MACIARIELLO SMITH AMUNDSEN LLC 15WC034801 -C 293 15WC 35076 CRANDALL, RANDY P MRS PIKKEL INC 12/18/14 PIGNATELLI & ASSOCIATES 294 15WC 35108 MERKEL, ANGELA RIVER BLUFF NURSING HOME 09/12/15 BLACK & JONES WILLIAMS MCCARTHY LLP 295 15WC 35233 GALVAN, CECILIA SYNCREON 11/17/14 HOLECEK & ASSOCIATES 296 15WC 35347 HAYNES-CLAY, DONNA G CHRYSLER LLC 06/10/14 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 297 15WC 35418 WATT, CRAIG QUALITY METAL FINISHING 09/29/15 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 298 15WC 35538 SPARKS, KEVIN THE MEIGHAN GROUP W 10/16/13 BLACK & JONES 299 15WC 35746 KLOSOWSKI, KARL J HIGHLAND PARK CVS, LLC 08/13/15 GESMER LAW OFFICES, PC HINSHAW & CULBERTSON 300 15WC 35798 GARCIA, NANCY US PANELS 07/09/15 ALEXANDER, PETER LTD. HOLECEK & ASSOCIATES 301 15WC 35868 SCHMOLDT, CODEY A ALDI INC. 07/13/15 GREG TUITE & ASSOC MACIOROWSKI SACKMANN & ULRIC 302 15WC 36267 PERKINS, DEWAYNE PHELPS INDUSTRIES 10/08/15 MARKS INJURY LAW SLAVIN & SLAVIN 303 15WC 36548 WILCOX, MILTON WOODS EQUIPMENT CO 05/20/14 WOODRUFF & JOHNSON COZZI & GOGGIN-WARD 304 15WC 36592 LIEBER, STACY HEALTHPORT 08/28/15 BLACK & JONES THOMAS & PORTELA 305 15WC 37656 GARCIA, JOSE VENTRA BELVIDERE 07/23/15 GESMER LAW OFFICES, PC BRUCE WARREN 306 15WC 37793 PERSON, CRYSTAL CHRYSLER CORP 10/12/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 307 15WC 38095 SCOTT, ERIC TRADESMAN INTL 09/13/15 308 15WC 38281 RODRIGUEZ, REYNALDO CASEY'S GENERAL STORES, I 06/18/15 FRANCINE B WHITE 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 DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 309 15WC 38391 GILLE, ALYSSA CHRYSLER 09/25/15 CLARK FROST WILLIAMS MCCARTHY LLP 310 15WC 38422 THOMAS, JAMES EARL FAUST LANDMARK APARTMENTS 11/01/14 BLACK & JONES BRYCE DOWNEY & LENKOV LLC 311 15WC 38703 PENA, MADELINE ROSEWOOD CARE CENTER 03/15/15 GESMER LAW OFFICES, PC RUSIN & MACIOROWSKI LTD 312 15WC 38825 KINGAMBO, MARTHES DANFOSS DRIVES 08/20/15 GESMER LAW OFFICES, PC GAROFALO SCHREIBER STORM 313 15WC 39241 TERRY, LINDA DAVITA HEALTH INC. 07/05/14 BLACK & JONES WIEDNER & MCAULIFFE LTD 314 15WC 39327 SHELTON, JAMES C PEARL CITY ELEVATOR CO-OP 07/09/13 BLACK & JONES CAPUANI & SCHNEIDER 315 15WC 39510 GONZALES, CINDY L AVIATON AIR MANAGEMENT SY 09/25/15 GESMER LAW OFFICES, PC MACIOROWSKI SACKMANN & ULRIC 316 15WC 39677 TURNER, LORETTA A CAVE ENTERPRISE OPERATION 12/08/15 DWORKIN AND MACIARIELLO 317 15WC 39974 GARIBAY, MARTHA ANDROID INDUSTRIES 05/12/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 318 15WC 41074 FERONE, MARCY CHRYSLER LLC 04/16/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 319 15WC 41091 HILLIARD, GREGORY H WILLIAM CHARLES CONSTRUCT 06/11/15 CLARK FROST CLARK FROST 320 15WC 41094 CAMP, HAROLD SUNPRO 07/23/15 SAUNDERS CONDON & KENNY HEYL ROYSTER VOELKER & ALLEN 321 15WC 41584 TURNGREN, TIMOTHY CHRYSLER LLC 11/21/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 16WC000265 -C 322 15WC 41706 MICHALSEN, JULIE CITY OF ROCKFORD 12/01/14 GESMER LAW OFFICES, PC HEYL ROYSTER VOELKER & ALLEN 323 15WC 41709 JOHNSON, JONNY BARNES INTERNATIONAL 10/02/14 BLACK & JONES 324 15WC 42115 STONE, DANIEL SECURITAS 05/14/15 SCHREINER MALLOY & ETZLER STONE & JOHNSON CHARTERED 325 15WC 42185 KLECZKOWSKI, MARY DIOCESE OF ROCKFORD, IL 08/26/15 CACCIATORE, WILLIAM T KEEFE CAMPBELL & ASSOC LLC 326 15WC 42233 DITSWORTH, MICHELLE CHRYSLER LLC. 04/24/15 KATZ FRIEDMAN EAGLE ET AL 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 DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 327 15WC 42261 JACKSON, MARJORIE ROSEWOOD CARE CTR 05/28/15 328 15WC 42342 GALLAGHER, JOHN P. ADVANCE AUTO PARTS 05/20/15 GREG TUITE & ASSOC GOLDBERG SEGALLA LLC 329 15WC 42452 GUTIERREZ, JESUS NORTHWEST PALLET SUPPLY 12/16/15 DWORKIN AND MACIARIELLO HEYL ROYSTER VOELKER & ALLEN 330 15WC 42488 HANEY, BRADLEY WORLDWIDE FLIGHT SERVICES 06/15/15 BLACK & JONES KEEFE CAMPBELL & ASSOC LLC 331 15WC 42491 QUICK, ROBERT FLEET LIFT TRUCK SERVICE 05/26/15 BLACK & JONES BRADY CONNOLLY & MASUDA PC 332 16WC 00264 SPAIN, BRIANNA ANDROID INDUSTRIES 10/20/14 BLACK & JONES WIEDNER & MCAULIFFE LTD 333 16WC 00370 RUCKER, JEANNETTE GARDA 12/18/14 GESMER LAW OFFICES, PC KEEFE CAMPBELL & ASSOC LLC 334 16WC 00648 HARAS, JOHN RVP ENTERPRISES, LLC 11/18/15 FRANKS, GERKIN & MCKENNA P HOLECEK & ASSOCIATES 335 16WC 00768 GIVENS, STEVIE COMMONWEALTH EDISON 10/16/13 BLACK & JONES CHILTON YAMBERT PORTER LLP 336 16WC 00998 TITKO, SERGEY ALTEC INC 12/30/15 DEAN J CARAS & ASSOCIATES WIEDNER & MCAULIFFE LTD 337 16WC 01458 SEAS, SHARLEEN ILLINOIS STATE POLICE @ 04/27/15 RIDGE & DOWNES ASSISTANT ATTY GENERAL 338 16WC 01531 BARBER, SCOTT ROCK RIVER WATER 03/13/14 GESMER LAW OFFICES, PC WILLIAMS MCCARTHY LLP 339 16WC 02267 CANNEGIETER, JULIE PACKAGING COORDINATORS IN 08/15/14 NASH LAW OFFICE PC LAW OFFICES JOSEPH MARCINIAK 340 16WC 02523 RAMIREZ, MARY RALCORP HOLDINGS, INC AND 07/20/15 HETHERINGTON KARPEL BOBBER RUSIN & MACIOROWSKI LTD 341 16WC 02567 HARDWICK, ELLIOTT GET FRESH PRODUCE 01/21/16 COSTA IVONE LLC RODDY LAW LTD 342 16WC 03107 ERB, BRYAN K JOSEPH BEHR & SONS INC 06/19/15 COZZI & GOGGIN-WARD 343 16WC 03166 KRATCHNER, SCOTT UTC AEROSPACE SYSTEMS 09/02/15 KATZ FRIEDMAN EAGLE ET AL MACIOROWSKI SACKMANN & ULRIC 344 16WC 03496 MEJIA, EUJENIO AKA PRESTIGE MAINTENANCE USA 10/30/15 BLACK & JONES COZZI & GOGGIN-WARD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 22 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 345 16WC 03715 FRANTZ, KEITH ALDI FOODS 12/13/15 BLACK & JONES MACIOROWSKI SACKMANN & ULRIC 346 16WC 03718 GIVENS, CRAIG BAY VALLEY FOODS 08/15/14 BLACK & JONES KEEFE CAMPBELL & ASSOC LLC 347 16WC 03955 EARL, MICHAEL FCA US LLC 10/19/15 WOODRUFF & JOHNSON WIEDNER & MCAULIFFE LTD 348 16WC 04134 STRONG, JOHN METALS USA 11/14/15 BLACK & JONES POULOS & DIBENEDETTO LAW 349 16WC 04138 NIGHSWONGER, STEVEN TAYLOR COMPANY 05/15/15 BLACK & JONES MACIOROWSKI SACKMANN & ULRIC 350 16WC 04594 MARSHALL, AMANDA TIGER TAIL LOUNGE INC 11/06/15 NASH LAW OFFICE PC NYHAN BAMBRICK KINZIE & LOWR 351 16WC 04949 VIEL, PEGGY FCA US LLC 09/18/15 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 352 16WC 05206 CARTER, HENRY GE AVIATION SYSTEMS LLC 03/25/15 MARKS INJURY LAW MACIOROWSKI SACKMANN & ULRIC 353 16WC 05272 PEARSE, PATRICK TELETECH TECHNOLOGY SOLUT 01/02/15 GESMER LAW OFFICES, PC RUSIN & MACIOROWSKI LTD 354 16WC 05585 WEDEKIND, TROY FED EX 07/13/15 BLACK & JONES QUINTAIROS PRIETO WOOD & BOY 16WC005586 -C 16WC019032 -C 16WC027461 -C 355 16WC 05807 MESSINK, CYNTHIA KUMMER AMERICA CORP 01/19/16 GESMER LAW OFFICES, PC LAW OFFICES JOSEPH MARCINIAK 356 16WC 05888 TAYLOR, TED BLOUNT INTERNATIONAL, INC 02/19/15 GESMER LAW OFFICES, PC COZZI & GOGGIN-WARD 357 16WC 05939 MATHEWS, ROSEMARY R CITY OF ROCKFORD POLICE D 02/03/16 REESE & REESE HEYL ROYSTER VOELKER & ALLEN 16WC018893 -C 358 16WC 06089 GRAHAM, CHARLENE BCBS OF IL 03/27/15 BLACK & JONES LAW OFFICES STEPHEN CARTER 16WC025257 -C 359 16WC 06094 SHARKO, YAROSLAV NEW WINDOWS CO 10/14/15 MICHAEL CHABAN LAW OFFICE HOLECEK & ASSOCIATES 360 16WC 06213 FRANK, RICKY II CHRYSLER LLC 08/24/15 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 361 16WC 06717 GRIFFIN, THOMAS A TOMERMO INC 02/03/16 TUITE LAW ROSARIO CIBELLA

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 23 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 362 16WC 07098 GILMORE, TODD ROCKFORD MASS TRANSIT DIS 12/04/15 ALEXANDER, PETER LTD. RUSIN & MACIOROWSKI LTD 363 16WC 07104 LAWSON-ROSS, BECKY PACKAGING COORDINATORS IN 10/23/15 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 364 16WC 07179 PEYTON, CARA IAC BELVIDERE CROSSLINK A 10/14/15 WOODRUFF & JOHNSON GANAN & SHAPIRO 365 16WC 07256 ARAMBULA, LUIS A. VAUGHN'S HOME FURNISHINGS 10/17/15 GESMER LAW OFFICES, PC RODDY LAW LTD 366 16WC 07443 RILL, H YVONNE ROCKFORD SCHOOL DIST 205 09/08/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 367 16WC 07446 MANNING, GERALD FCA US LLC 09/08/14 WOODRUFF & JOHNSON WIEDNER & MCAULIFFE LTD 368 16WC 07472 MENESES, ALFONSO ALLYN MASONRY, INC 06/08/15 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 369 16WC 07911 JOHNSON-BARNES, JAIME FCA US LLC 01/29/15 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 370 16WC 08400 SCHEWE, BRUCE GLEASON CUTTING TOOLS, IN 02/05/16 DOUGLAS RALLO PC COZZI & GOGGIN-WARD 371 16WC 08570 ROHMAN, DENNIS M ILLINOIS DEPARTMENT OF LA @ 09/24/15 BRASSFIELD KRUEGER & RAMLO COLIN KICKLIGHTER 372 16WC 09338 SULLIVAN, DONALD P FCA US LLC 03/02/15 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 373 16WC 09513 OSTRANDER, SEAN GRUPO ANTOLIN 03/04/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 374 16WC 09540 SANCHEZ, DONNELL NVUS METALS, INC. 02/17/16 RICHARD O. GREENFIELD THOMAS & PORTELA 375 16WC 09577 MANDERA, ANNA FCA US LLC 02/20/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 376 16WC 09622 ALANIS, AIDA HEALTHCARE PLUS 12/30/15 BLACK & JONES HOLTKAMP LIESE ET AL 377 16WC 09625 LAWSON, KEITH IPSEN INC 02/29/16 BLACK & JONES GAROFALO SCHREIBER STORM 378 16WC 09875 WLODARCZYK, DAWID ILLINOIS STATE POLICE DIS 03/09/16 SANDMAN LEVY & PETRICH ASSISTANT ATTY GENERAL 379 16WC 09929 MARTENS, HEIDI A CITY OF ROCKFORD, A MUNIC 03/07/14 TUITE LAW HEYL ROYSTER VOELKER & ALLEN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 24 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 380 16WC 10149 HARRISON, SARAH ALDEN PARK STRATHMOOR 03/07/16 LEE, MARK N LAW OFFICE LAW OFFICES FRANCESCA LARSEN 381 16WC 10178 JANESKI, JERED KAYLABOB, INC 02/25/16 CLARK FROST 382 16WC 10759 RODRIGUEZ, RENE FCA US LLC 03/02/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 383 16WC 11221 NEBIU, LINDORA ROCKFORD MEMORIAL HOSPITA 10/02/14 FRANCINE B WHITE WIEDNER & MCAULIFFE LTD 384 16WC 11387 BERUMEN, TERESA ANDROID BELVIDERE LL 10/04/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 385 16WC 11397 THOMAS, AFTON RAUN TRANSPORTATION 03/30/16 BLACK & JONES JAMES M KELLY 386 16WC 11426 BARTELS, MICHAEL J DELONG CO., INC. 03/08/16 REESE & REESE COZZI & GOGGIN-WARD 387 16WC 11575 LOPEZ, LEONARDO MARBLE WORKS 01/27/16 REESE & REESE WOLFE & JACOBSON, LTD 388 16WC 11761 CHAVEZ, ANDREW CHEM PROCESSING 07/14/14 BLACK & JONES 389 16WC 11813 ROTHER, ANGELA M SYNCREON US AUTOMOTIVE 03/16/16 BARRICK SWITZER LONG ET AL WIEDNER & MCAULIFFE LTD 390 16WC 11953 MENDEZ, CASSIE F SWEDISH AMERICAN HOSPITAL 07/22/15 ANKIN LAW OFFICE WILLIAMS MCCARTHY LLP 391 16WC 12051 WINDER, ROBERT GRAFCOR PACKAGING INC 03/01/16 TUITE LAW LAW OFFICES JOSEPH MARCINIAK 392 16WC 12072 MC MULLIN, KATELYN FCA US LLC 02/15/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 393 16WC 12385 CUEVAS, LUIS ROCKFORD BOLT AND STEEL 12/13/12 BLACK & JONES LAW OFFICES FRANCESCA LARSEN 394 16WC 12524 BERMAN, DANIEL FURST STAFFING 02/29/16 BLACK & JONES PERRY GENTILE 395 16WC 12534 MANNING, GERALD FCA US LLC 06/03/15 WOODRUFF & JOHNSON WIEDNER & MCAULIFFE LTD 396 16WC 12876 ERNST, NICHOLAS A BLOUNT INTERNATIONAL 01/15/16 MERTES & MERTES PC 397 16WC 13032 KELLEMS, MELANIE SCHNUCKS 04/04/16 NASH LAW OFFICE PC LEMP & MURPHY

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 25 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 398 16WC 13292 SNOWDON, DEAN R ROCKTON SCHOOL DISTRICT 07/25/13 CONSIDINE LAW OFFICES 399 16WC 13544 HENDERSON, AMY ROCKFORD MEMORIAL HOSPITA 01/06/16 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 400 16WC 13571 TOBIN, BRIAN PREMIUM TRANSP. STAFFING 03/10/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 401 16WC 13578 ADAMS, KATHERINE CORNER TAP 12/19/15 BLACK & JONES HEYL ROYSTER VOELKER & ALLEN 402 16WC 13673 CASIMIR, JAMES ROCKFORD PRODUCTS LLC 11/18/15 BLACK & JONES GILDEA & COGHLAN 403 16WC 13837 VISENTIN, MARK ROCKFORD ICE HOGS 01/22/16 FLOYD LAW FIRM HENNESSY & ROACH PC 404 16WC 14019 AGUILAR, ARMANDO CCA MIDWEST INC 12/01/14 MEYERS & FLOWERS WIEDNER & MCAULIFFE LTD 405 16WC 14031 CAPUANO, ANTHONY MID-STATE CONCRETE INDUST 03/01/16 BLACK & JONES 406 16WC 14317 SHEPARD, TIMOTHY AIM DISTRIBUTION INC 04/08/16 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 407 16WC 14475 GRABLE, JASON W COM ED/EXELON WEST 04/25/16 REESE & REESE RUSIN & MACIOROWSKI LTD 408 16WC 14489 ODDO, STEVEN FCA US LLC 01/21/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 409 16WC 14651 BENJAMIN, JACOB EBERSPAECHER NORTH AMERIC 04/15/16 GOLDBERG WEISMAN & CAIRO L THOMAS & PORTELA 410 16WC 14696 LOFT, JOHN STATE OF ILLINOIS @ 10/06/14 VANDERGINST LAW PC ASSISTANT ATTY GENERAL 411 16WC 15424 GREEN, PAULA STATE OF IL DORS 04/18/16 BLACK & JONES ASSISTANT ATTY GENERAL 412 16WC 15720 BALDAWI, AHMED AL VALSPAR CORP. 03/20/15 GOLDSTEIN BENDER & ROMANOF RUSIN & MACIOROWSKI LTD 16WC015721 -C 16WC015722 -C 413 16WC 16129 MCWILLIAMS, WILLIAM T. ROCKFORD MASS TRANSIT DIS 04/06/16 LEE, MARK N LAW OFFICE 414 16WC 16150 KOON, LAURAJ. FREEPORT HEALTH NETWORK 08/14/14 TUITE LAW GAROFALO SCHREIBER STORM 415 16WC 16224 GARDNER, RICHARD D JR FAMILY DOLLAR INC 12/31/15 TUITE LAW WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 26 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 416 16WC 16427 COLLETTI, MARIA ROCKFORD PARK DISTRICT 04/23/16 DWORKIN AND MACIARIELLO RUSIN & MACIOROWSKI LTD 417 16WC 16622 JOHNSON, MEGAN F. DEAN FOODS DBA ICE CREAM 05/21/15 TUITE LAW BRADY CONNOLLY & MASUDA PC 418 16WC 16778 MERCER, TOMMY GCA SERVICES GROUP 08/12/14 GESMER LAW OFFICES, PC POWER & CRONIN LTD 419 16WC 16830 CROPPER, ROBERT FISCHER EXCAVATING INC 03/27/11 GESMER LAW OFFICES, PC 420 16WC 16891 BROWN, CARLOS TREEHOUSE FOODS 01/13/16 BLACK & JONES RUSIN & MACIOROWSKI LTD 421 16WC 17006 EASON, KIESIA CHRYSLER CORP ASSEMBLY PL 10/20/15 LANNON LANNON & BARR LTD WIEDNER & MCAULIFFE LTD 422 16WC 17332 MARTINEZ, FERNANDO FIAT CHRYSLER AUTOMOTIVE 04/06/16 MARTIN L GLINK LAW OFFICE WIEDNER & MCAULIFFE LTD 423 16WC 17398 BYL, ROSE PECATONIA SCHOOL DISTRICT 03/07/16 BLACK & JONES RODDY LAW LTD 424 16WC 17569 DAVIS, OKIE SWEDISH AMERICAN 07/02/15 NEWLAND & NEWLAND WILLIAMS MCCARTHY LLP 425 16WC 17712 TUCKER, BILLY TAYLOR COMPANY 05/25/16 DWORKIN AND MACIARIELLO MACIOROWSKI SACKMANN & ULRIC 426 16WC 17946 MENDOZA, JOSE METALS USA 02/17/16 BOTTO GILBERT 427 16WC 18282 ADAMS, SHAWN FCA US LLC 05/26/16 WOODRUFF & JOHNSON WIEDNER & MCAULIFFE LTD 428 16WC 18888 GREEN, KARIN ROCKFORD BOARD OF EDUCATI 06/29/15 FRANCINE B WHITE WIEDNER & MCAULIFFE LTD 429 16WC 19022 PFAFF, TERESA WALMART 07/01/15 BLACK & JONES QUINTAIROS PRIETO WOOD & BOY 430 16WC 19030 JONES, RICHARD SYNCREON NORTH AMERICA 03/31/16 BLACK & JONES HOLECEK & ASSOCIATES 431 16WC 19349 JIMENEZ, FELIPE GUERRILLA GRAFFIX 10/10/15 GESMER LAW OFFICES, PC RIPES NELSON BAGGOT KALOBRAT 432 16WC 19462 KRISCHKE, DANNIELLE PEAK FITNESS 02/22/16 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 433 16WC 19663 HUGHES, RUBY SNACK KING 07/23/13 DWORKIN AND MACIARIELLO HOLECEK & ASSOCIATES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 27 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 434 16WC 19818 KELLY, MERCEDEZ ALDEN PARK STRATHMOOR 01/21/16 LEE, MARK N LAW OFFICE 435 16WC 20000 SORENSEN, STEVEN J F & F TIRE WORLD INC 02/09/16 FRANCINE B WHITE GAROFALO SCHREIBER STORM 436 16WC 20022 PLOMOS, CATHERINE CORCORAN, DAVID DR. 01/10/15 BLACK & JONES 437 16WC 20161 SOLIZ, BARBARA ANDROID INDUSTRIES 09/15/15 WOODRUFF & JOHNSON 438 16WC 20233 EARLY, SHAWN C. WASTE CONNECTIONS, INC. 05/09/16 TUITE LAW 439 16WC 20440 WYNER, ERIC J LOU BACHRODT CHEVROLET 07/17/15 RICHARD E ALEKSY 440 16WC 20453 GENANDT, SUSAN CORNERSTONE CREDIT UNION 02/16/16 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 441 16WC 20459 DENHAM, MARK RICHARD HAAN PROPERTY REN 04/01/15 BLACK & JONES HEYL ROYSTER VOELKER & ALLEN 442 16WC 20465 WIGTON, NANCY WINNEBAGO COUNTY HEALTH D 06/20/16 BLACK & JONES WILLIAMS MCCARTHY LLP 443 16WC 20559 FRESCAS, ALEJANDRO ANDROID INDUSTRIES 11/26/15 KATZ FRIEDMAN EAGLE ET AL SMITH AMUNDSEN LLC 444 16WC 20636 PRESLEY, COURTNEY CITY OF ROCKFORD POLICE D 03/31/15 NASH LAW OFFICE PC HEYL ROYSTER VOELKER & ALLEN 445 16WC 20644 MCCLELLAN, TONJA CLINE TOOL & SERVICE COMP 03/03/16 CLARK FROST 446 16WC 20884 GRIFFIN, EDWYNNE M ARAMARK UNIFORM & 02/26/16 TUITE LAW WIEDNER & MCAULIFFE LTD 447 16WC 21096 HORTON, DANIELLE ANDROID INDUSTRIES 06/08/16 GOLDBERG WEISMAN & CAIRO L 448 16WC 21176 JIMENEZ, LUIS R FIAT CHRYSLER AUTOMOBILES 06/28/14 JACOBSON & SCHIEFELBEIN WIEDNER & MCAULIFFE LTD 449 16WC 21291 RIVERS, FERNANDEZ BEHR IRON & METAL 05/28/16 BLACK & JONES COZZI & GOGGIN-WARD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 28 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 450 16WC 21418 MUSSER, ASHLEY WAVERLY PLACE OF STOCKTON 10/09/15 DWORKIN AND MACIARIELLO BRADY CONNOLLY & MASUDA PC 451 16WC 21513 LARSON, ROBBY SYCREON 04/25/16 GESMER LAW OFFICES, PC GAROFALO SCHREIBER STORM 16WC023091 -C SYNCREON 452 16WC 21539 PARHAM, STUDGE GRUPO ANTOLIN 06/16/16 KATZ FRIEDMAN EAGLE ET AL 453 16WC 21829 PIPPEL, KERRY TRI-DIM FILTER CORP 08/04/15 BLACK & JONES INMAN & FITZGIBBONS 454 16WC 21843 BOLAR, TERRY BIMBO BAKERIES USA INC 10/08/15 FRANCINE B WHITE 455 16WC 22037 GAMBINI, RICHARD A. JR. CITY OF ROCKFORD POLICE D 05/26/16 REESE & REESE HEYL ROYSTER VOELKER & ALLEN 456 16WC 22243 FOAT, KATASHA APAC 10/04/15 CHASE & WERNER LTD HENNESSY & ROACH PC 457 16WC 22258 HAYES, JESSICA DAVENJO INC. DBA BURGER K 06/25/16 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 458 16WC 22323 ANTONSON, MICHAEL MJ ELECTRIC 06/06/16 BAUM RUFFOLO & MARZAL LTD RUSIN & MACIOROWSKI LTD 459 16WC 22452 GONZALEZ, MARIA ARAMARK UNIFORM SERVICES 04/08/16 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 460 16WC 22519 RENTON, MICHAEL ROCKFORD MASS TRANSIT DIS 03/04/16 LEE, MARK N LAW OFFICE KEEFE & DEPAULI 461 16WC 22546 CARTWRIGHT, JOHNATHAN UTC AEROSPACE SYSTEMS 06/02/16 KATZ FRIEDMAN EAGLE ET AL MACIOROWSKI SACKMANN & ULRIC 462 16WC 22567 BROWN, TONYA MENARDS 10/05/15 BLACK & JONES CHILTON YAMBERT PORTER LLP 463 16WC 22586 CURRY, JEANETTE FCA US LLC 03/15/16 WOODRUFF & JOHNSON WIEDNER & MCAULIFFE LTD 16WC024082 -C 464 16WC 22589 KUZIORA, TOMASZ FCA US LLC 04/11/16 WOODRUFF & JOHNSON WIEDNER & MCAULIFFE LTD 465 16WC 22593 SINGLETON, CHERYL L ANDROID INDUSTRIES 07/09/16 KATZ FRIEDMAN EAGLE ET AL 466 16WC 22999 BARBER, ELMADONA MONDELEZ INTERNATIONAL 11/17/15 FRANCINE B WHITE WIEDNER & MCAULIFFE LTD 467 16WC 23185 YOUNG, CATHERINE M SNAK KING 05/24/16 HAUSER LAW LLC COZZI & GOGGIN-WARD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 29 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 468 16WC 23635 COLEY, MAURICE PES PAYROLL DBA EXTREME R 07/22/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 469 16WC 23860 KOLB, LISA PEARL VALLEY FARMS 04/07/16 BART DURHAM RODDY LAW LTD 470 16WC 23913 RILEY, KEN KIMBALL MIDWEST DBA MIDWE 06/07/16 CLARK FROST 471 16WC 24036 HILL, COLLEEN DEPARTMENT OF HUMAN SERVI 05/06/15 BLACK & JONES ASSISTANT ATTY GENERAL 472 16WC 24039 MARTIN, JOSEPH C STAFF ON SITE OF IL INC 07/22/16 TUITE LAW 473 16WC 24066 RYLATT, JULIE A. STATE OF ILLINOIS DEPT. O @ 07/22/16 TUITE LAW 474 16WC 24827 CHAVEZ, JUANA PCI PHARMA SERVICES (FORM 06/15/16 KATZ FRIEDMAN EAGLE ET AL LAW OFFICES JOSEPH MARCINIAK 475 16WC 24934 GONZALEZ, MARIA ARAMARK UNIFORM SERVICES 05/29/15 GESMER LAW OFFICES, PC 476 16WC 24936 RILEY, MICHAEL B CITY OF ROCKFORD 08/04/16 THOMAS W DUDA HEYL ROYSTER VOELKER & ALLEN 477 16WC 25012 CLINE, DAVID E. NORTH BOONE COMMUNITY UNI 02/19/16 TUITE LAW 478 16WC 25264 OVERBEY, RAYMOND BERGSTROM, INC 07/01/99 BLACK & JONES 479 16WC 25603 ELLIS, EDMOND CITY OF FREEPORT 03/28/16 JAMES J BURKE LAW OFFICE NYHAN BAMBRICK KINZIE & LOWR 480 16WC 25749 SNELL, TRUDY L WARNER ELECTRIC LLC 07/27/16 TUITE LAW HENNESSY & ROACH PC 481 16WC 25839 MOORE, WILLIAM J ABLE BUILDING MAINTENANCE 10/27/15 ALEXANDER, PETER LTD. 482 16WC 25845 NOYOLA, CARLOS CAPITAL BUILDING SERVICES 03/08/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 483 16WC 26142 SCHMIDT, RAND FCA US LLC 07/15/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 484 16WC 26426 KVOOL, COLIN ROCKFORD POLICE DEPARTMEN 07/04/16 BLACK & JONES HEYL ROYSTER VOELKER & ALLEN 485 16WC 26546 WATTS, WILLIAM B WESLEY WILLOWS CORPORATIO 05/27/16 TUITE LAW NYHAN BAMBRICK KINZIE & LOWR

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 30 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 486 16WC 26559 MOLL, JANE E FREEPORT HEALTH NETWORK 04/12/16 LOREN S GOLDEN GAROFALO SCHREIBER STORM 487 16WC 26737 HACKENBURG, BRIAN NATIONAL FREIGHT INDUSTRI 04/13/15 BLACK & JONES QUINN JOHNSTON HENDERSON ETA 488 16WC 26805 BROWN, CARLOS TREE HOUSE FOODS 03/20/16 BLACK & JONES RUSIN & MACIOROWSKI LTD 489 16WC 27359 CARRODINE, BRANDON LJ BROGGI TRANSPORTATION 08/23/16 RUBENS AND KRESS QUINTAIROS PRIETO WOOD & BOY 490 16WC 27472 DAHLBERG, MICHAEL MIDWEST CONVERTERS 05/24/16 BLACK & JONES RUSIN & MACIOROWSKI LTD 16WC027473 -C 491 16WC 27538 WEBB, TAMIKA QUALITY METAL FINISHING C 07/19/16 BLACK & JONES RUSIN & MACIOROWSKI LTD 492 16WC 27541 MOSQUERA MOSQUERA, YACKEL ARAMARK UNIFORM SERVICES 02/15/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 493 16WC 27763 BULIK, CYNTHIA LAND OF OZ, INC 05/16/16 CLARK FROST KNELL & O'CONNOR 494 16WC 28013 BAUTISTA, CHRISTOPHER A. ARVEL ELDRIDGE ROOFING & 05/24/14 TUITE LAW SMITH AMUNDSEN LLC 495 16WC 28090 BRUCE, JEROME GUNITE CORPORATION 01/19/15 TUITE LAW RUSIN & MACIOROWSKI LTD 496 16WC 28098 STORM, GRAIL L CONSERV FS, INC 12/30/15 TUITE LAW RUSIN & MACIOROWSKI LTD 497 16WC 28194 VOLKEY, SHANE OAKLE SUB ASSEMBLY 08/24/16 MARTIN V KUGIA PERRY GENTILE 498 16WC 28540 DAY, ADAM K R & D THIEL 04/21/16 WIEDNER & MCAULIFFE LTD 499 16WC 28594 JOINER, FELICIA MAPLE CREST CARE CENTER 08/25/16 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 500 16WC 28766 VOSS, PAMELA MOSTLY CATS VETERINARY CL 11/24/15 GESMER LAW OFFICES, PC WOLFE & JACOBSON, LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 31 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 501 16WC 29023 LAMBERT, MONIQUE UNIVERSAL HOSPITAL SERVIC 03/28/13 BLACK & JONES HOLECEK & ASSOCIATES 502 16WC 29813 NEWHAUFEN, BEVERLY HENREY GENERAL MILLS 04/29/16 MARTIN V KUGIA PAUL A COGHLAN & ASSOC 16WC031283 -C 503 16WC 29950 PARRA, LETICIA EBERSPAECHER 08/28/15 KATZ FRIEDMAN EAGLE ET AL RUSIN & MACIOROWSKI LTD 504 16WC 30127 CLARK, EMMANUEL OAKLEY SUB ASSEMBLY 08/15/16 MARTIN V KUGIA 505 16WC 30137 MANRIQUEZ, MELISSA BARBARA OLSEN CENTER OF H 03/19/16 BLACK & JONES RUSIN & MACIOROWSKI LTD 506 16WC 30222 READER, ROBERT L WINNEBAGO COUNTY HIGHWAY 04/04/16 TUITE LAW 507 16WC 30425 HOMAN, SONYA THE DEPOT 09/10/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 508 16WC 30449 DRIVER, JENNIFER DEPT OF REHAB SVC @ 09/09/14 GESMER LAW OFFICES, PC HELEN LOZANO 509 16WC 30517 MANZANO, ARTURO EUCLID CHEMICAL 11/01/15 BLACK & JONES RODDY LAW LTD 510 16WC 30523 PETSCH, JOSEPH LANE'S AUTO SERVICE, INC 09/09/16 GESMER LAW OFFICES, PC ROSARIO CIBELLA 511 16WC 30882 MILLER SR., TONY AUSTIN WESTRAN 06/23/14 KATZ FRIEDMAN EAGLE ET AL 16WC030883 -C 512 16WC 30941 KOCH, KEITH EXELON CORPORATION 09/26/16 HORWITZ HORWITZ & ASSOC NYHAN BAMBRICK KINZIE & LOWR 513 16WC 31047 MERSON, JOHN RUAN TRANSPORTATION 07/11/16 BLACK & JONES JAMES M KELLY 514 16WC 31069 DIMARIO, PATRICIA WINNEBAGO COUNTY 12/30/15 GESMER LAW OFFICES, PC WILLIAMS MCCARTHY LLP 515 16WC 31257 SHLOBA, HELEN HMS HOST FAMILY RESTAURAN 07/03/16 GESMER LAW OFFICES, PC ROBERT L. SMITH 516 16WC 31447 GONZALEZ-GARIBAY, PEDRO GRJ TRUCKING 05/12/16 GESMER LAW OFFICES, PC 517 16WC 31573 DE JIMENEZ, MARIA M TH FOODS 06/10/16 GESMER LAW OFFICES, PC BRADY CONNOLLY & MASUDA PC 518 16WC 31836 MORRIS, TENNES R JR SYNCREON 08/13/16 BLACK & JONES GAROFALO SCHREIBER STORM

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 32 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 519 16WC 31928 SEDERSTROM, BRIAN PACCAR PARTS 10/05/16 GESMER LAW OFFICES, PC BRADY CONNOLLY & MASUDA PC 520 16WC 31981 RHANOR, MICHAEL ENTERPRISE RENT-A-CAR 10/06/16 GESMER LAW OFFICES, PC KNELL & O'CONNOR 521 16WC 31994 MARIN, BEATRIZ DAY CARE RESOURCES INC 07/22/14 ALEXANDER, PETER LTD. WIEDNER & MCAULIFFE LTD 522 16WC 32098 SVEDBERG, VIKTOR ROCKFORD ICE HOGS 10/27/13 GORDON LAW OFFICES LTD HENNESSY & ROACH PC 16WC032099 -C 523 16WC 32425 ANGULO, FERNANDO FCA US LLC 08/23/16 KATZ FRIEDMAN EAGLE ET AL 524 16WC 32659 PHILLIPS, VANESSA ALDI 06/10/16 MARTIN V KUGIA MACIOROWSKI SACKMANN & ULRIC 525 16WC 32818 BURDEN, DAWN SAUER-DANFOSS CO 10/20/13 BLACK & JONES HENNESSY & ROACH PC 526 16WC 32856 LOPEZ-ESTRADA, MONICA GREENWOOD, INC 09/19/16 SALVATO & O'TOOLE NYHAN BAMBRICK KINZIE & LOWR 527 16WC 33016 COOK, RICHARD ROCKFORD PRODUCTS 11/01/14 GESMER LAW OFFICES, PC GILDEA & COGHLAN 528 16WC 33060 CHARRON, DAVID FCA US LLC 08/11/16 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 529 16WC 33205 GUSTAFSON, JEFFREY R CITY OF ROCKFORD 04/05/16 THOMAS W DUDA HEYL ROYSTER VOELKER & ALLEN 530 16WC 33222 LOVE, RAYMOND GUNITE CORP 05/31/16 BLACK & JONES RUSIN & MACIOROWSKI LTD 531 16WC 33334 BRINKMEYER, JEFFREY A CASSENS TRANSPORT COMPANY 12/21/15 FRANKS, GERKIN & MCKENNA P KNAPP, OHL & GREEN 532 16WC 33412 ADRIAN, STUART YRC WORLDWIDE 10/11/16 BLACK & JONES HENNESSY & ROACH PC 533 16WC 33422 ALLEN, ROSE 7 ELEVEN 10/08/15 CLARK FROST KEEFE CAMPBELL & ASSOC LLC 534 16WC 33625 MAGNUSON, RAYMOND M GUNITE CORPORATION 03/07/16 TUITE LAW RUSIN & MACIOROWSKI LTD 535 16WC 33827 ANDRADE, LEONARDO ARTEAGA BROTHERS CONSTRUC 09/12/16 GESMER LAW OFFICES, PC 536 16WC 33907 SCHAEFER, RONNY BUSH GARDENS BAR & GRILL 08/05/16 GESMER LAW OFFICES, PC RODDY LAW LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 33 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 537 16WC 33977 DURAN-JUAREZ, SALLY LOWE'S DISTRIBUTION 04/30/16 O'CONNOR & NAKOS 538 16WC 34032 COKE, JONATHAN NATIONAL TECHNICAL SYSTEM 10/20/15 RUSIN & MACIOROWSKI LTD 539 16WC 34063 BROWN, FELICIA ROCKFORD MASS TRANSIT 10/03/16 BLACK & JONES RUSIN & MACIOROWSKI LTD 540 16WC 34136 MCNAB, SEAN NOODLES & COMPANY 10/25/16 DWORKIN AND MACIARIELLO 541 16WC 34169 MOSS, SHONDALE FURST STAFFING 11/02/16 DWORKIN AND MACIARIELLO 542 16WC 34458 FINCH, GREG SPIDER CO 03/30/16 GESMER LAW OFFICES, PC GANAN & SHAPIRO 543 16WC 34807 MCNAB, SEAN T NOODLES & COMPANY 10/25/16 SHELDON I MINKOW & ASSOCIA 544 16WC 34880 VOSSOUGHI, AMANDA FCA US LLC 10/11/16 KATZ FRIEDMAN EAGLE ET AL 545 16WC 34903 DENNY, PRINCESS UNITED AIRLINES INC. 08/04/15 HETHERINGTON KARPEL BOBBER 546 16WC 34967 CHIPMAN, STEVEN FCA US LLC 03/27/15 KATZ FRIEDMAN EAGLE ET AL 547 16WC 35047 HERSCHLAG, CYNTHIA ECOWATER 08/02/14 BLACK & JONES 548 16WC 35080 WEINER, TIMOTHY NORTH PARK RENTALS 09/17/16 CAPRON & AVGERINOS PC INMAN & FITZGIBBONS 549 16WC 35243 BOONE, D'EVYRON CITY OF ROCKFORD POLICE D 07/24/16 NASH LAW OFFICE PC HEYL ROYSTER VOELKER & ALLEN 550 16WC 35416 FERRIERO, BENN ST LOUIS BLUES 01/24/15 WOLFE LAW PC HENNESSY & ROACH PC 551 16WC 35570 FREGOSO, EULOGIO TH FOODS, INC 08/29/15 BLACK & JONES RODDY LAW LTD 552 16WC 35720 CROUCH, TODD FCA US LLC 11/06/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 553 16WC 35973 REYES, JOSE A ANDROID INDUSTRIES 10/06/16 ALEXANDER, PETER LTD. WIEDNER & MCAULIFFE LTD 554 16WC 36265 HUGHES, RON CHARTWELL STAFFING SOLUTI 11/02/16 GOLDBERG WEISMAN & CAIRO L

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 34 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 555 16WC 36297 HITT, ETTA M UHS 10/17/16 BLACK & JONES HOLECEK & ASSOCIATES 556 16WC 36318 MATHEWSON, RITA K MERIDIAN CUSD #223 01/18/16 TUITE LAW WIEDNER & MCAULIFFE LTD 16WC038121 -C 557 16WC 36458 BERRONES, ROBERTO ARAMARK CORRECTIONAL SERV 12/01/14 BLACK & JONES WIEDNER & MCAULIFFE LTD 558 16WC 36472 RICE, LEON TITAN TIRE 10/17/16 BLACK & JONES GRANT & FANNING 559 16WC 36561 EULER, DONALD KL BUILDERS 05/02/16 DWORKIN AND MACIARIELLO BRADY CONNOLLY & MASUDA PC 560 16WC 36653 JULY-ALMOND, JEANINE CHRISTIAN LIFE SCHOOLS 09/18/15 CLARK FROST 561 16WC 36745 CONARD, ADAM INTERNATIONAL AUTOMOTIVE 10/25/16 CHRISTIAN & MANNO GANAN & SHAPIRO 562 16WC 36941 MASTERSON, NICHOLAS L BORDER FOODS OF WISCONSIN 05/19/16 TUITE LAW LAW OFFICES FRANCESCA LARSEN 563 16WC 37073 BURFIELD, STACY PCI 12/01/12 BLACK & JONES SPIEGEL & CAHILL, PC 564 16WC 37076 FAGERSTROM, KELLY SUPERIOR AMBULANCE SERVIC 11/16/16 BLACK & JONES POWER & CRONIN LTD 565 16WC 37131 MEDLEY, DAVID LA LAKESIDE INTERNATIONAL TR 08/26/15 TUITE LAW GANAN & SHAPIRO 566 16WC 37170 HALE, JOSEPH L JR ANDROID INDUSTRIES 10/14/16 ALEXANDER, PETER LTD. WIEDNER & MCAULIFFE LTD 567 16WC 37377 BRANCH, LYNETTE MERCY ROCKFORD 05/31/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 568 16WC 37380 OLSEN, DAVID HOME DEPOT 11/02/16 BLACK & JONES MC ANDREWS & NORGLE LLC 569 16WC 37701 HUTCHISON, MARCIA HONEYWELL 03/01/14 BLACK & JONES RODDY LAW LTD 16WC037702 -C

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 35 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 570 16WC 37783 OROZCO, GERARDO PACCAR 11/16/16 BLACK & JONES BRADY CONNOLLY & MASUDA PC 571 16WC 37806 MOLINA, MARCO ATC PROPERTY PROS, LLC 11/25/16 WIEDNER & MCAULIFFE LTD 17WC002733 -C COLON'S RESALE SHOP 572 16WC 38031 MATTI, ALIN OCEAN BLUE TRUCKING INC 11/21/16 DWORKIN AND MACIARIELLO 573 16WC 38129 SALLIS, SUMMER IAC 11/10/16 BLACK & JONES 574 16WC 38248 KARL, ASHLEY M SYNCREON USA 12/02/16 REESE & REESE KEEFE CAMPBELL & ASSOC LLC 575 16WC 38438 GRISSOM, EARL JCK CONSTRUCTION 10/13/16 FRIEND LEVINSON & BERGAL RUSIN & MACIOROWSKI LTD 576 16WC 38521 KERR, LISA FREEPORT MEMORIAL HOSP 07/06/16 GESMER LAW OFFICES, PC GAROFALO SCHREIBER STORM 577 16WC 38809 ROBINSON, RODNEY CLIFFBREAKERS RIVERSIDE H 04/18/15 DWORKIN AND MACIARIELLO 578 16WC 38898 JONES, LASAONYA, ROCKFORD SCHOOL DIST 205 08/18/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 579 16WC 39269 SECHLER, ROBERT ARAMARK 12/15/16 GESMER LAW OFFICES, PC 580 16WC 39348 HUERTERO, MERCEDES SCHEIDAIRY FARMS INC 10/28/16 BLACK & JONES 581 16WC 39470 SWEENEY, THOMAS WOODWARD, INC 08/31/16 GESMER LAW OFFICES, PC 582 17WC 00073 DENNISON, DEREK FCA US LLC 07/26/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 583 17WC 00287 ORTIZ, GRISELDA EBM INC 12/12/16 STEWART C ORZOFF 584 17WC 00538 REYES, MARTHA AUSTIN WESTRAN 04/01/16 BLACK & JONES WOLFE & JACOBSON, LTD 585 17WC 00958 ZAMORA, LAURA A JONES NATURALS LLC 09/06/16 SALK, STEVEN B & ASSOC LTD 586 17WC 01204 MOORE, JANICE M MONDELEZ GLOBAL LLC 11/20/14 TUITE LAW WIEDNER & MCAULIFFE LTD 587 17WC 01382 MACK, JOHN FOLKERTS MANUFACTURING 11/07/16 DWORKIN AND MACIARIELLO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 36 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 588 17WC 01495 CHAMPLIN, ROGER PRATT INDUSTRIES CORRUGAT 11/03/16 BLACK & JONES HEYL ROYSTER VOELKER & ALLEN 589 17WC 01498 MAY, KRIS MIDWEST PACKAGING & CONTA 07/05/16 BLACK & JONES COZZI & GOGGIN-WARD 590 17WC 01597 TABOR, JONATHAN FURST STAFFING 09/20/16 GESMER LAW OFFICES, PC ACCIDENT FUND HOLDINGS 591 17WC 01701 REED, SCOTT MEIBORG BROTHERS, INC. 09/10/15 GESMER LAW OFFICES, PC WOLFE & JACOBSON, LTD 592 17WC 01815 DENNISTON, BRADLEY ROCKFORD MANUFACTURING GR 10/04/16 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 593 17WC 01847 GUSTAFSON, JULIE ROCKFORD HEALTH SYSTEM 06/12/15 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 594 17WC 02177 HARRIES, FANTASY ROCKFORD MASS TRANSIT 12/19/16 BLACK & JONES POWER & CRONIN LTD 595 17WC 02223 STALLWORTH, DENNIS DELICATE PLASTICS, INC. 12/01/16 MARKS INJURY LAW 596 17WC 02302 VAZQUEZ, JOHNNY CITY OF ROCKFORD POLICE D 10/23/16 THOMAS L NASH PC 597 17WC 02314 GROGAN, JOHN SYNCREON 12/12/16 KATZ FRIEDMAN EAGLE ET AL SMITH AMUNDSEN LLC 598 17WC 02342 KEHOE, ELAISOIN YALE ENFORCEMENT @ 12/10/16 MARSZALEK AND MARSZALEK HOLECEK & ASSOCIATES 599 17WC 02523 PEREZ-ESCRIBANO, WILFREDO AUSTIN WESTRAN 12/06/16 BLACK & JONES WOLFE & JACOBSON, LTD 600 17WC 02533 JONES, BRENDA HERITAGE WOODS 12/28/16 BLACK & JONES POWER & CRONIN LTD 601 17WC 02639 LUBINSKI, FRANCIS FCA US LLC 02/01/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 602 17WC 02642 METRAKOUDES, NICK C ESTES EXPRESS LINE 01/11/17 BLACK & JONES WIEDNER & MCAULIFFE LTD 603 17WC 02762 RYAN, TODD CASSENS TRANSPORT 10/25/16 GESMER LAW OFFICES, PC KNAPP, OHL & GREEN 604 17WC 02814 HARMS, MICHAEL RD RMF NOOTER INC 01/02/17 TUITE LAW KNELL LAW LLC 605 17WC 02958 JOHNSON, DANNY CALDWELL GROUP 01/03/17 BLACK & JONES LAW OFFICES OF EDWARD J. KOZ

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 37 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 606 17WC 03121 BEARD, CAROL WEST SIDE TRANSPORT 01/14/17 COSTA IVONE LLC 607 17WC 03259 HARMON, CHRISTOPHER PA PETERSON LLC 12/09/16 MARKS INJURY LAW LAW OFFICES FRANCESCA LARSEN 608 17WC 03355 DAVIS, JOHN A ROCKFORD SCHOOL DIST #205 12/12/16 THOMAS W DUDA WIEDNER & MCAULIFFE LTD 609 17WC 03486 ADAMS, GARY URBAN EQUITY PROPERTIES, 01/24/17 GESMER LAW OFFICES, PC RODDY LAW LTD 610 17WC 03530 LOWE, EMANUEL METRO STAFFING 11/21/16 BLACK & JONES 611 17WC 03618 MOORMAN, PATSY D G&K SERVICES INC 01/19/17 TUITE LAW ARNETT LAW GROUP 612 17WC 03646 DAVENPORT, JAMES ROCKFORD PROCESS CONTROL 10/06/15 GESMER LAW OFFICES, PC NYHAN BAMBRICK KINZIE & LOWR 613 17WC 03841 TAYLOR, KATHLEEN FCA US LLC 05/07/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 614 17WC 04148 ANDERSON, LORI R LIFE LINE SCREENING 01/03/17 GESMER LAW OFFICES, PC LAW OFFICES JOSEPH MARCINIAK 615 17WC 04177 BILLALOBOS, ALDO MR. BULTS INC 12/22/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 616 17WC 04642 REIFSTECK, MARGARET WINNEBAGO CO SPC ED COOPE 11/16/16 BLACK & JONES INMAN & FITZGIBBONS 617 17WC 04645 FARMER, ROSEMARIE BYRON SCHOOL DISTRICT #22 10/18/16 BLACK & JONES 618 17WC 04929 MITCHELL, JOHN HEIR OF BR CHERRY VALLEY SIGN COMPAN # 09/21/16 BARRICK SWITZER LONG ET AL WIEDNER & MCAULIFFE LTD 619 17WC 04989 ALVAREZ, FRANCISCO R&D THIEL 07/04/16 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 620 17WC 05057 BRAUER, TAMRA K MEIJER 01/15/17 GESMER LAW OFFICES, PC KOPKA, PINKUS DOLIN, PC 621 17WC 05193 BROWN JR., MARVIN D OWENS CORNING 09/25/13 BLACK & JONES 622 17WC 05598 SAYNER, SCOTT LINDBLAD CONSTRUCTION COM 01/25/17 SCHWEICKERT & GANASSIN INMAN & FITZGIBBONS 623 17WC 05619 HEADLEY, ORVILLE MR ORVILLE HEADLY 02/06/17 BLACK & JONES HENNESSY & ROACH PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 38 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 624 17WC 05780 SOMMERFIELD, DANIEL CITY OF BELVIDERE 12/05/16 SREENAN & CAIN PC NYHAN BAMBRICK KINZIE & LOWR 625 17WC 05949 BIEGA, DANIEL CAROLINA HURRICANES 10/27/15 FLOYD LAW FIRM 626 17WC 06002 MORSE, SHERI ROCKFORD SCHOOL DISTRICT 01/26/17 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 627 17WC 06091 LAWHON, VALEREY L LIFETOUCH PUBLISHING 04/14/16 BLACK & JONES LEAHY EISENBERG & FRAENKEL 628 17WC 06267 JACKSON, ROMELDA WALGREENS 01/04/16 BLACK & JONES GILDEA & COGHLAN 629 17WC 06383 THRUMAN, SUE A DANFOSS POWER 09/12/16 TUITE LAW HENNESSY & ROACH PC 630 17WC 06608 ALEXANDER, MATTHEW QPS EMPLOYMENT GROUP, INC 10/28/16 DEPAOLO ZADEIKIS GORE WOLFE & JACOBSON, LTD 631 17WC 06651 STRANG, DUWAYNE TLC COMPANIES 11/25/15 BLACK & JONES INMAN & FITZGIBBONS 632 17WC 06683 BRUSH, ERIC WASTE MANAGEMENT INC 08/15/16 BLACK & JONES HENNESSY & ROACH PC 633 17WC 06686 POWERS, AMANDA ROCKFORD SCHOOL DISTRICT 09/01/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 634 17WC 06884 GAYLORD, PATRICIA TRI-DIM FILTER CORP 03/02/17 KATZ FRIEDMAN EAGLE ET AL 635 17WC 07073 GARCIA, RUBEN MID-STATE CONCRETE INDUST 12/15/15 BLACK & JONES GAROFALO SCHREIBER STORM 636 17WC 07334 LOPEZ, ANA CARLSON CAPITAL MFG CO 02/15/17 GESMER LAW OFFICES, PC 637 17WC 07375 RUVALCABA, JOSE LUIS PAPER RECOVERY SERVICES C 02/02/17 JAMES ELLIS GUMBINER & ASS 638 17WC 07612 FLORES, KARI USF HOLLAND, INC 01/04/17 HEDEEN, MICHAEL J PC 639 17WC 07789 HERNANDEZ, MARTINA ND INDUSTRIES, INC 02/21/17 GESMER LAW OFFICES, PC HENNESSY & ROACH PC 640 17WC 07939 HUDSON, DAISHA ROCKFORD SCHOOL DISTRICT 01/17/17 CHARLES LEVY & ASSOC LTD WIEDNER & MCAULIFFE LTD 641 17WC 08001 TAPPAINER, JACK FCA US LLC 08/15/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 39 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 642 17WC 08045 GARRETT, GREGORY CINCINNATI TOOL STEEL CO 11/22/16 MARKS INJURY LAW WIEDNER & MCAULIFFE LTD 643 17WC 08168 OGDEN, TROY WASTE CONNECTIONS, INC 12/15/16 STROW LAW LLC 644 17WC 08194 HALL, BRENETTA PRESENCE ST JOSEPH CTR 11/15/16 BLACK & JONES KEEFE CAMPBELL & ASSOC LLC 645 17WC 08197 RASMUSSEN, ANDREW THOMPSON LINEAR 02/20/17 BLACK & JONES 646 17WC 08499 GAMBINI JR., RICHARD A CITY OF ROCKFORD POLICE D 02/13/17 REESE & REESE HEYL ROYSTER VOELKER & ALLEN 647 17WC 08581 NACHAMPSSACK, KINGKAMONE TESTORS CORPORATION 01/09/17 KATZ FRIEDMAN EAGLE ET AL RODDY LAW LTD 648 17WC 08686 COLLINS, RITA LOWE'S DISTRIBUTION CENTE 11/14/16 BLACK & JONES KEEFE CAMPBELL & ASSOC LLC 649 17WC 08750 WEST, PAMELA D KAYABOB, INC 01/11/16 VELLA & LUND 650 17WC 09047 CALLAWAY, JOYCE OREGON COMMUNITY UNIT SCH 01/20/15 SCHWEICKERT & GANASSIN 651 17WC 09075 PETERSON, DENISE (DIANE) DOLLAR TREE 04/01/16 BLACK & JONES BRYCE DOWNEY & LENKOV LLC 652 17WC 09086 JARRELL, ROBERT J CONCORDIA WIRELESS/TRIAD 02/16/17 MARK E MORELAND 653 17WC 09124 JONES, DEBBIE D GCA EDUCATION SVCS CENTRA 11/29/16 TUITE LAW POWER & CRONIN LTD 654 17WC 09225 MONTES, ELIZABETH WIS INTERNATIONAL 10/12/16 BLACK & JONES HENNESSY & ROACH PC 655 17WC 09228 ANDERSON, ASHLEY APAC CUSTOMER SERVICE 11/04/15 BLACK & JONES QUINTAIROS PRIETO WOOD & BOY 656 17WC 09266 ISHAM, STEPHEN YRC WORLDWIDE 03/14/16 BLACK & JONES HENNESSY & ROACH PC 657 17WC 09322 PRINNER, BROCK BLAIN'S FARM & FLEET 08/20/15 GESMER LAW OFFICES, PC 658 17WC 09359 MASINOVIC, ASMIR UNIFIRST 02/16/17 RICHARD E ALEKSY BRADY CONNOLLY & MASUDA PC 17WC011938 -C 659 17WC 09689 SAMMARRIE, WALEED AL LOWE'S COMPANIES, INC 02/05/17 SREENAN & CAIN PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 40 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 660 17WC 09694 MANRIQUEZ, REBECCA LANDSTAR INWAY INC 07/29/16 BLACK & JONES COZZI & GOGGIN-WARD 661 17WC 10209 SCHUTH, MARK ROCKFORD RESCUE MISSION 11/22/16 GESMER LAW OFFICES, PC NYHAN BAMBRICK KINZIE & LOWR 17WC010210 -C 662 17WC 10584 SCHEELER, CURT HARRIS SILVER AND SONS, I 12/10/16 FRANKS, GERKIN & MCKENNA P GANAN & SHAPIRO 663 17WC 10599 MORALES, ALICIA ROCKFORD PROCESS CONTROL 05/29/13 BLACK & JONES 664 17WC 10626 WILSON, MARK W IPSEN, INC 02/28/17 KATZ FRIEDMAN EAGLE ET AL 665 17WC 10803 SHAW, DUSTIN EXELON-BYRON GENERATING S 03/08/17 LAW OFFICE OF CHRIS DOSCOT 666 17WC 10851 CRUZ, RUBIN ALDEN DEBES REHABILITATIO 04/01/17 STRONG LAW OFFICE LAW OFFICES FRANCESCA LARSEN 667 17WC 10938 SPIVEY, LETA INGERSOLL CUTTING TOOL CO 04/04/16 CLARK FROST 668 17WC 10965 NIELSEN, LESLIE MR STEVE DORNICK 10/18/15 BLACK & JONES GILDEA & COGHLAN 669 17WC 11054 SCOTT, SHAWN GUNITE CORP 10/05/16 BLACK & JONES RUSIN & MACIOROWSKI LTD 670 17WC 11058 FOSTER, ZENA M UNITED TECHNOLOGIES CORP 10/27/14 FRANCINE B WHITE MACIOROWSKI SACKMANN & ULRIC 671 17WC 11151 TANDARA, JUSTIN V BARNES INTERNATIONAL INC. 03/03/17 REESE & REESE 672 17WC 11395 SOTELO, MONICA FRANCHESCO'S RISTORANTE 01/02/16 TURNER & SACKETT LLC 673 17WC 11618 THOMAS, VERA J CORTECH LLC 01/11/17 TUITE LAW 674 17WC 11621 JAMES, LESLIE MAXIM HEALTHCARE 01/06/16 GESMER LAW OFFICES, PC RUSIN & MACIOROWSKI LTD 675 17WC 11660 LERCH, MATTHEW SCHMERSE LAWN SERVICE 08/26/16 WOODRUFF & JOHNSON RODDY LAW LTD 676 17WC 11791 FLORES, LUCIA ROCKFORD MEMORIAL HOSPITA 10/30/16 GOLDBERG WEISMAN & CAIRO L WIEDNER & MCAULIFFE LTD 677 17WC 12130 GOOD, BRENT A BRETHREN HOME INC 08/29/16 TUITE LAW

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 41 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 678 17WC 12290 LUX, CONSTANCE BON TON DISTRIBUTION CTR 11/07/16 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 679 17WC 12510 MARQUEZ, YESENIA PCI 05/13/16 GESMER LAW OFFICES, PC 680 17WC 12515 CROSS, MAURICE TRISTAR METALS 02/10/17 BLACK & JONES HOLECEK & ASSOCIATES 681 17WC 12521 JACK, MARK ALDER GROUP, INC 11/11/16 CLARK FROST 682 17WC 12771 CRAIN, SANDRA ROCKFORD BOARD OF EDUCATI 12/15/16 ALEXANDER, PETER LTD. WIEDNER & MCAULIFFE LTD 683 17WC 12828 SCHMIDT, MINDY BERNER FOODS INC 01/20/17 BLACK & JONES 684 17WC 12957 LEE, DEBORAH BERNER FOOD & BEVERAGE 02/13/17 DWORKIN AND MACIARIELLO 685 17WC 12990 GAMBOA-MONTANEZ, LUCIA ROCKFORD SPECIALTIES COMP 12/05/16 TUITE LAW NYHAN BAMBRICK KINZIE & LOWR 686 17WC 13127 LOOS, MASON FIAT CHRYSLER AUTOMOTIVE 01/06/17 HEDEEN, MICHAEL J PC WIEDNER & MCAULIFFE LTD 687 17WC 13162 GOMEZ, JESUS BL WELLWOOD SERVICES 04/25/17 TUITE LAW LAW OFFICES JOSEPH MARCINIAK 688 17WC 13198 HOWARD, STANLEY JOSEPH MASTER DISTRIBUTORS 01/01/16 BLACK & JONES HOLECEK & ASSOCIATES 689 17WC 13217 MCLAUGHLIN, RYAN LDR CONSTRUCTION & RESTOR 04/06/17 BLACK & JONES HENNESSY & ROACH PC 690 17WC 13367 LE, VINH P GLEASON CUTTING TOOLS COR 04/03/17 GOLDBERG WEISMAN & CAIRO L COZZI & GOGGIN-WARD 691 17WC 13483 STANTON, ASHLEY CARDINAL STAFFING SERVICE 01/26/17 BLACK & JONES HENNESSY & ROACH PC 692 17WC 13582 DAVES, THOMAS SENIOR RESOURCE CENTER 03/01/17 GESMER LAW OFFICES, PC PERRY GENTILE 693 17WC 13668 OLSEN, KATHLEEN MARSHALLS 02/09/15 BLACK & JONES BRADY CONNOLLY & MASUDA PC 694 17WC 13671 CARTWRIGHT, BRANDON J & A LAWNS AND LANDSCAPI 10/31/16 BLACK & JONES 695 17WC 13677 LAESCH, ERICK CASSENS TRANSPORT 12/13/16 BLACK & JONES KNAPP, OHL & GREEN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 42 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 696 17WC 13752 MATTHEWS, NANETTE FEDEX GROUND 09/07/16 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 697 17WC 13916 MALLARD, PHELLANESICE ALDEN PARK STRATHMOOR 05/06/17 DWORKIN AND MACIARIELLO 698 17WC 13952 DORNBUSCH, MICHAEL FURST STAFFING 04/12/17 BLACK & JONES ACCIDENT FUND HOLDINGS 699 17WC 14044 GUASTO, ANTHONY UNITED PARCEL SERVICE 04/27/17 GOLDBERG WEISMAN & CAIRO L ASA LAW GROUP 700 17WC 14086 LABRIE, PIERRE-CEDRIC ROCKFORD ICE HOGS 04/15/16 FLOYD LAW FIRM 701 17WC 14102 CUNNINGHAM, STEVEN TRI-DIM FILTER CORPORATIO 05/01/17 KATZ FRIEDMAN EAGLE ET AL 702 17WC 14174 MILLER, SUSAN L SWEDISH AMERICAN HEALTH S 01/16/17 CACCIATORE, WILLIAM T 703 17WC 14266 CHANTHAPHONE, SONENALINH CITY OF ROCKFORD FIRE DEP 04/19/17 REESE & REESE HEYL ROYSTER VOELKER & ALLEN 704 17WC 14363 AURAND, LORI A SCHNUCKS MARKETS, INC 06/01/15 TUITE LAW 705 17WC 14396 CASILLAS, ANTONIO GLEN ELLEN STORAGE 04/18/17 EDWIN REYES LEGAL GROUP 706 17WC 14681 RICHARDSON, THOMAS A ROCKFORD PUBLIC SD #205 01/30/17 TUITE LAW WIEDNER & MCAULIFFE LTD 707 17WC 14832 CUNNINGHAM, AMANDA FCA US LLC 09/29/16 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 708 17WC 14855 FLEENER, CHRISTOPHER O. MILLER ENGINEERING 03/24/16 TUITE LAW WIEDNER & MCAULIFFE LTD 709 17WC 14895 KURTENBACH, NICK WASTE CONNECTIONS INCDBA 08/10/16 STROW LAW LLC 710 17WC 15007 MOODY, CRAIG O'HAVER TRANSPORTATION 05/02/17 BLACK & JONES 711 17WC 15187 HILL, KATE MCDONALDS 03/31/17 GESMER LAW OFFICES, PC 712 17WC 15485 HURSH, WILLIAM ROCKFORD SCHOOL DISTRICT 08/18/16 KATZ FRIEDMAN EAGLE ET AL 713 17WC 15509 LUTE, CYNTHIA UNIDINE CORP 04/11/17 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 43 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 714 17WC 15514 DULL, ROBERT SERTA MATTRESS CO 04/13/17 BLACK & JONES BRYCE DOWNEY & LENKOV LLC 715 17WC 15855 JACOBS, SUSAN ROCKFORD TOOL CRAFT 10/15/15 BLACK & JONES ROBERT L. SMITH 716 17WC 15977 FLORES RAMOS, JOSE MANUEL FORREST PALLET SERVICES, 04/04/17 WOODRUFF & JOHNSON CHILTON YAMBERT PORTER LLP 717 17WC 16005 SARTINO, MICHAEL PACIFIC PULMONARY SERVICE 05/03/17 BLACK & JONES 718 17WC 16100 THORSEN, GERALD ANDREW M. NELSON DBA ANDR 04/04/17 STROW LAW LLC ASSISTANT ATTORNEY GENERAL 719 17WC 16113 HOSKINS, ROSEMARY BELOIT HEALTH SYSTEM 00/00/00 PERRY GENTILE 720 17WC 16260 CARTER, DAVID TITAN TIRE CORP OF FREEPO 05/21/15 MARKS INJURY LAW 721 17WC 16362 NELSON, CYNTHIA ALPINE BANK & TRUST CO 11/01/16 CLARK FROST HOLECEK & ASSOCIATES 722 17WC 16371 CROSS, FARREN PCI PAHRMA SERVICES 05/11/17 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 723 17WC 16492 RAIH, PATRICIA ADDUS HEALTHCARE 12/13/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 724 17WC 16689 HUGHES, KIM SYNCREON AUTOMOTIVE 11/29/16 O'CONNOR & NAKOS KEEFE CAMPBELL & ASSOC LLC 725 17WC 16844 WILCOX, ARTHUR HUGHES RESOURCES 04/24/17 DUDLEY & LAKE LLC HOLECEK & ASSOCIATES 726 17WC 16891 STUCKEY, JASON BEVERLY MATERIALS, LLC 11/21/16 HORWITZ HORWITZ & ASSOC 727 17WC 17013 WILKINS, PATRICIA ROCKFORD MASS TRANSIT 05/17/17 BLACK & JONES RUSIN & MACIOROWSKI LTD 728 17WC 17330 STACHE, KYLE MEDINA NURSING CENTER 09/07/15 KEEFE CAMPBELL & ASSOC LLC 729 17WC 17661 ANDREWS, TODD MULLER PINEHURST DAIRY 11/07/16 CLARK FROST 730 17WC 17741 STANTON, ASHLEY CARDINAL STAFFING SERVICE 02/06/17 BLACK & JONES 731 17WC 17909 HERNANDEZ, MARIA MONDELEZ, MARIA 10/17/14 RICHARD O. GREENFIELD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 44 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 732 17WC 17912 HERNANDEZ, MARIA MONDELEZ INT'L INC 07/21/16 RICHARD O. GREENFIELD 733 17WC 17951 CRUZ, RAUL JONES NATURAL CHEWS CO 11/23/16 GESMER LAW OFFICES, PC 734 17WC 17995 GARCIA-PEREZ, LORENA QPS STAFFIGN SERVICES INC 02/07/17 BLACK & JONES WOLFE & JACOBSON, LTD 735 17WC 18018 MATHESON, ROBERT L JR ROCKFORD MEMORIAL HOSPITA 03/23/15 TUITE LAW WIEDNER & MCAULIFFE LTD 736 17WC 18230 SHIVLEY, JOSEPH J LOUI BACHRODT 03/09/17 JOHN E LUSAK 737 17WC 18624 CRACKENBERGER, GARY PEARL VALLEY EGGS 07/26/16 PIGNATELLI & ASSOCIATES 738 17WC 18637 CLAY, RAVEN MILESTONE 09/01/16 BLACK & JONES 739 17WC 18640 RUNDBERG, TORI GENRAL MILLS, INC 01/15/17 BLACK & JONES BRYCE DOWNEY & LENKOV LLC 740 17WC 18644 MANNING, BENJAMIN MID-STATES SCREW CORP 05/02/17 BLACK & JONES WOLFE & JACOBSON, LTD 741 17WC 18752 ELLIOTT, BRANDON P HOME DEPOT USA, INC. 05/29/17 TUITE LAW ADELSON TESTAN & BRUNDO 742 17WC 18839 MARTINEZ, ANTONIO STEEL CUTTERS, INC. 11/19/16 BLACK & JONES GAROFALO SCHREIBER STORM 743 17WC 18845 BROWN, LAKENYA FURST STAFFING 04/23/17 NESSLER, FREDERIC LAW OFFI 744 17WC 18899 CEBUHAR, MICHELLE ILLINOIS LOTTERY 04/07/16 745 17WC 18908 REISER, JOHN FCA US LLC 06/07/17 BLACK & JONES WIEDNER & MCAULIFFE LTD 746 17WC 18913 EDDINGER, BRENDA S NAPLETON AUTO WERKS 03/24/16 DAVID H CARTER GANAN & SHAPIRO 747 17WC 19006 DONAVAN, THOMAS MARTIN TRANSPORTATION SYS 10/27/16 PERRY GENTILE 748 17WC 19041 DIXON, BRIAN BLOUNT INTERNATIONAL INC 05/17/17 TAXMAN POLLOCK 749 17WC 19163 DISMUKE, CARLETTIA ST ANTHONY'S MEDICAL CENT 05/26/17 DWORKIN AND MACIARIELLO HINSHAW & CULBERTSON

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 45 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 750 17WC 19249 CHIPMAN, PAMELA GE AVIATION 06/01/17 KATZ FRIEDMAN EAGLE ET AL 751 17WC 19306 SALDANA, PEDRO G BRYNOLF MANUFACTURING INC 03/07/17 TUITE LAW 752 17WC 19319 MARKS, CHELSEA ROCKFORD PARK DISTRICT 06/01/17 BLACK & JONES HENNESSY & ROACH PC 753 17WC 19455 JOHNSON, TANISHA HELP AT HOME 02/27/17 GESMER LAW OFFICES, PC 754 17WC 19642 OLTHOFF, RONALD FIRE AND SAFETY EQUIPMENT 06/06/17 GESMER LAW OFFICES, PC 755 17WC 19747 LEGAULT, DEANNA M ROCKFORD PUBLIC SCHOOL @ 09/06/16 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 756 17WC 19950 SCHUSTER, BENJAMIN J CITY OF ROCKFORD POLICE D * 04/08/17 REESE & REESE 757 17WC 19959 LEESON, DIANE HARLEM CONSOLIDATED 12/12/16 WIEDNER & MCAULIFFE LTD 758 17WC 20151 GARKEY, SANDRA EASER SEALS * 05/09/17 BLACK & JONES 759 17WC 20156 FLOETER, MACKENZIE CHEMTOOL INC * 06/23/17 BLACK & JONES MACIOROWSKI SACKMANN & ULRIC 760 17WC 20160 BRYANT, JAMES DYNA-KLEEN * 03/09/16 BLACK & JONES KNELL & O'CONNOR 761 17WC 20163 ARELLANO, JOANNA BARBARA OLSEN CENTER OF H * 03/23/17 BLACK & JONES 762 17WC 20201 AMMONS, FRANCES E FREEPORT SCHOOL DISTRICT * 05/10/17 TUITE LAW 763 17WC 20295 ROLDAN, RODOLFO SYNCREON * 03/15/16 KATZ FRIEDMAN EAGLE ET AL 764 17WC 20347 EELLS, THOMAS COMMONWEALTH EDISON * 08/26/16 SCHAFER DERANGO & CAIN CLAYBORNE SABO & WAGNER 765 17WC 20461 JOHNSON, DIANA L BELOIT ANIMAL HOSPITAL * 06/13/17 REESE & REESE CAPUANI & SCHNEIDER 766 17WC 20531 SABINE, LISA ANDROID INDUSTRIES * 09/09/14 BLACK & JONES 767 17WC 20534 JONES, JAUNAY FCA US LLC * 06/14/17 BLACK & JONES WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 46 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 768 17WC 20744 FISHER, CROY FLEMING HEATING AND AIR * 10/24/16 BLACK & JONES 769 17WC 20787 KOLB, TREVOR MAS ROOFING SIDING & DECK * 05/11/17 BART DURHAM KNELL & O'CONNOR 770 17WC 20828 FREET, MICHAEL S WINNEBAGO COUNTY SHERIFFS * 05/05/17 STROW LAW LLC 771 17WC 20882 ELLIS-GOOCHER, STEPHANI EASTER SEALS METRO * 04/27/17 STORTO FINN & ROSINSKI 772 17WC 21126 KEEDI, MIRNA ROCKFORD SCHOOL DISTRICT * 02/06/17 CLARK FROST WIEDNER & MCAULIFFE LTD 773 17WC 21129 MC ELYEA, VESTLE RAY JR ADVANCED DISPOSAL * 02/22/17 BLACK & JONES INMAN & FITZGIBBONS 774 17WC 21132 ALLEN, MICHAEL IAC * 04/01/16 BLACK & JONES 775 17WC 21285 JOHNSON, PATRICK M SCHAFER GEAR WORKS * 06/13/17 BLACK & JONES 776 17WC 21293 BLACKWELL, KEITH GUSTAVE A LARSON COMPANY * 04/26/17 HORWITZ HORWITZ & ASSOC NOBLE & ASSOCIATES PC 777 17WC 21409 GERMAIN, RENEE L FREEPORT HEALTH NETWORK * 01/26/17 TUITE LAW 778 17WC 21424 JOHNSON, SHAUN METRO STAFF INC * 05/19/17 GESMER LAW OFFICES, PC 779 17WC 21435 WENBERG, JACOB S EWT/3DCNC INC * 11/10/16 TUITE LAW 780 17WC 21521 SPILLARE, RANDY P MILLER ENGINEERING * 01/28/17 HETHERINGTON KARPEL BOBBER WIEDNER & MCAULIFFE LTD 781 17WC 21587 THURMAN, RAMON TMI HOSPITALITY * 05/09/17 LEE, MARK N LAW OFFICE 782 17WC 21713 HART, MARGARET FCA US, LLC * 07/02/17 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 783 17WC 21817 LEON, MARICELA EVOLUTION STAFFING INC * 05/11/17 TUITE LAW 784 17WC 21902 MARTIN, MARGARET CORTECH, LLC * 04/25/17 BLACK & JONES 785 17WC 21907 ISHAM, STEPHEN YRC WORLDWIDE * 03/14/16 BLACK & JONES 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 DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 786 17WC 21968 RUBIO, ROSA HERITAGE MOLD INC * 04/06/17 GESMER LAW OFFICES, PC LAW OFFICES JOSEPH MARCINIAK 787 17WC 22173 RAMOS, JOHANN QPS EMPLOYMENT GROUP * 07/22/17 COSTA IVONE LLC 788 17WC 22241 FUNK, DAVID HAMILTON-SUNDSTRAND UTC * 01/25/17 KATZ FRIEDMAN EAGLE ET AL MACIOROWSKI SACKMANN & ULRIC 789 17WC 22303 MARSCHALL, LISA UPS * 07/19/17 MARKS INJURY LAW ASA LAW GROUP 790 17WC 22318 MILES, ELI JR. TRI-DIM FILTER CORP * 01/16/17 BLACK & JONES 791 17WC 22330 STEFANOWICZ, ALEKSANDER JARO ROOFING CO. * 06/27/17 HORWITZ HORWITZ & ASSOC 792 17WC 22816 LUX, CONSTANCE BON TON DISTRIBUTION CENT * 06/08/17 GESMER LAW OFFICES, PC 793 17WC 22979 LARSON, TRESEA ROCKFORD MEMORIAL HOSPITA * 11/12/13 BLACK & JONES WIEDNER & MCAULIFFE LTD 794 17WC 23056 MCLESTER, RAMONA LUCRAMARE, INC DBA * 07/10/17 THOMAS J STIBERTH LAW OFFI 795 17WC 23060 VARGAS GONZALEZ, ALICIA FURST STAFFING * 04/21/17 BLACK & JONES ACCIDENT FUND HOLDINGS 796 17WC 23063 THOMAS, QUENTIN DR PEPPER SNAPPLE GROUP * 01/25/17 BLACK & JONES 797 17WC 23178 BARNHART, MICHAEL CITY OF ROCKFORD DEPT * 05/09/17 REESE & REESE HEYL ROYSTER VOELKER & ALLEN 798 17WC 23228 SHELBY, KAERA D CITY OF ROCKFORD * 04/20/17 FOOTE MIELKE CHAVEZ & O'NE 799 17WC 23446 CRUZ, JAVIER COMCAST CORPORATION * 01/22/16 GESMER LAW OFFICES, PC 800 17WC 23478 HAWKINS, MARKITA K CARDINAL SERVICES LLC * 01/29/17 TUITE LAW 801 17WC 23568 ELLIOTT, LAURIE J TAYLOR CORP, DIV'N OF UNI * 09/03/14 WOLFE LAW PC 802 17WC 23796 GLASGOW, RONALD JR. SHERWIN WILLIAMS * 03/13/17 BLACK & JONES 803 17WC 23799 ARTEAGA, CLAUDIO MODERN SUSPENSION SYSTEMS * 02/14/14 BLACK & JONES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 48 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 804 17WC 23946 SCHWARTZ, JEFFREY D PRODRIVERS * 06/16/17 WILLIAMS, ROBERT B LAW OFF 805 17WC 24102 PTERO, KEVIN MELECIO NORTHWEST EXPRESS * 07/25/17 BLACK & JONES 806 17WC 24194 ARAUJO, GORIS JONE'S NATURAL CHEWS * 05/15/16 BLACK & JONES PERRY GENTILE 807 17WC 24197 GAUTHIER, MIKE GDC COMPANIES * 01/23/16 BLACK & JONES 808 17WC 24294 PHILLIPS, ANEATER ROCKFORD RESCUE MISSION * 03/28/17 NASH LAW OFFICE PC WILLIAMS MCCARTHY LLP 809 17WC 24339 MESCH JR, DARYL MWTS * 03/13/17 BLACK & JONES 810 17WC 24782 RUSSELL, RIAN PINNACLE LOGISTICS * 08/06/17 BLACK & JONES 811 17WC 24804 TRIPLETT, NATHAN UNITED SANITATION * 03/17/17 DWORKIN AND MACIARIELLO 812 17WC 24857 SCHULTZ, DAVID BRIDGEWAY * 06/28/17 GESMER LAW OFFICES, PC 813 17WC 25006 AHLGREN, BRADLEY FCA US LLC * 05/13/17 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 814 17WC 25039 CARLBORG, BRIAN AT&T * 08/01/17 CAPRON & AVGERINOS PC 815 17WC 25103 PETSCH, JOSEPH LANE'S AUTO SERVICE, INC * 01/11/17 GESMER LAW OFFICES, PC 816 17WC 25246 WHITMORE, ANDRE TH FOODS INC * 06/26/17 DWORKIN AND MACIARIELLO BRADY CONNOLLY & MASUDA PC 817 17WC 25296 GIBSON, KATHRYN GRUPO ANTOLIN * 08/23/17 KATZ FRIEDMAN EAGLE ET AL 818 17WC 25349 ANDRADE, ELVIA JONES NATURAL CHEWS CO * 10/20/15 SOSTRIN AND SOSTRIN PC 819 17WC 25513 ALLEN, KURT E BALLARD ELECTRIC DIVISION * 05/27/16 ALEXANDER, PETER LTD. 820 17WC 25543 LEE, BRIAN AUTO RELEASING, INC * 12/09/16 CLARK FROST KNAPP, OHL & GREEN 821 17WC 25569 YANCE, RENEE STATE OF ILLINOIS @ * 08/19/17 GESMER LAW OFFICES, PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 49 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 822 17WC 25619 PETERSON, JOAN M PCI PHARMA SERVICES * 03/07/17 GESMER LAW OFFICES, PC 823 17WC 25738 RUSH, BRIAN J MEIBORG BROS INC * 06/14/17 FRANKS, GERKIN & MCKENNA P 824 17WC 25761 STARK, JAMES FRANKLIN TOWNSHIP CEMETER * 06/26/17 GESMER LAW OFFICES, PC 825 17WC 25821 STRAWSER, BRIAN CITY OF ROCKFORD * 06/26/16 HEYL ROYSTER VOELKER & ALLEN 826 17WC 25860 GIBBONS, JENNIFER SWEDISH AMERICAN HOSPITAL * 08/26/17 GESMER LAW OFFICES, PC 827 17WC 25908 GUNDERSON, BETHANN ALDI INC * 03/07/17 TAMVAKIS, GEORGE L MACIOROWSKI SACKMANN & ULRIC 828 17WC 26126 BAKER, DAVID F TITAN INTERNATIONAL,INC * 11/01/16 GRANT & FANNING 829 17WC 26375 MULLINS, JEFF FCA US LLC * 06/05/17 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 830 17WC 26386 ROBINSON, FELISA M BARBARA OLSON CENTER OF H * 03/17/16 JOHN J CASTANEDA RUSIN & MACIOROWSKI LTD 831 17WC 26437 CLARK, EMMANUEL OAKLEY SUB ASSEMBLY * 04/14/16 MARTIN V KUGIA 832 17WC 26458 FISCHER, RAYMOND TRI-DIM FILTER CORP * 08/01/17 BLACK & JONES 833 17WC 26464 FAYNE, MARCUS METRO STAFFING * 08/15/17 BLACK & JONES 834 17WC 26467 FREEMAN, MARK ROCKFORD MASS TRANSIT * 07/01/17 BLACK & JONES 835 17WC 26617 JONES, NIKEYA BROSE * 09/01/17 DWORKIN AND MACIARIELLO 836 17WC 26705 WALKER, BRENT TRI-DIM FILTER CORP * 08/26/17 BLACK & JONES 837 17WC 26769 KOCH, JOHN UPS * 07/13/17 BLACK & JONES ASA LAW GROUP 838 17WC 26837 MADRIGAL, ALICIA STAFF ON SITE UNITED INC * 08/10/16 HERRERA LAW CENTER 839 17WC 26849 DAINTY, SHAE SYNCREON * 08/19/17 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 DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 840 17WC 27016 BEAUFILS, RICHARD CITY OF ROCKFORD POLICE D * 08/24/17 GESMER LAW OFFICES, PC 841 17WC 27123 DOTSON, JANICE SUNRISE TRANSPORTATION * 08/23/17 BLACK & JONES 842 17WC 27128 PETERSON, DENISE (DIANE) DOLLAR TREE * 04/10/17 BLACK & JONES 843 17WC 27188 MEHLBAUM, BETH EASTER SEALS * 02/10/17 DWORKIN AND MACIARIELLO 844 17WC 27210 GIOPPO, LISA LOWE'S COMPANIES, INC * 07/18/17 GESMER LAW OFFICES, PC 845 17WC 27266 WALKER, JENNIFER TDS AUTOMOTIVE HOLDINGS I * 11/22/16 KEEFE CAMPBELL & ASSOC LLC 846 17WC 27398 VALENZUELA, LORINE PAHNTOM REGIMENT INC * 07/03/17 CLARK FROST 847 17WC 27519 LILLY, BRIAN QPS EMPLOYMENT * 07/28/17 DWORKIN AND MACIARIELLO 848 17WC 27614 TILLEY, KATHERINE YANGEFENG AUTOMOTIVE INTE * 09/06/17 MC HARGUE, JAMES P LAW OFF 849 17WC 27688 GOBER, MELISSA FCA US, LLC * 05/21/17 BLACK & JONES 850 17WC 27729 HARROLLE, CATHLEEN FCA US LLC * 11/01/16 KATZ FRIEDMAN EAGLE ET AL 851 17WC 27824 JOHNSON, YOLANDA SERVICOM * 08/26/17 BLACK & JONES 852 17WC 27849 FINN-SCHAIBLE, KELLI ABLE HOME HEALTH, LLC * 09/04/17 BARRICK SWITZER LONG ET AL PERRY GENTILE 853 17WC 27884 FLORES, ALFREDO TH FOODS * 08/09/17 KATZ FRIEDMAN EAGLE ET AL 854 17WC 28048 BARNES, PHILLIP ADDUS HEALTHCARE * 06/20/17 BLACK & JONES 855 17WC 28051 GOODWIN, ZACHARY REITZEL ROOFING INC * 11/11/16 BLACK & JONES 856 17WC 28119 HARRELL, AVERY FREEPORT STREET DEPARTMEN * 06/12/17 DWORKIN AND MACIARIELLO 857 17WC 28228 KEHOE, ELAISOIN SUNNY ISLAND RV * 08/21/17 MARSZALEK AND MARSZALEK

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 51 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR ROCKFORD 45002 ON 11/06/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 858 17WC 28380 ORTIZ, CARLOS F THE KUEHNE GROUP, INC * 12/11/16 BARRICK SWITZER LONG ET AL 859 17WC 28684 HAGEN, JONATHON SPINHIRNE TRANSFER * 06/07/17 WOODRUFF & JOHNSON 860 17WC 28747 SMALLEY, JESSICA PORTILLO'S * 05/11/16 DWORKIN AND MACIARIELLO 861 17WC 28820 MEADOWS, TREMAYNE AEROTEK STAFFING AGENCY * 12/17/16 BLACK & JONES 862 17WC 28823 WEAVER, TRENT TITAN TIRE * 08/30/17 BLACK & JONES