ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 1 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 1 01WC 20295 ST VINCENT, CAROL SUE CHRYSLER CORPORATION 03/03/01 THOMAS R LICHTEN WILLIAMS & MCCARTHY 02WC038639 -C 03WC037758 -C DAIMLER CHRYSLER CORPORATI 05WC005739 -C 05WC005740 -C DAIMLER CHRYSLER CORPORATI 07WC029633 -C 2 07WC 37748 JONES, DEAN NICOR GAS 06/09/07 BLACK & JONES RUSIN & MACIOROWSKI LTD 07WC037749 -C 07WC048432 -C 3 08WC 10425 TAYLOR, PAULA ST OF IL - IDFPR-DPR @ 12/04/07 DREW J FERRACUTI ASSISTANT ATTORNEY GENERAL 11WC009621 -C STATE OF ILLINOIS 4 09WC 38391 BURNELL, DAVIS S & S CARTAGE 10/11/08 BLACK, JIM LAW OFFICE HINSHAW & CULBERTSON 5 09WC 52126 CHEMELLO, JUDY CRUSANDER CLINIC 08/01/09 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 09WC052127 -C 09WC052128 -C 09WC052129 -C 6 11WC 20798 JOHNSON, PAUL R L LEEK 04/30/11 BLACK & JONES CHILTON YAMBERT PORTER LLP 7 12WC 02773 SMITH, MICHAEL CHEM TOOL INC 09/20/11 JOHN S. ELIASIK LAW OFFICES JOSEPH MARCINIAK 8 12WC 07220 CUMBA, MARIBELLE JAC BELVIDERE CROSSLINK A 02/03/12 KATZ FRIEDMAN EAGLE ET AL GANAN & SHAPIRO 15WC026858 -C IAC BELVIDERE CROSSLINK 15WC026859 -C 17WC011558 -C IAC BELVIDERE CROSSLINK AK 9 12WC 11534 DOWNING, JEFFREY A FREEPORT METAL SPECIALTIE 03/09/11 GREG TUITE & ASSOC BRADY CONNOLLY & MASUDA PC 10 12WC 12635 NACHAMPASSACK, KINGKAMONE TESTORS CORPORATION 03/01/11 KATZ FRIEDMAN EAGLE ET AL EVANS & DIXON 11 12WC 12636 NACHAMPASSACK, KINGKAMONE TESTORS CORPORATION 01/18/11 KATZ FRIEDMAN EAGLE ET AL EVANS & DIXON 12 12WC 13666 MINARDI, ANTHONY R CARDINAL GLASS COMPANY 03/15/12 GREG TUITE & ASSOC ROBERT L. SMITH 13WC017675 -C

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 2 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 13 12WC 24517 DAVIS, GERALD T STERLING COMMERCIAL ROOFI 06/04/12 CACCIATORE, WILLIAM T PAUL A COGHLAN & ASSOC 14 12WC 29417 MACAULAY, YVONNE BERNER FOOD & BEVERAGE 04/12/12 THOMAS J STIBERTH LAW OFFI CAPUANI, FRANK S 12WC036465 -C 15 13WC 00712 CARRILLO, KELLI LUMEA STAFFING 12/19/09 BLACK & JONES 16 13WC 11687 JACOBS, PAUL CHRYSLER ASSEMBLY PLANT 01/30/13 ANESI OZMON RODIN NOVAK KO WIEDNER & MCAULIFFE LTD 17 13WC 16325 HULTQUIST, RICHARD L ED TRNYRE & CO 01/01/11 BLACK & JONES CLARK FROST 18 13WC 22899 KINGPHAVONG, PHANOMPHONE TESTORS CORPORATION 02/12/13 KATZ FRIEDMAN EAGLE ET AL EVANS & DIXON 19 13WC 29206 MELTON, ANTHONY DOUBLE A ROOFING W 11/04/12 BLACK & JONES 20 13WC 33061 HOYLE, NANCY SWEDISH AMERICAN MEDICAL 03/04/11 BLACK & JONES WILLIAMS MCCARTHY LLP 21 13WC 40593 GUTIERREZ, ZENON AUSTIN-WESTRAN 05/20/13 ANESI OZMON RODIN NOVAK KO RIPES NELSON BAGGOT KALOBRAT 14WC029921 -C 22 13WC 42632 DELEHANTY, GENE TH FOODS 12/12/13 FRANCINE B WHITE HOLECEK & ASSOCIATES 23 14WC 01497 BILJESKOVIC, LUKA ZENITH CUTTER 12/19/12 HORWITZ HORWITZ & ASSOC COZZI & GOGGIN-WARD 24 14WC 07333 LUNDSTROM, JEFF HILDEN REMODELING 09/13/13 BLACK & JONES 25 14WC 19733 NGUYEN, HA HAMILTON SUNDSTRAND 06/01/11 BLACK & JONES RUSIN & MACIOROWSKI LTD 26 14WC 20766 PRINCE, LARRY SEIMENS 03/12/14 RIDGE & DOWNES HOLECEK & ASSOCIATES 27 14WC 28487 PETERSON, RICHARD G COMCAST CABLEVISION 01/02/14 REESE & REESE POWER & CRONIN LTD 14WC038348 -C 15WC017127 -C 15WC038083 -C 28 14WC 33731 BAUMAN, MICHAEL D CITY OF ROCKFORD 03/05/14 THOMAS W DUDA HEYL ROYSTER VOELKER & ALLEN 16WC003687 -C

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 3 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 29 14WC 34757 MARTINEZ, REUBEN JOHN D AMERICAN DREAM HOME INC. 08/29/14 MARTIN V KUGIA COZZI & GOGGIN-WARD 30 14WC 39510 FLETCHER, JAMES WINNEBAGO COUNTY HIGHWAY 09/19/13 BLACK & JONES WILLIAMS MCCARTHY LLP 31 14WC 42688 TORIBIO, ALEJANDRO JAN CORTEZ/JC REMODELING W 10/22/14 BLACK & JONES 32 15WC 00032 GRAMMER, TYLER CATCH THE WAVE 10/29/14 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 33 15WC 01838 WRIGHT, WALTER MAHONEY ENVIRONMENT 12/18/14 PETER F FERRACUTI & ASSOCI LITCHFIELD CAVO 34 15WC 04342 GLORIA, JOSEPH WALMAR C/O CLAIMS MANAGEM 02/08/14 POLANSKY & CICHON CHTD QUINTAIROS PRIETO WOOD & BOY 35 15WC 09360 CUEVAS, LUIS ROGERS BROTHERS INC 02/25/15 COHN LAMBERT RYAN & SCHNEI HOLECEK & ASSOCIATES 36 15WC 12564 KLOEPPING, MARK WOODS EQUIPMENT CO 08/01/13 PIGNATELLI & ASSOCIATES COZZI & GOGGIN-WARD 37 15WC 14333 AVILA, RODRIGO R & D THIEL INC 02/17/15 GALLIANI DOELL & COZZI LTD WIEDNER & MCAULIFFE LTD 38 15WC 17938 HOTLOVAC, MURIS ROCKNELL FASTENERS 05/16/15 GESMER & REYNOLDS PC INMAN & FITZGIBBONS 39 15WC 18311 FLETCHER, JAMES WINNEBAGO COUNTY HWY DEPT 10/28/14 BLACK & JONES WILLIAMS MCCARTHY LLP 40 15WC 20568 TILLMAN, THOMAS CHRYSLER LLC 06/01/15 ANKIN LAW OFFICE WIEDNER & MCAULIFFE LTD 41 15WC 20853 MCKEE, KARA SECRETARY STATE OF ILLINO @ 05/20/15 BLACK & JONES ASSISTANT ATTORNEY GENERAL 42 15WC 22576 SHORES, KEVIN SPG INTERNATIONAL LLC 07/01/12 BLACK & JONES LAW OFFICES FRANCESCA LARSEN 43 15WC 23583 LANEGRAFF, EDWARD KOJA CONSTRUCTION 02/04/15 BLACK & JONES BRYCE DOWNEY & LENKOV LLC 44 15WC 24636 BECK, KAITLYN DAIRY QUEEN 04/03/15 GWC INJURY LAWYERS LLC 45 15WC 25039 JONES, KATHY DO IT BEST 06/05/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 46 15WC 25543 FIEDLER, LORI WOODWARD GOVERNOR 11/04/14 MARKS INJURY LAW HINSHAW & CULBERTSON

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 4 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 47 15WC 27540 CARRISON, JOHN W ACCURATE CNC MACHING INC 06/22/15 GREG TUITE & ASSOC WIEDNER & MCAULIFFE LTD 48 15WC 28561 MCGUIRE, CHARLES L ROCKFORD BOARD OF EDUCATI 06/19/12 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 49 15WC 33943 REDMOND, PATRICK TH FOODS 01/06/15 ANESI OZMON RODIN NOVAK KO BRADY CONNOLLY & MASUDA PC 50 15WC 34397 ROFFERS, MONICA (WIDOW OF HAGEMANN TRUCKING LLC # 07/14/15 JAMES M KELLY 51 15WC 35019 ALLEN, LAURELL K CHRYSLER 02/12/15 BLACK & JONES WILLIAMS MCCARTHY LLP 15WC035020 -C 15WC035022 -C 52 15WC 35090 REYES, ANA NORTHERN PRECISION PLASTI 04/21/15 BLACK & JONES 53 15WC 37805 MORRIS, BRAD ADVANCE AUTO PARTS 05/19/14 BLACK & JONES 54 15WC 39325 SPEARMAN, SAMMIE STPHENSON NURSING HOME 11/15/15 BLACK & JONES INMAN & FITZGIBBONS 55 15WC 41808 STREIT, KEVIN A MONDELEZ GLOBAL LLC 10/16/14 GREG TUITE & ASSOC 56 16WC 00276 WALLACE, RONALD JR ED ENTYRE 11/24/15 DWORKIN AND MACIARIELLO CLARK FROST 57 16WC 01452 ROMAN, LORENA GRUPO ANTOLIN 10/22/15 KATZ FRIEDMAN EAGLE ET AL HENNESSY & ROACH PC 58 16WC 04132 BEAMUS, PAMELA FCA US LLC 08/06/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 15WC009735 -C CHRYSLER CORP. 15WC034471 -C 16WC004131 -C 16WC016894 -C 59 16WC 05656 DIEHL, DAN L STATE OF IL DEPT OF TRANS @ 01/27/14 TUITE LAW ASSISTANT ATTY GENERAL 60 16WC 07471 JORDAN, TIARA DASCO PRO 02/29/16 BLACK & JONES WOLFE & JACOBSON, LTD 61 16WC 09573 NAYONIS, MICHAEL WOODWARD GOVERNOR CO 07/08/04 BLACK & JONES HINSHAW & CULBERTSON 16WC009574 -C 62 16WC 11140 VEGA, REBECCA FCA USA, INC 01/21/16 GESMER & REYNOLDS PC 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 ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 63 16WC 11211 SPRAY, JOHN D BURKHART TRUCKING INC 03/23/16 BARRICK SWITZER LONG ET AL JAMES M KELLY 64 16WC 12930 BACON, GEANETTE CHRYSLER DIVISION FCA US 06/26/15 RICHARD O. GREENFIELD WIEDNER & MCAULIFFE LTD 19WC004702 -C 65 16WC 16180 BRINKMEYER, WESLEYAN CENTRAL RUBBER COMPANY 05/16/16 RIDGE & DOWNES MC ANDREWS & NORGLE LLC 66 16WC 19591 PETERSEN, DONALD OSF ST ANTHONY MEDICAL CE 03/13/16 BLACK & JONES HINSHAW & CULBERTSON 67 16WC 20151 MACIEL, YAYA J SLIDEMATIC PRECISION COMP 02/11/16 GESMER & REYNOLDS PC LAW OFFICES JOSEPH MARCINIAK 68 16WC 21252 BAUMAN, MICHAEL D CITY OF ROCKFORD 04/02/16 THOMAS W DUDA HEYL ROYSTER VOELKER & ALLEN 69 16WC 21826 DAUGHERTY, JENNIFER BERGSTROM MFG CO 04/01/16 BLACK & JONES WOLFE & JACOBSON, LTD 70 16WC 22497 LEMBKE, JAMES MCDERMAID 08/11/14 HORWITZ HORWITZ & ASSOC LAW OFFICES OF EDWARD J. KOZ 71 16WC 23733 ANDRADE, CONCEPCION LAWNCARE BY WALTER 06/10/16 O'CONNOR & NAKOS RIPES NELSON BAGGOT KALOBRAT 72 16WC 24069 BROWN, EDITH TESTORS 07/12/16 BLACK & JONES 73 16WC 24610 RILEY-STEELE, MELENDY FCA US LLC 10/07/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 74 16WC 26227 THOMAS, LUTHER SYNCREON 05/03/16 BLACK & JONES KEEFE CAMPBELL BIERY & ASSOC 75 16WC 27022 MCWETHY, TANYA INTERNATIONAL AUTOMOTIC 02/07/14 STRONG LAW OFFICE GANAN & SHAPIRO 16WC027028 -C 16WC027029 -C 76 16WC 27242 19B WACKER, CARRIE B. ILLINOIS STATE TOLL @ 04/26/16 TUITE LAW GANAN & SHAPIRO 18WC011134 -C 77 16WC 28857 RODRIGUEZ, EMILIO JR FCA US 12/11/15 HORWITZ HORWITZ & ASSOC WILLIAMS MCCARTHY LLP 78 16WC 30034 BADER, KRISTIE UTC AEROSPACE SYSTEMS 04/19/16 KATZ FRIEDMAN EAGLE ET AL RUSIN & MACIOROWSKI LTD 79 16WC 30522 PETSCH, JOSEPH LANE'S AUTO SERVICE, INC 03/17/16 GESMER & REYNOLDS PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 6 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 80 16WC 31572 MACKENZIE, THERESA C PACKAGING COORDINATORS, I 09/15/16 TUITE LAW JOSEPH MARCINIAK 81 16WC 31901 MUSSER, MARJORIE K KOLB-LENA, INC 10/20/13 TUITE LAW KEEFE CAMPBELL & ASSOC LLC 16WC038115 -C 18WC026684 -C 82 16WC 32909 HIRTH, COLE M REGAL PRODUCTS 02/13/15 FRANCINE B WHITE PERRY GENTILE 83 16WC 34127 DONEGAN, DELOREAN WALMART SUPERCENTER 06/06/16 BLACK & JONES QUINTAIROS PRIETO WOOD & BOY 84 16WC 34224 DIBBIN, EDWARD WINNEGAGO COUNTY 03/19/15 GOTTREICH & GRACE 85 16WC 34269 SMITH, KEITH FCA US LLC 04/11/15 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 86 16WC 34271 CHIPMAN, PAMELA GE AVIATION AIR 03/10/16 KATZ FRIEDMAN EAGLE ET AL RUSIN & MACIOROWSKI LTD 87 16WC 36935 THATCHER, JOHNNY M FCA US LLC 06/27/16 TUITE LAW WIEDNER & MCAULIFFE LTD 88 16WC 37130 SIVERIO, EWA K WAL-MART STORES, INC. 11/23/15 TUITE LAW QUINTAIROS PRIETO WOOD & BOY 89 16WC 37799 LOGAN, JAMES IMAGE PROS ASPHALT MAINTE 11/10/15 BLACK & JONES CHILTON YAMBERT PORTER LLP 90 16WC 38616 BOWERS, JOHN PEPSI-COLA OF ROCKFORD 08/01/13 BLACK & JONES WOLFE & JACOBSON, LTD 91 16WC 39367 RIOS, LUIS LC AUTO SALES W 11/08/16 MC HARGUE & JONES VELLA & LUND 92 17WC 00346 KOLLENG, MATTHEW SYSCO CORPORATION 11/08/16 ACEVES & PEREZ PC QUINTAIROS PRIETO WOOD & BOY 93 17WC 02522 ZIMMERMAN, KATHRINE VAN MATRE HEALTHSOUTH REH 07/29/16 BLACK & JONES SPIEGEL & CAHILL, PC 94 17WC 03945 BARRERA, PASCUAL ANCO STEEL COMPANY, INC 05/12/16 KINNALLY FLAHERTY KRENTZ & 95 17WC 04750 CONTRERAS, ALEJANDRO RW DUNTEMAN CO 08/08/14 JONATHAN SCHLACK 96 17WC 05269 JONES, CHRISTINA COMPANION ANIMAL CLINIC 02/08/17 DWORKIN AND MACIARIELLO JOSEPH MARCINIAK 97 17WC 05876 FINK, JUDY, WIDOW OF VAN GALDER COACH USA # 01/22/17 MARKS INJURY LAW POULOS & DIBENEDETTO LAW

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 7 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 98 17WC 06083 WILLIAMS, EARL METRO STAFFING INCORPORAT 11/21/16 BRASSFIELD KRUEGER & RAMLO WIEDNER & MCAULIFFE LTD 99 17WC 06655 ROSE, DANIEL S TARGET 09/30/16 ALEXANDER, PETER LTD. NYHAN BAMBRICK KINZIE & LOWR 100 17WC 07117 CONGRAVE RUDE, CHENIN OSF ST ANTHONY MEDICAL CE 12/26/16 FRANCINE B WHITE HINSHAW & CULBERTSON 101 17WC 08174 SIMPSON, WILMA D PINNACLE LOGISTICS 12/30/16 GESMER & REYNOLDS PC KEEFE CAMPBELL BIERY & ASSOC 102 17WC 08728 STOVALL, BRENT ROCKFORD BOARD OF EDUCATI 01/24/17 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 103 17WC 09101 KASKE, JOSHUA MODERN ADVANCED MANUFACTU 12/08/15 KATZ FRIEDMAN EAGLE ET AL 104 17WC 10298 MARONDE, CHRISTINA STATE OF ILLINOIS @ 11/14/16 GESMER LAW OFFICES, PC HELEN LOZANO 105 17WC 11068 BLAZER, DONALD PTO SERVICES 03/07/17 BLACK & JONES 106 17WC 11628 MCVAY, JORDAN BEHR IRON METAL 06/30/14 GESMER LAW OFFICES, PC 107 17WC 11655 DUYNE, MICHAEL MIDWEST PACKAGING & CONTA 04/03/17 NASH LAW OFFICE PC COZZI & GOGGIN-WARD 108 17WC 12830 LUNDE, JACOB ROCKFORD SPECIALTIES CO 02/28/15 BLACK & JONES WOLFE & JACOBSON, LTD 109 17WC 13214 CASAZZA, MEREDITH BON TON STORES, INC 10/26/16 BLACK & JONES BRADY CONNOLLY & MASUDA PC 18WC020119 -C 110 17WC 14677 MARTINEZ, LIZ M. ROCKFORD SD #205 05/09/17 REESE & REESE WIEDNER & MCAULIFFE LTD 111 17WC 14849 WILLIAMS, LAWRENCE BOONE COUNTY AUTO BODY 10/07/16 BLACK & JONES GANAN & SHAPIRO 112 17WC 15006 HARRISON, JOSEPH P COILCRAFT 01/03/17 PIGNATELLI & ASSOCIATES HENNESSY & ROACH PC 113 17WC 15446 GEHRT, COLE IDOT @ 08/19/15 FRANCINE B WHITE HELEN LOZANO 114 17WC 15508 BRANT, KRISTINA NICAA HEAD START 03/29/17 BLACK & JONES RUSIN & MACIOROWSKI LTD 115 17WC 16860 SHEETS, MATTHEW UNITED PARCEL SERVICE 10/14/16 ROSS TYRRELL NYHAN BAMBRICK KINZIE & LOWR

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 8 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 116 17WC 17368 CROFFOOT, CRAIG S STEPHENSON COUNTY SHERIFF 12/20/16 HAUSER LAW LLC INMAN & FITZGIBBONS 117 17WC 17894 SWANSON, DEBORAH BON-TON DISTRIBUTION CENT 06/02/17 GESMER & REYNOLDS PC BRADY CONNOLLY & MASUDA PC 118 17WC 17949 WILBOURN, JOHN SNAK KING CORP 11/14/16 MARKS INJURY LAW COZZI & GOGGIN-WARD 119 17WC 17994 GOMEZ-SANCHEZ, ARISTEO CPM RECYLING SERVICES 11/23/16 BLACK & JONES 120 17WC 17997 MARQUEZ, JONATHAN CHEMTOOL INC 05/07/17 BLACK & JONES RUSIN & MACIOROWSKI LTD 121 17WC 18432 BUCK, KAREN WINNEBAGO COUNTY HEALTH D 02/15/17 NICHOLAS ROBERT RECCHIA WILLIAMS MCCARTHY LLP 122 17WC 18715 GOWAN, LYNWOOD MEADE ELECTRIC CO, INC 09/16/16 SCHWEICKERT & GANASSIN RUSIN & MACIOROWSKI LTD 123 17WC 19033 LIVINGSTON, DAWN COUNTY OF WINNEBAGO 06/15/17 GESMER & REYNOLDS PC 124 17WC 19508 HARTMAN, MICHAEL ILL DEPT OF TRANSPORTATIO @ 01/24/17 GESMER & REYNOLDS PC ASSISTANT ATTORNEY GENERAL 125 17WC 20882 ELLIS-GOOCHER, STEPHANI EASTER SEALS METRO 04/27/17 STORTO FINN & ROSINSKI NOBLE & ASSOCIATES PC 126 17WC 21124 MARTIN, ERIK C FCA USA, LLC 06/14/17 ANKIN LAW OFFICE WIEDNER & MCAULIFFE LTD 127 17WC 22577 ETHRIDGE, RONALD K MALCOLM EATON ENTERPRISES 07/11/14 HAUSER LAW LLC COZZI & GOGGIN-WARD 128 17WC 22852 BERTUCCI, DEBORAH GALENA & ASSOC, INC DBA 04/01/16 DEPAOLO & ZADEIKIS GANAN & SHAPIRO 129 17WC 23062 VICKERMAN, JUSTIN ONE OF A KIND WALL DESIGN 07/26/17 BLACK & JONES 130 17WC 24856 SCHULTZ, DAVID BRIDGEWAY 07/25/17 GESMER & REYNOLDS PC PERRY GENTILE 131 17WC 25038 CARLBORG, BRIAN AT&T 06/14/17 CAPRON & AVGERINOS PC INMAN & FITZGIBBONS 17WC025039 -C 132 17WC 25541 O'CONNOR, MARY VISITING NURSES ASSN 04/19/17 CLARK FROST WIEDNER & MCAULIFFE LTD 133 17WC 25753 EVANS, BETTEY L PINNACLE LOGISTICS 06/15/17 GESMER & REYNOLDS PC KEEFE CAMPBELL BIERY & ASSOC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 9 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 134 17WC 25941 HARRIS, JEFF MULLER PINESHURST 01/17/17 BRASSFIELD KRUEGER & RAMLO 135 17WC 26373 EDMONDS, CHARLES J EAST DUBUQUE NITROGEN 06/14/16 KATZ FRIEDMAN EAGLE ET AL 136 17WC 26466 ROOS, LAWRENCE SIMOS INSOURCING SOLUTION 08/15/17 BLACK & JONES BRADY CONNOLLY & MASUDA PC 137 17WC 26717 HANOOSH, SALIH N FURST STAFFING SERVICES, 04/23/17 BLACK & JONES ACCIDENT FUND HOLDINGS 18WC038078 -C 138 17WC 26927 FOREMAN, ELIJAH MONDELEZ INTERNATIONAL 03/09/15 FRANCINE B WHITE WIEDNER & MCAULIFFE LTD 139 17WC 27217 SWEAT, AMANDA L MERIDIAN CUSD #223 05/16/17 TUITE LAW NYHAN BAMBRICK KINZIE & LOWR 140 17WC 28050 JAMES, TRAVIS GKN ROCKFORD 07/29/17 DWORKIN AND MACIARIELLO RIPES NELSON BAGGOT KALOBRAT 141 17WC 28373 PRICE, AMY FCA US LLC 09/01/17 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 142 17WC 28627 SCHABACKER, EUGENE S SPARKY'S ELECTRICAL 08/08/17 TUITE LAW HEYL ROYSTER VOELKER & ALLEN 143 17WC 28772 KREPFLE, RICHARD DURAND SCHOOL DISTRICT 07/10/17 BLACK & JONES GAROFALO SCHREIBER STORM GRA 144 17WC 29718 MAY, OTTO JR FCA US, LLC 07/05/15 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 145 17WC 29747 VAGLE, BRAD (ON BEHALF OF STILLMAN BANK 06/26/17 BLACK & JONES 146 17WC 30007 COLLINS, JAVAR FURST STAFFING 07/10/17 DERANGO & CAIN 147 17WC 30302 RAISBECK, TIMOTHY STATE OF ILLINOIS/IDOT @ 09/09/16 ROSENBERG EISENBERG ASSOC ASSISTANT ATTORNEY GENERAL 17WC030303 -C 18WC029987 -C 148 17WC 30424 CREVISTON, TEDDIE BUDDY'S HOME FURNISHINGS 09/19/17 BLACK & JONES HENNESSY & ROACH PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 10 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 149 17WC 30703 INGRAM, LANETKA ALDEN PARK STRATHMOOR 08/26/17 DWORKIN AND MACIARIELLO 150 17WC 30765 MONTANA, MARIAN ROCKFOD SCHOOL DISTRICT # 07/21/17 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 17WC030777 -C 151 17WC 30948 ZERKEL, SUSAN ST RITA'S CHURCH 09/12/17 WOODRUFF & JOHNSON KEEFE CAMPBELL BIERY & ASSOC 152 17WC 31292 LANE-BARRY, JERRY 3P CONSTRUCTION AND REMOD W 05/15/17 BLACK & JONES 153 17WC 31568 BRAUER, TAMRA MEIJER 10/16/17 GESMER & REYNOLDS PC KOPKA, PINKUS DOLIN, PC 154 17WC 32102 HALL, GREGORY METRO STAFFING 10/12/17 BLACK & JONES SLAVIN & SLAVIN 155 17WC 32251 BERGER, JAMES AXIOM FOODS INC 10/15/17 BLACK & JONES WARMOUTH LAW PC 156 17WC 32274 RIVERA, MARIO AELDRIDGE ROOFING & SIDIN 10/13/17 GESMER LAW OFFICES, PC 157 17WC 32407 ZIMMERMAN, NICHOLE L FEDERAL EXPRESS CORPORATI 03/08/17 BLACK & JONES HANSON LAW OFFICE 158 17WC 32507 VAN BARRIGER, JOSEPH R BAY VALLEY FOODS 08/25/17 GESMER LAW OFFICES, PC KEEFE CAMPBELL BIERY & ASSOC 159 17WC 32563 MUHASKY, DAVE HOLLAND MOTORS 04/11/12 GOLDBERG WEISMAN & CAIRO L HENNESSY & ROACH PC 19WC015896 -C 160 17WC 32796 RICHARDSON, JOHNETTA ROCKFORD HOME SERVICES DR 09/27/17 ASSISTANT ATTORNEY GENERAL 161 17WC 33158 GUY, ANDREA WOODS EQUIPMENT 08/01/17 PIGNATELLI & ASSOCIATES WOLFE & JACOBSON, LTD 162 17WC 33759 RIVERA, MARIO ANGEL ORTEGA 10/13/17 GESMER & REYNOLDS PC HENNESSY & ROACH PC 163 17WC 33858 PETERS, MARY KOLB-LENA CHEESE CO 07/29/17 BLACK & JONES KEEFE CAMPBELL & ASSOC LLC 164 17WC 34036 OVERTON-MILLER, DAWN R SEARS HOLDINGS CORPORATIO 10/24/17 TUITE LAW GAROFALO SCHREIBER STORM GRA 165 17WC 35749 LOVE, GERALD R ILLINOIS DEPARTMENT @ 03/07/17 FRANKS, GERKIN & MCKENNA P 166 17WC 36428 SAGER, RANDY BENNETT BOALS TRUCKING, I 05/30/17 BRADY CONNOLLY & MASUDA PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 11 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 167 17WC 36565 CARDENAS, JOSE GALVAN AEROTEK 09/15/17 BLACK & JONES WIEDNER & MCAULIFFE LTD 168 17WC 36904 KINCH, BETH ROCKFORD PUBLIC SCHOOLS 02/01/11 BLACK & JONES WIEDNER & MCAULIFFE LTD 17WC036905 -C 169 17WC 36952 MANOS, RANDY FITZGERALD EQUIPMENT 05/07/15 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 170 17WC 37589 PRINE, BRIAN CITY OF ROCKFORD 10/12/17 GESMER LAW OFFICES, PC HEYL ROYSTER VOELKER & ALLEN 171 17WC 37992 HERRERA, OCTAVIO MARTINEZ TRES-M-SOLUTIONS LLC 10/04/17 HAUSER LAW LLC 172 17WC 38027 CEHIC, DZEVIDA ROCKNEL FASTENER, INC 04/14/17 CLARK FROST KOPKA, PINKUS DOLIN, PC 173 18WC 00292 HALL, JEFFRY A COUNTY OF WINNEBAGO 07/28/17 TUITE LAW WILLIAMS MCCARTHY LLP 174 18WC 00569 GILMORE, BONNIE L HOMEGOODS, INC 01/12/17 TUITE LAW BRADY CONNOLLY & MASUDA PC 175 18WC 01034 SHONDEL, DAWN CARDINAL STAFFING 10/26/17 DWORKIN AND MACIARIELLO HENNESSY & ROACH PC 176 18WC 01522 PEHL, SUSAN QPS STAFFING 11/03/17 GESMER LAW OFFICES, PC WOLFE & JACOBSON, LTD 177 18WC 01566 VIEDERIS, PAT CARDINAL GLASS COMPANY 01/30/17 HORWITZ HORWITZ & ASSOC BRADY CONNOLLY & MASUDA PC 178 18WC 01702 COLE, GABRIELLE CASEYS GENERAL STORES 05/07/17 WHITESIDE & GOLDBERG LTD HEYL ROYSTER VOELKER & ALLEN 179 18WC 01863 THOAMS, MARZAVIOUS UPS 10/10/17 BLACK & JONES 180 18WC 02024 STROH, VANESSA ROCHELLE GARDENS CARE CEN 11/16/17 BLACK & JONES KNELL LAW LLC 181 18WC 02874 BIRD, MICHAEL OAKLEY SUB-ASSEMBLEY 12/14/17 MARTIN V KUGIA ACCIDENT FUND HOLDINGS 18WC005095 -C 19WC005965 -C 19WC005966 -C 19WC005967 -C 182 18WC 03322 MARYOTT, HOLLY M DARDEN RESTAURANTS, INC 01/13/18 TUITE LAW WIEDNER & MCAULIFFE LTD 183 18WC 03366 GROOMS, DANA L SWEDISH AMERICAN HOSPITAL 01/05/17 KELLY & KING WILLIAMS MCCARTHY LLP

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 12 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 184 18WC 03639 MARTINEZ-VALDEZ, MAYRA JONES NATURAL CHEWS 09/20/17 BLACK & JONES ACCIDENT FUND HOLDINGS 185 18WC 04397 LASHER, BRANDY ALDI, INC 11/30/17 GESMER & REYNOLDS PC BRADY CONNOLLY & MASUDA PC 186 18WC 04431 CUMBA, MARIBELLE RESOURCE MFG/PROLOGISTIX 07/07/17 KATZ FRIEDMAN EAGLE ET AL NYHAN BAMBRICK KINZIE & LOWR 187 18WC 04548 NAVA, NICANDRO CHRYSLER, LLC/ 11/20/17 RUEDA, IVAN A WILLIAMS MCCARTHY LLP 188 18WC 05183 MARQUEZ, MONICA SLIDEMATIC PRECISION COMP 04/26/17 SOSTRIN AND SOSTRIN PC JOSEPH MARCINIAK 189 18WC 05245 SMITH, MARK MORNING DISPOSAL, INC 01/10/18 GESMER & REYNOLDS PC RIPES NELSON BAGGOT KALOBRAT 190 18WC 05577 SMITH, APRIL PARKVIEW NURSING HOME 01/22/17 BLACK & JONES BRYCE DOWNEY & LENKOV LLC 191 18WC 05700 STOREY, RHONDA S AJ KENT, INC DBA GOODTIME 09/17/13 TUITE LAW 192 18WC 05988 AYERS, JEWELL WAL-MART 01/24/18 GESMER LAW OFFICES, PC QUINTAIROS PRIETO WOOD & BOY 193 18WC 06198 19B TORRES, JOSE WASTE CONNECTIONS 01/04/18 ADRIAN MURATI BRADY CONNOLLY & MASUDA PC 194 18WC 06484 HOOKS, STEVE CURTIS METAL FINISHING 01/15/18 BLACK & JONES HENNESSY & ROACH PC 195 18WC 06843 MURPHY, CHRISTAL FCA US, LLC 02/06/18 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 196 18WC 07468 ERUINS, LASHONDA ROSECRANCE, INC 09/11/17 PUMILIA LAW LLC 197 18WC 08070 STRAM, JASON SPAHN AND ROSE LUMBER 11/22/17 GESMER & REYNOLDS PC HEYL ROYSTER VOELKER & ALLEN 198 18WC 08727 DANNO, PATRICK ILLINOIS STATE TOLL @ 02/06/18 GESMER & REYNOLDS PC NYHAN BAMBRICK KINZIE & LOWR 199 18WC 08860 WATTS, ANDREA CHRYSLER 11/11/17 COVEN LAW GROUP WIEDNER & MCAULIFFE LTD 200 18WC 09006 ERBE, BRANDON S. CHERRY VALLEY FIRE PROTEC 01/16/18 THOMAS W DUDA 201 18WC 09262 REINE, COLLEEN ROCKFORD RIGGING, INC 10/15/17 NASH LAW OFFICE PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 13 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 202 18WC 09596 REINE, COLLEEN ROCKFORD RIGGING, INC. 10/31/17 NASH LAW OFFICE PC 203 18WC 09767 PYFER, JAMES SHEET METAL CONNECTORS 06/22/16 GESMER & REYNOLDS PC HOLECEK & ASSOCIATES 204 18WC 10367 MAUERMAN, DUSTIN LOWE'S DISTRIBUTION CENTE 06/05/17 GESMER & REYNOLDS PC BRADY CONNOLLY & MASUDA PC 205 18WC 10579 NUNEZ, REINALDO MIDCOR SUPPLY 03/31/18 BOTTO GILBERT WIEDNER & MCAULIFFE LTD 206 18WC 11004 SMELSER, JONATHAN DCA US LLC 10/11/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 207 18WC 11071 NEMENSKI, PHILLIP R MIDSTATES CONCRETEINDUSTR 09/11/17 SOSTRIN AND SOSTRIN PC GAROFALO SCHREIBER STORM GRA 208 18WC 11288 GELENCIR, JOHN CHRYSLER 09/06/17 BROWN & CROUPPEN WIEDNER & MCAULIFFE LTD 209 18WC 11981 HARRIS, TIMOTHY CHRYSLER 02/22/18 ASHER, RAYMOND L LTD WIEDNER & MCAULIFFE LTD 19WC001017 -C 210 18WC 12164 HERNANDEZ, ERIC SALVATION ARMY 01/15/18 DERANGO & CAIN EVANS & DIXON 211 18WC 12541 STRYSIK, CASEY UNIVERSAL DIRECT MARKETIN W 04/16/18 BRIAN J MC MANUS & ASSOC, ASSISTANT ATTORNEY GENERAL 212 18WC 12779 ESTATE OF JENNIFER M CARO ROCKFORD PARK DISTRICT 03/07/18 LAWFIRST HENNESSY & ROACH PC 213 18WC 12949 STOHR, IAN EMERY AIR, INC. 11/29/17 BLACK & JONES BRADY CONNOLLY & MASUDA PC 214 18WC 12953 ZELLNER, EDWARD WINNEBAGO COUNTY 12/18/16 BLACK & JONES WILLIAMS MCCARTHY LLP 215 18WC 13193 SMELTZER, MARK EXELON CORP 04/19/18 HORWITZ HORWITZ & ASSOC RUSIN & MACIOROWSKI LTD 216 18WC 13230 ASTANEDA-ARCE, YADIRA SLIDEMATIC PRECISION COMP 04/16/18 COPLAN & CRANE, LTD WOLFE & JACOBSON, LTD 217 18WC 13694 CALDERA, MARIBEL DIVERSIFIED MAINTENANCE 03/27/18 BLACK & JONES HARRIS DOWELL FISHER & HARRI 218 18WC 14130 PHILLIPS, MYRNA BERNER FOODS 05/05/18 O'CONNOR & NAKOS HOLECEK & ASSOCIATES 219 18WC 14319 GUMS, WANDA SAVENCIA CHEESE LLC 11/01/17 DWORKIN AND MACIARIELLO KEEFE CAMPBELL BIERY & ASSOC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 14 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 220 18WC 14396 BILLINGSLY, BARBARA FCA US LLC 01/25/18 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 221 18WC 14924 LANDWEHR, VALERIE ED ETNYRE & CO 05/03/18 BLACK & JONES CLARK FROST 222 18WC 15577 AGUILERA, JUAN AMERICOLD LOGISTICS 10/20/17 DWORKIN AND MACIARIELLO GAROFALO SCHREIBER STORM GRA 223 18WC 15624 LEVERTON, DAVID REYES HOLDINGS, LLC 10/02/17 KATZ FRIEDMAN EAGLE ET AL HENNESSY & ROACH PC 224 18WC 15761 SCHUENKE, KEITH AUTOZONE DEVELOPMENT, LLC 08/18/17 CLARK FROST GILDEA, COGHLAN & REGAN LTD. 225 18WC 15799 CASTANEDA-ARCE, YADIRA QPS EMPLOYMENT GROUP 04/16/18 GESMER & REYNOLDS PC 226 18WC 15851 CIMINO, ALDO MIDWEST PACKAGING & CONTA 06/19/17 GESMER & REYNOLDS PC LAWRENCE COZZI - LAW OFFICE 227 18WC 15910 TRUCKENMILLER, DARRYL STEPHENSON SERVICE CO 03/05/18 BLACK & JONES HEYL ROYSTER VOELKER & ALLEN 228 18WC 16578 MUNCH, ALLISON EASTERSEALS ACADEMY 11/22/16 BLACK & JONES NOBLE & ASSOC 18WC016579 -C 18WC021082 -C 229 18WC 16581 HARRIS, ANTWON FURST STAFFING 04/15/18 BLACK & JONES ACCIDENT FUND HOLDINGS 230 18WC 16897 HARRIS, THIMOTHY COUNTY OF WINNEBAGO RIVER 04/15/18 TUITE LAW WILLIAMS MCCARTHY LLP 231 18WC 16964 GONZALEZ, INGRID CRUSADER COMMUNITY HEALTH 04/01/18 ADRIAN MURATI WOLFE & JACOBSON, LTD 232 18WC 16980 WESSMAN, KRISTEN FCA US LLC 11/28/17 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 19WC015733 -C 233 18WC 17035 SKAKAVAC, DANICA WAL-MART ASSOCIATES, INC. 03/14/18 GESMER & REYNOLDS PC GANAN & SHAPIRO 234 18WC 17318 RIESEN, DAVID THERMOPLASTIC INC. 01/25/18 BLACK & JONES JOSEPH MARCINIAK

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 15 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 235 18WC 17647 DOBSON, DAVID WILLIAM CHARLES INVESTMEN 01/16/18 GESMER & REYNOLDS PC HOLECEK & ASSOCIATES 236 18WC 17756 ONG, JONAS ENVIRONMENTAL SPECIALTIES 05/11/18 BLACK & JONES THOMAS & PORTELA 18WC017757 -C 237 18WC 17759 CARMACK, MARY FCA US LLC 04/21/18 BLACK & JONES WILLIAMS MCCARTHY LLP 238 18WC 17765 SCOTT JR, JACKIE RAY FORRESTVILLE VALLEY SD 22 02/16/18 BLACK & JONES RUSIN & MACIOROWSKI LTD 239 18WC 17768 HERNANDEZ, ALEJANDRA HELP AT HOME 01/09/18 BLACK & JONES INMAN & FITZGIBBONS 240 18WC 18147 LOUIS, ANTHONY ROCKFORD ICE HOGS 11/10/17 GORDON LAW OFFICES LTD HENNESSY & ROACH PC 241 18WC 18504 APARICIO, MARIA ELIASAR MCDONALDS 06/01/18 BLACK & JONES HENNESSY & ROACH PC 242 18WC 18514 FOLEY, HEATHER FORRESTON FIRE PROTECTION 10/26/16 BLACK & JONES BRADY CONNOLLY & MASUDA PC 243 18WC 18751 GARCIA, RICARDO THORNE ASSOCIATES, INC 02/28/18 GOLDBERG WEISMAN & CAIRO L EDWARD J. KOZEL 244 18WC 19267 MELENDEZ, MIRCA I LOWE'S HOME CENTERS, LLC 11/05/16 TUITE LAW KEEFE CAMPBELL BIERY & ASSOC 18WC019268 -C 245 18WC 19305 COCHRAN, SHEILA SAS RETAIL SERVICES 03/26/18 POLANSKY & CICHON CHTD KELLEY KRONENBERG 246 18WC 19328 MALLEN, SUSAN ALLIED UNIVERSAL SECURITY 01/21/18 LEONARD LAW GROUP LLC GAROFALO SCHREIBER STORM GRA 247 18WC 19465 COOPER, COLLIES GUNITE CORP 03/23/18 BLACK & JONES RUSIN & MACIOROWSKI LTD 248 18WC 19648 KERO, TANNER CHICAGO BLACK HAWKS 02/18/18 GORDON LAW OFFICES LTD 249 18WC 20120 KEMPKE, WILL MR. ALBERT J TILFORD DBA W 05/22/18 BLACK & JONES 250 18WC 20280 WILLIAMS, MICHELLE GENERAL MILLS 01/11/16 GESMER & REYNOLDS PC BRYCE DOWNEY & LENKOV LLC 251 18WC 20290 HERTZNER, PAMELA FCA US LLC 06/08/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 252 18WC 20511 NORDHEIM, BRIANA FCA US LLC 02/02/18 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 16 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 253 18WC 20575 BALLUFF, KEVIN FAMILY DOLLAR 04/27/18 DWORKIN AND MACIARIELLO BRYCE DOWNEY & LENKOV LLC 254 18WC 20617 RODRIGUEZ, JOSE THOMPSON PIPE GROUP 05/30/18 GESMER & REYNOLDS PC LEAHY EISENBERG & FRAENKEL 255 18WC 20828 ROCHON, SERGE NATIONWIDE INBOUND, INC 12/12/17 GESMER & REYNOLDS PC RUSIN & MACIOROWSKI LTD 256 18WC 20890 TOVAR, ORMARI AEROTEK 06/26/18 FOOTE MIELKE CHAVEZ O'NEIL 257 18WC 21113 SANDS, NIKKI STATE OF IL @ 03/16/18 BLACK & JONES ASSISTANT ATTORNEY GENERAL 258 18WC 21498 DALLAS, LEE SWEDISH AMERICAN HOSPITAL 06/27/18 VASILATOS & COTTER LLC WILLIAMS MCCARTHY LLP 259 18WC 21924 MURO, ROSA TH FOODS 06/08/18 BOTTO GILBERT EVANS & DIXON 260 18WC 22227 LAMB, JANICE FCA US LLC 11/23/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 261 18WC 22673 BAILEY, BRANDON L AEROTEK INC 06/23/18 TUITE LAW LITCHFIELD CAVO 262 18WC 22694 YOUNG, SHANEKA GUNITE CORPORATION 07/25/18 DWORKIN AND MACIARIELLO RUSIN & MACIOROWSKI LTD 263 18WC 22857 RODRIGUEZ, IRMA SURESTAFF, INC 08/22/17 GOLDSTEIN AIOSSA & GOOD LOUIS MUNDY 264 18WC 23258 MOORE, DEBRETTA FCA US LLC 04/14/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 265 18WC 23261 FOREMAN, WHITNEY FCA US LLC 05/11/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 266 18WC 23767 MORRIS, TESS AEROTEK 05/20/18 DWORKIN AND MACIARIELLO SPIEGEL & CAHILL, PC 267 18WC 24013 LANDWEHR, VALERIE ED ETNYRE & CO. 07/27/18 BLACK & JONES CLARK FROST 268 18WC 24210 BRANDT, BEVAN AMS MECHANICAL SYSTEMS, I 06/27/18 NILSON STOOKAL GLEASON CAP GAROFALO SCHREIBER STORM GRA 269 18WC 24609 LETCHER, LAWRENCE PIZZA HUT 08/03/17 DWORKIN AND MACIARIELLO WOLFE & JACOBSON, LTD 270 18WC 24826 LEMUS, JESUS DAN DALPRA PROPERTY MANAG 05/12/18 KATZ FRIEDMAN EAGLE ET AL

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 17 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 271 18WC 24852 BRAVO, ALFONSO TOP DIE CASTING CO INC 04/11/18 LEONARD LAW GROUP LLC BRADY CONNOLLY & MASUDA PC 272 18WC 24859 O'HARA, KENNETH DHL EXPRESS USA INC 07/27/18 ANKIN LAW OFFICE HENNESSY & ROACH PC 273 18WC 24965 MCGEE, JAMAL CINTAS CORP 08/07/18 BLACK & JONES POWER & CRONIN LTD 274 18WC 25284 BAYLOR, TERESA CASEY'S GENERAL STORE 03/30/18 GESMER & REYNOLDS PC 275 18WC 25648 MASON, RACHEL RENT-A-CENTER 07/25/18 BLACK & JONES HENNESSY & ROACH PC 276 18WC 25851 HILL, TAMEKA FCA CHRYSLER 08/11/18 ARGIONIS & ASSOCIATES LLC WILLIAMS MCCARTHY LLP 277 18WC 26194 FEHR, DOUG FCA US LLC 10/05/17 BLACK & JONES WILLIAMS MCCARTHY LLP 278 18WC 26365 ROBINSON, MICHAEL FCA US LLC 07/30/18 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 279 18WC 26449 MILES, FRANCES ROSS DRESS FOR LESS 08/25/18 HORWITZ HORWITZ & ASSOC NYHAN BAMBRICK KINZIE & LOWR 280 18WC 26681 KNECHT, MICHAEL R USF HOLLAND INC 05/21/18 TUITE LAW HENNESSY & ROACH PC 281 18WC 26702 FLAHERTY, CASEY ROCKNEL FASTENER INC 08/21/18 DAVID W MARTAY INMAN & FITZGIBBONS 282 18WC 26873 SAUCEDO-CAMPOS, GONZALO ANCHOR HARVEY COMPONENTS, 08/18/18 COHN LAMBERT RYAN & SCHNEI HENNESSY & ROACH PC 283 18WC 26922 CULLINS, ERIC GUNITE CORP 04/15/18 BLACK & JONES RUSIN & MACIOROWSKI LTD 284 18WC 26925 STONECIPHER, DAWN ARAMARK UNIFORM SERVICES 08/03/18 BLACK & JONES INMAN & FITZGIBBONS 285 18WC 27070 CUSHMEER, ALONZO J BRENNTAG GREAT LAKES @ 12/27/17 NO ATTORNEY EVANS & DIXON, LLC 286 18WC 27461 LAUER, BRAD CHRYSLER CORPORATION 04/05/18 CAPRON & AVGERINOS PC WILLIAMS MCCARTHY LLP 287 18WC 27792 CHRISTOPHER, ANISSA LANDSTAR 08/17/18 BLACK & JONES LAWRENCE COZZI - LAW OFFICE 288 18WC 27838 JONES, DAVID YANGFENG AUTOMOTIVE INTER 08/19/18 BLACK & JONES HENNESSY & ROACH PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 18 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 289 18WC 28359 HOIUM, JORDY M FCA US LLC 09/03/17 TUITE LAW WIEDNER & MCAULIFFE LTD 290 18WC 28413 COOK, ROME PA PETERSON AT THE CITADE 07/06/18 BLACK & JONES 291 18WC 28530 VON GILLERN, JEAN H MACY'S RETAIL HOLDINGS IN 06/18/18 TUITE LAW BRYCE DOWNEY & LENKOV LLC 292 18WC 28556 PETERSEN, DONALD OSF ST ANTHONY MEDICAL CE 03/13/16 BLACK & JONES HINSHAW & CULBERTSON 293 18WC 28654 CASTANON, PAULINA ANDROID INDUSTRIES 03/01/18 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 294 18WC 28668 LYNCH, JASON AMERICAN ALUMINUM 07/26/18 SCHAFER DERANGO & CAIN 295 18WC 28764 COPPERNOLL, MICHELE CR ASSOCIATES 08/18/18 GESMER & REYNOLDS PC JOSEPH MARCINIAK 296 18WC 29103 LETCHER, DINEEN BBS GROUP, INC 08/24/18 DWORKIN AND MACIARIELLO QUINTAIROS PRIETO WOOD & BOY 297 18WC 29217 WILLIAMS, FRANCESCA FCA US LLC 06/16/18 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 298 18WC 29748 PARRINELLO, ANTHONY FCA US, LLC 07/10/18 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 299 18WC 29941 DIEHL, STEPHANIE YANFENG AUTOMOTIVE INTERI 09/26/18 KATZ FRIEDMAN EAGLE ET AL HENNESSY & ROACH PC 300 18WC 29942 DIEHL, STEPHANIE YANFENG AUTOMOTIVE INTERI 09/13/18 KATZ FRIEDMAN EAGLE ET AL HENNESSY & ROACH PC 301 18WC 30015 TEDRICK, REBECCA S MERCY HEALTH SYSTEM CORP 03/01/18 TUITE LAW WIEDNER & MCAULIFFE LTD 302 18WC 30581 CAUTHEN, JEFFERY FURST STAFFING 08/22/18 GESMER & REYNOLDS PC ACCIDENT FUND HOLDINGS 303 18WC 30666 COLBY, WILLIAM "BILL" FCA US LLC 08/01/18 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 304 18WC 30890 GADDIS, PAMELA (PAM) YANFENG AUTPMOTIVE INTERI 08/08/18 KATZ FRIEDMAN EAGLE ET AL HENNESSY & ROACH PC 305 18WC 31090 CARDENAS, SANDRA FERNANDE ANDROID INDUSTRIES 07/13/17 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 306 18WC 31116 CURRAN, ANTHONY R CITY OF ROCKFORD POLICE D 09/18/18 REESE & REESE HEYL ROYSTER VOELKER & ALLEN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 19 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 307 18WC 31269 CAUTHEN, JEFFERY FREEPORT SCHOOL DISTRICT 12/15/16 GESMER & REYNOLDS PC LAWRENCE COZZI - LAW OFFICE 308 18WC 31341 STUKENBERG, KIMBERLY OREGON COMM UNIT S.D. #22 05/29/18 SEIDMAN MARGULIS & FAIRMAN GAROFALO SCHREIBER STORM GRA 309 18WC 31384 PESCHANG, EDWARD H CITY OF ROCKFORD 02/28/17 GESMER & REYNOLDS PC HEYL ROYSTER VOELKER & ALLEN 310 18WC 31428 MYERS, BROOKE FCA US LLC 07/03/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 311 18WC 31466 GLOMB, MARY TACO BELL 09/11/18 BLACK & JONES HENNESSY & ROACH PC 312 18WC 31616 SHERER, DAVID ANDRITZ PAPER MACHINE 01/26/18 BLACK & JONES 313 18WC 31704 EDGESTON, JULIUS PHELPS INDUSTRIES 08/08/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 18WC031705 -C 314 18WC 31709 CARDENAS, SANDRA FERNANDE ANDROID INDUSTRIES 09/10/18 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 315 18WC 31799 GOBER, MELISSA FCA US, LLC 02/15/18 BLACK & JONES WILLIAMS MCCARTHY LLP 316 18WC 31856 COLBORNE, JOE COLORADO AVALANCHE 11/10/17 GORDON LAW OFFICES LTD HENNESSY & ROACH PC 18WC031857 -C 317 18WC 31951 SIMMONS, BRADLEY USF HOLLAND 10/04/18 BLACK & JONES HENNESSY & ROACH PC 318 18WC 31954 BARNES, BRANDON CARPENTER CONTRACTORS 05/29/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 319 18WC 32010 CARLSON, DANIEL FCA US LLC 09/10/18 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 320 18WC 32212 JOHNSON, JEREMY SPHERION STAFFING SERVICE 08/24/18 321 18WC 32384 MCDONOUGH, BRENDA PNC BANK 10/21/16 NASH LAW OFFICE PC 322 18WC 32437 CARRISON, JOHN W SUGAR RIVER MACHINE SHOP, 08/09/18 TUITE LAW NYHAN BAMBRICK KINZIE & LOWR 19WC017021 -C 323 18WC 32464 SINGMOUANGTHONG, TOON CITY OF ROCKFORD 09/13/18 GESMER & REYNOLDS PC HEYL ROYSTER VOELKER & ALLEN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 20 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 324 18WC 32844 GOMEZ, MARIA E MARTINEZ GALENA LODGING VENTRURES 09/08/18 COSTA IVONE LLC LAWRENCE COZZI - LAW OFFICE 325 18WC 32886 THOMPKINS, OMAR WP BEVERAGES LLC 07/18/18 BLACK & JONES 326 18WC 33015 FINKLEA, TASHA L PRESENCE LIFE CONNECTIONS 08/03/18 DWORKIN AND MACIARIELLO BRADY CONNOLLY & MASUDA PC 327 18WC 33072 ROGERS, ROYE OSF ST ANTHONY'S MEDICAL 08/23/18 LIPKIN & APTER HINSHAW & CULBERTSON 328 18WC 33255 ORTEGA, SERGIO CENTRAL RUBBER CO 07/23/18 BOTTO GILBERT MC ANDREWS & NORGLE LLC 329 18WC 33753 TENNIN, BEN PREMIUM TRANSPORTATION 02/26/18 BLACK & JONES WOLFE & JACOBSON, LTD 330 18WC 33771 JIMENEZ, JESUS ROCKFORD FASTENERS, INC 03/15/18 ANESI OZMON RODIN NOVAK KO HOLECEK & ASSOCIATES 331 18WC 34250 LEWIS, QUANTRELL ASSURED STAFFING INC 10/18/18 GESMER & REYNOLDS PC 332 18WC 34377 MC LIN, ROSETTA FCA US, LLC 05/14/18 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 333 18WC 34509 MELCHOR, SEBASTIAN VENUS PAINTING CO, C/O 08/13/18 HETHERINGTON KARPEL BOBBER RUSIN & MACIOROWSKI LTD 334 18WC 34618 PHINNESSEE, ROBERT MODERN ADVANCED MANUFACTU 06/07/18 DWORKIN AND MACIARIELLO KEEFE CAMPBELL BIERY & ASSOC 335 18WC 34737 WALLACE, DONALD DURAND COMMUNITY UNIT 09/24/18 KATZ FRIEDMAN EAGLE ET AL GAROFALO SCHREIBER STORM GRA 336 18WC 34974 BARNES, WILLIAM COMBINED ROOFING, INC 10/25/18 STEPHANIE WEISSMAN EDWARD J. KOZEL 337 18WC 35403 SNUGGERUD, LUC ROCKFORD ICE HOGS 11/02/18 GORDON LAW OFFICES LTD HENNESSY & ROACH PC 338 18WC 35517 ESTRELLA, DAVID ML FARM SYSTEMS, INC 11/16/18 COSTA IVONE LLC EVANS & DIXON 339 18WC 35747 MARTINEZ, ELADIO CARRASCO V & B TRUCKING, INC. 08/11/18 STEVEN B SALK & ASSOC LTD NYHAN BAMBRICK KINZIE & LOWR 340 18WC 35879 WYATT, MITCHELL A CALEDONIA HAULERS 11/12/18 PATRICOSKI, MARK G 341 18WC 36096 PUEZ, EDDY CONCENTRIC AB 11/29/18 DWORKIN AND MACIARIELLO JOSEPH MARCINIAK

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 21 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 342 18WC 36173 KERN, JEFFREY RYDER INTEGRATED LOGISTIC 11/16/18 SHANNON LAW GROUP HEYL ROYSTER VOELKER & ALLEN 343 18WC 36798 ROCHA, DAMIEN DANIE RUIZ 09/28/18 BLACK & JONES 344 18WC 36827 RODRIGUEZ, JOSE TOP DIE CASTING 02/06/18 GOLDBERG & DOHAN 345 18WC 36928 DENTON, AMANDA L AEROTEK, INC 11/01/18 TUITE LAW HENNESSY & ROACH PC 346 18WC 36964 ESPINOZA, BENJAMIN CMG PROPERTY MANAGEMENT, 08/18/17 GESMER & REYNOLDS PC NYHAN BAMBRICK KINZIE & LOWR 347 18WC 36970 TRAVIS, TAMMY FOREST CITY REHAB CE 10/31/18 BLACK & JONES BRADY CONNOLLY & MASUDA PC 348 18WC 37027 CASTANEDA, JULIAN THOMPSON PIPE GROUP- PRES 05/23/18 GESMER & REYNOLDS PC ROSARIO CIBELLA 349 18WC 37143 ROBINS, DAVID GREENLEE TEXTRON 02/01/18 BLACK & JONES GAROFALO SCHREIBER STORM GRA 350 18WC 37147 SCHMIDT, NICOLE MAGNA SERVICES OF AMERICA 10/10/18 BLACK & JONES POWER & CRONIN LTD 351 18WC 37272 APPLEBY, GALE INTERNATIONAL PAPER CO 10/06/18 BLACK & JONES GOLDBERG SEGALLA LLC 352 18WC 37442 CARLSON, KAREN OSF HEALTHCARE SYSTEM 07/18/18 GESMER & REYNOLDS PC HINSHAW & CULBERTSON 353 18WC 37535 BORNEMEIER, LISA HELP AT HOME, INC 10/11/18 GOLDBERG WEISMAN & CAIRO L 354 18WC 37584 WILLIAMS, BRIAN USF HOLLAND 05/03/18 BLACK & JONES HENNESSY & ROACH PC 355 18WC 37586 WILLIAMS, BRIAN USF HOLLAND 08/03/18 BLACK & JONES HENNESSY & ROACH PC 356 18WC 38042 MOORMAN, JEFFREY ILLINOIS DEPARTMENT @ 07/23/18 FRANKS, GERKIN & MCKENNA P ASSISTANT ATTORNEY GENERAL 357 18WC 38351 ORTIZ, JESUS OLD DOMINION FREIGHT LINE 09/07/18 GESMER & REYNOLDS PC EVANS & DIXON 358 18WC 38368 BOWEN, RACHEL ROSEWOOD CARE CENTER 12/13/18 KARCHMAR & STONE 359 18WC 38462 GUERRERO, MARTHA JONES NATURALS HOLDINGS I 09/14/18 GESMER & REYNOLDS PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 22 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 360 19WC 00008 WALLACE, LAUREN SECURITAS SECURITY SRVCS 12/11/18 ANGELINI & ORI LLC STONE & JOHNSON CHARTERED 361 19WC 00302 KEY, RITA ROCKFORD RESCUE MISSION 10/16/18 GESMER & REYNOLDS PC HEYL ROYSTER VOELKER & ALLEN 362 19WC 00612 FISH, JANICE BYRON SCHOOL DISTRICT #22 01/10/17 BLACK & JONES WIEDNER & MCAULIFFE LTD 363 19WC 00800 FLOREZ, KEVIN VELASQUEZ & SONS 04/03/18 ADRIAN MURATI 364 19WC 01011 WHITFORD, MARK JP CULLEN & SONS INC 11/05/18 GOLDBERG WEISMAN & CAIRO L EDWARD J. KOZEL 365 19WC 01170 RAAB, KIRK JO DAVIESS COUNTY SHERIFF 03/31/17 REYNOLDS & KENLINE LLP INMAN & FITZGIBBONS 19WC001171 -C 366 19WC 01202 PERKO, DIXIE KONECRANES/KCI HOLDING US 11/29/18 GOLDBERG WEISMAN & CAIRO L LAWRENCE COZZI - LAW OFFICE 367 19WC 01626 PARKS, JACKIE QPS EMPLOYMENT 10/11/18 GESMER & REYNOLDS PC WOLFE & JACOBSON, LTD 368 19WC 01640 RICHARDS, KIM R COUNTY OF WINNEBAGO 11/04/18 TUITE LAW WILLIAMS MCCARTHY LLP 369 19WC 01647 PARKS, JACKIE QPS EMPLOYMENT 12/12/18 BLACK & JONES WOLFE & JACOBSON, LTD 370 19WC 02010 AGUILERA, ELIZABETH DUNKIN DONUTS 06/28/18 GESMER & REYNOLDS PC LAWRENCE COZZI - LAW OFFICE 371 19WC 02014 ANDERSON, JOSHUA OGLE COUNTY SHERIFF'S DEP 10/15/18 BLACK & JONES INMAN & FITZGIBBONS 372 19WC 02046 KNIFFEN, DAVID WINNEBAGO CNTY SHERIFF'S 08/30/18 REESE & REESE WILLIAMS MCCARTHY LLP 373 19WC 02115 BECK, KIMBERLY THE CONNECTION 01/19/19 DWORKIN AND MACIARIELLO GRIFFIN, LORETTA M LAW OFFIC 374 19WC 02373 BROWN, THOMAS MIKE HARRIS MASONRY CONTR 06/08/16 HORWITZ HORWITZ & ASSOC RUSIN & MACIOROWSKI LTD 375 19WC 02581 STEELE, DARLENE J FURST STAFFING 07/24/18 PIGNATELLI & ASSOCIATES ACCIDENT FUND HOLDINGS 19WC002582 -C 376 19WC 02598 HAWBAKER, JANICE ACCEL ENTERTAINMENT INC 11/07/18 PIGNATELLI & ASSOCIATES WIEDNER & MCAULIFFE LTD 377 19WC 02634 PELLEY, TYRAN RAYNER COVERING SYSTEM 10/18/18 BLACK & JONES WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 23 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 378 19WC 02973 COTTRELL, JOSEPH R.L. LEEK INDUSTRIES 11/13/18 BLACK & JONES WOLFE & JACOBSON, LTD 379 19WC 03158 ZEHNER, WICHUDA HOME STAFF INC 01/08/18 GESMER & REYNOLDS PC GANAN & SHAPIRO 380 19WC 03174 MENDEL, MICHAEL FEDEX EXPRESS 02/02/16 GESMER & REYNOLDS PC 381 19WC 03270 NIETO, ETHELVINA YANFENG AUTOMOTIVE 03/03/18 GESMER & REYNOLDS PC 382 19WC 03384 DRAPER, DOUG HARRIS REBAR ROCKFORD INC 03/06/18 FREDERIC NESSLER & ASSOC WIEDNER & MCAULIFFE LTD 383 19WC 03408 LARSEN, TED LIEBOVICH BROTHERS 02/01/11 BLACK & JONES POULOS & DIBENEDETTO LAW 384 19WC 03411 BURIE, ELIZABETH ASPEN DENTAL 11/30/18 BLACK & JONES LAWRENCE COZZI - LAW OFFICE 385 19WC 03833 SHUMAN, BRODERICK FOSLER CONSTRUCTION 09/10/18 BRADY CONNOLLY & MASUDA PC 386 19WC 04113 VIDALES, DANIEL LUNG FUNG #2 01/13/19 GESMER & REYNOLDS PC JOSEPH MARCINIAK 387 19WC 04530 ALVAREZ, NICOLE FCA US LLC 12/13/18 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 388 19WC 04950 GROZDANOVIC, MIHAJLO THOMAS SERVICES, INC 02/11/19 GRAUER & KRIEGEL LLC WIEDNER & MCAULIFFE LTD 389 19WC 05063 KIELY, KIMBERLY M CITY OF ROCKFORD POLICE D 08/19/18 REESE & REESE HEYL ROYSTER VOELKER & ALLEN 390 19WC 05208 NEUBAUER, ALISSA K PARAMEDIC SERVICES OF ILL 12/04/18 REESE & REESE HENNESSY & ROACH PC 391 19WC 05242 CHASE, SARAH VALLEY MILL PUB AND GRILL W 07/20/18 BLACK & JONES 392 19WC 05246 SAYGO, LATRICA SIMOS INSOURCING SOLUTION 01/17/19 BLACK & JONES BRADY CONNOLLY & MASUDA PC 393 19WC 05249 VIVIAN, JENNIFER FCA US LLC 09/28/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 394 19WC 05263 JANICKE, KIMBERLY R SNAK KING 08/26/18 HAUSER LAW LLC 19WC005264 -C 395 19WC 05305 RUIZ, JUAN DANFOSS 02/07/19 DWORKIN AND MACIARIELLO WOLFE & JACOBSON, LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 24 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 396 19WC 05515 WILSON, CURT LOVES PARK POLICE DEPT 09/14/18 FOOTE MIELKE CHAVEZ O'NEIL NYHAN BAMBRICK KINZIE & LOWR 397 19WC 05657 KUCHER, JOSEPH FCA US LLC 02/01/19 BLACK & JONES WILLIAMS MCCARTHY LLP 398 19WC 05672 WADSWORTH, BRIAN CITY OF ROCKFORD POLICE D 12/21/16 GESMER & REYNOLDS PC HEYL ROYSTER VOELKER & ALLEN 399 19WC 05692 WUBBEN, RONALD STAR MANUFACTURING 10/05/18 BLACK & JONES CAPUANI, FRANK S 400 19WC 05852 MEYERS, CHARLES JR EVOLUTION STAFFING 01/02/19 DWORKIN AND MACIARIELLO 401 19WC 06050 LEVINE, DENA D CANDLEWICK LAKE ASSOCIATI 02/06/19 REESE & REESE 402 19WC 06104 KAUKE, KENNETH ROCKFORD SCHOOL DIST #205 10/02/18 CLARK FROST WIEDNER & MCAULIFFE LTD 403 19WC 06378 RUVOLO, MICHAEL J JR. STATE OF ILLINOIS DEPT OF @ 07/25/17 TUITE LAW ASSISTANT ATTORNEY GENERAL 19WC006379 -C 404 19WC 06588 CHASTEEN, CHERYL FORD TOOL & MACHINING LLC 06/11/18 GESMER & REYNOLDS PC JOSEPH MARCINIAK 19WC006589 -C 405 19WC 06622 BOWES, BRIAN CARDINAL STAFFING SERVICE 04/01/18 BLACK & JONES HENNESSY & ROACH PC 406 19WC 06657 MUNOZ, OMAR A MYERS INDUUSTRIES 02/20/19 HENNESSY & ROACH PC 407 19WC 06825 HOLZ, ALANDA BARKAU AUTOMOTIVE 02/08/18 MARKS INJURY LAW RUSIN & MACIOROWSKI LTD 408 19WC 06878 LEACH, JAMES MACLELLAN INTEGRATED SRVS 10/26/18 DOUGLAS RALLO PC KNELL LAW LLC 409 19WC 07044 LUAISA, JUAN ILLINOIS STATE POLICE @ 02/18/19 RIDGE & DOWNES ASSISTANT ATTORNEY GENERAL 410 19WC 07101 WILSON, PAMEKA L INSTACART 02/27/19 ANESI OZMON RODIN NOVAK KO KRAKER FANNING & OLSEN 411 19WC 07297 DEVOE, JEROME AUTOZONE INC 02/26/19 BLACK & JONES GILDEA, COGHLAN & REGAN LTD. 412 19WC 07526 CHAPMAN, BOBBI CHRYSLER ASSEMBLY PLANT 02/19/19 DWORKIN AND MACIARIELLO WILLIAMS MCCARTHY LLP 413 19WC 07634 STYTZ, JEFFREY COMCAST 02/27/19 KROL BONGIORNO & GIVEN LTD POWER & CRONIN LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 25 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 414 19WC 07672 OLSEN, DENNIS KRAUTER FOREST PRODUCTS, 10/11/18 GESMER & REYNOLDS PC HENNESSY & ROACH PC 415 19WC 07677 CHRONISTER, APRIL MTP INC 06/04/18 GESMER & REYNOLDS PC CHILTON YAMBERT PORTER LLP 416 19WC 07843 MEDINA, EDVIN HENRY LUCAS GONZALEZ 01/03/19 DWORKIN AND MACIARIELLO LAWRENCE COZZI - LAW OFFICE 417 19WC 07862 PATEL, NIRAL KD POS, INC 01/11/18 DWYER & COOGAN EDWARD J. KOZEL 418 19WC 08293 MARTINEZ, MARGARITA YANFENG AUTOMOTIVE INTERI 08/02/18 DWORKIN AND MACIARIELLO HENNESSY & ROACH PC 419 19WC 08459 LISTON, GINA SWEDISH AMERICAN HOSPITAL 06/01/18 GESMER & REYNOLDS PC WILLIAMS MCCARTHY LLP 420 19WC 08535 EDWARDS, DANIEL STANDARD FORWARDING LLC 02/19/19 GOLDBERG WEISMAN & CAIRO L HENNESSY & ROACH PC 421 19WC 08632 BRITNELL, BRIAN C CITY OF LOVES PARK 02/07/19 TUITE LAW POWER & CRONIN LTD 422 19WC 08731 RICE, NANCY SAM'S CLUB 02/14/19 GESMER & REYNOLDS PC QUINTAIROS PRIETO WOOD & BOY 423 19WC 08830 LOMAX, HOLLY A HERITAGE WOODS OF FREEPOR 01/01/19 HAUSER LAW LLC GOLDBERG SEGALLA LLC 424 19WC 08840 ELLIOTT, DAVID A JAMCO PRODUCTS INC 02/27/19 TUITE LAW HENNESSY & ROACH PC 425 19WC 08935 BROSHOUS, DERYL APPLE CANYON LAKE POA 04/23/18 BLACK & JONES GAROFALO SCHREIBER STORM GRA 19WC008936 -C 426 19WC 08967 EDGE, CLINTON BARNES INTERNATIONAL, INC 01/26/17 BLACK & JONES HOLECEK & ASSOCIATES 427 19WC 08974 GRUTTER, LYNNE PANERA BREAD 02/10/19 BLACK & JONES GILDEA, COGHLAN & REGAN LTD. 428 19WC 09031 CONRAD, STEVE FCA US, LLC 06/04/18 WILLIAMS MCCARTHY LLP 429 19WC 09094 HOIDAHL, ROGER DALE H LONG SCREW MACHINE 12/20/17 GESMER & REYNOLDS PC JOSEPH MARCINIAK 430 19WC 09386 DAVIS, ERICKA FCA US LLC 03/06/19 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 431 19WC 09469 JUAREZ, LILIA GENERAL MILLS 11/26/18 LEO ALT BRYCE DOWNEY & LENKOV LLC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 26 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 432 19WC 09513 SNOW, MARK YANGFENG AUTOMOTIVE INTER 12/12/18 BLACK & JONES HENNESSY & ROACH PC 433 19WC 09543 FLETCHER, JOSEPH JR. FCA US LLC 12/07/18 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 434 19WC 09632 BRUZAN, ELIZABETH "BETH" CARDINAL SERVICES LLC 02/14/19 TUITE LAW HENNESSY & ROACH PC 435 19WC 09648 KING, ANGELA STAFF ON SITE MIDWEST INC 12/18/18 DWORKIN AND MACIARIELLO 436 19WC 09791 MARTIN, ROB WIN-BUR-SEW FIRE DEPT 02/08/19 BLACK & JONES POWER & CRONIN LTD 437 19WC 09869 KALEN, SCOTT VIKING CHEMICAL CO 02/12/19 BLACK & JONES HENNESSY & ROACH PC 438 19WC 09906 SMITH, KERMIT BERNER FOOD & BEVERAGE 11/09/18 GESMER & REYNOLDS PC HOLECEK & ASSOCIATES 439 19WC 10111 MOORE, ROSE FREEWAY CORP 01/02/19 BLACK & JONES HENNESSY & ROACH PC 440 19WC 10263 THOMAS, TAUSHA ROCKFORD PUBLIC SCHOOLS 04/05/17 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 441 19WC 10375 ALLEN, LAURELL FCA US LLC 08/03/18 BLACK & JONES 442 19WC 10561 WOLFENBERG, ADAM GENERAL MILLS, INC 02/20/19 MC HARGUE & JONES BRYCE DOWNEY & LENKOV LLC 443 19WC 10578 PARROTT, RICHARD WOODS EQUIPMENT 03/08/19 BLACK & JONES GAROFALO SCHREIBER STORM GRA 444 19WC 10687 SABIN, JENNIFER LOWES HOME IMPROVEMENT 03/27/19 BLACK & JONES KEEFE CAMPBELL BIERY & ASSOC 445 19WC 10712 JURING, ANGELA FCA US LLC 02/08/19 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 446 19WC 10838 GARVEY, TOM A FCA US LLC 01/31/19 GESMER & REYNOLDS PC WILLIAMS MCCARTHY LLP 447 19WC 11362 EKQUIST, WILLIAM WOODS EQPMNT A/K/A BLOUNT 02/14/18 PIGNATELLI & ASSOCIATES WOLFE & JACOBSON, LTD 448 19WC 11628 GARIBAY, MARTHA FCA US LLC 03/05/19 BLACK & JONES WIEDNER & MCAULIFFE LTD 449 19WC 11816 BONNER, JACQUELINE ROCKFORD MASS TRANSIT DIS 03/24/19 GESMER & REYNOLDS PC POWER & CRONIN LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 27 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 450 19WC 11865 STORY, ROBERT L (WIDOW) ILLINOIS STATE POLICE # 03/28/19 MORICI FIGLIOLI & ASSOC ASSISTANT ATTORNEY GENERAL 451 19WC 11937 HILL, KEVIN PAUL POMP'S TIRE 04/11/18 BRASSFIELD KRUEGER & RAMLO GAROFALO SCHREIBER STORM GRA 452 19WC 12165 DAVIS, RICK QPS EMPLOYMENT GROUP 03/27/19 DWORKIN AND MACIARIELLO WOLFE & JACOBSON, LTD 453 19WC 12178 GARVEY, TOM A FCA US, LLC 04/10/19 GESMER & REYNOLDS PC WILLIAMS MCCARTHY LLP 454 19WC 12357 KOZUCH, KATHY MERCY HEALTH HOSP-RIVERSI 02/23/19 BLACK & JONES WIEDNER & MCAULIFFE LTD 455 19WC 12369 CABALLERO SALGADO, ALEJAN DIVERSIFIED SRVS FOR 04/15/16 TUITE LAW ACCIDENT FUND HOLDINGS 456 19WC 12372 ROMERO, CARLOS TRI STAR METALS 02/25/19 MARKS INJURY LAW HOLECEK & ASSOCIATES 457 19WC 12573 DICKENS, DARIUS SECURE STAFFING LLC 04/24/19 DWORKIN AND MACIARIELLO RIPES NELSON BAGGOT KALOBRAT 458 19WC 12762 RETTIG, BRIAN WOODWARD, INC 03/22/19 BLACK & JONES HINSHAW & CULBERTSON 459 19WC 12765 RAMOS, JUAN ROCKFORD TOOLCRAFT 03/20/19 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 460 19WC 12811 RIOS, MARY FCA US LLC 04/24/19 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 461 19WC 13011 NICHOL, NIKA PHELPS INDUSTRIES 03/22/19 DAVID W MARTAY 462 19WC 13096 UGARTE, YURIDIANA SPX FLOW 11/02/18 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 463 19WC 13116 RITTER, JAIMIE L MERCY HEALTH 12/14/18 REESE & REESE 464 19WC 13277 SMITH, ERICA CINTAS 03/28/19 SOSTRIN AND SOSTRIN PC POWER & CRONIN LTD 465 19WC 13326 MURPHY, CARIZMA FCA US LLC 12/20/18 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 466 19WC 13366 RODRIGUEZ, GUILLERMO CCA, INC 03/25/19 WOODRUFF JOHNSON WIEDNER & MCAULIFFE LTD 467 19WC 13404 MUNZ, SUSAN ROCKFORD PUBLIC SCHOOL 09/21/18 FABIANO LAW OFFICES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 28 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 468 19WC 13422 HACKENBURG, BRIAN NATIONAL FREIGHT INDUSTRI 04/11/19 BLACK & JONES QUINN JOHNSTON HENDERSON ETA 469 19WC 13425 RADCLIFFE, OFELIA SEWARD SCREW PRODUCTS 08/27/18 BLACK & JONES HOLECEK & ASSOCIATES 470 19WC 13451 WICKLEIN, MICHAEL USF HOLLAND 10/01/18 BLACK & JONES HENNESSY & ROACH PC 471 19WC 13999 ROLDAN, RODOLFO SYNCREON 10/13/18 KATZ FRIEDMAN EAGLE ET AL GAROFALO SCHREIBER STORM GRA 472 19WC 14226 MELENDEZ, LUIS ALBERTO GO MASTER ROOFING AND REMODE 02/02/19 JAMES URTIS BRADY CONNOLLY & MASUDA PC 473 19WC 14352 REYNOLDS, ANNETTE PHELPS INDUSTRIES 03/01/19 BLACK & JONES GRIFFIN, LORETTA M LAW OFFIC 474 19WC 14360 MANDUJANO, ADAM MIKE HARRIS MASON CONTRAC 10/15/18 BLACK & JONES GANAN & SHAPIRO 475 19WC 14363 VAZQUEZ, SUSAN BERGSTROM CLIMATE SYSTEMS 11/01/18 BLACK & JONES WOLFE & JACOBSON, LTD 476 19WC 14421 MILLER, DAWN ST ANNE CENTER 04/26/19 GESMER & REYNOLDS PC NYHAN BAMBRICK KINZIE & LOWR 477 19WC 14481 BEHRS, ANDREW U.S. XPRESS, INC. 04/25/19 MARKHAM M JEEP & ASSOCIATE HENNESSY & ROACH PC 478 19WC 14973 ARELLANO, JOANNA BARBARA OLSEN CENTER OF H 11/28/18 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 479 19WC 14978 BABCOCK, MELODY FREEPORT SCHOOL DISTRICT 10/05/18 BLACK & JONES EVANS & DIXON 480 19WC 14985 HILL, MARILYN SYNCREON 04/23/19 BLACK & JONES KEEFE CAMPBELL BIERY & ASSOC 481 19WC 15155 GOMEZ, FRANCISCO ASPLUNDH TREE EXPERT CO 04/06/19 DWORKIN AND MACIARIELLO KNELL O'CONNOR DANIELWICZ 482 19WC 15256 SMITH, THERESA GE AVIATION 04/19/19 GESMER & REYNOLDS PC RUSIN & MACIOROWSKI LTD 483 19WC 15675 WHITE, DONNA CVS 02/15/19 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 484 19WC 15684 DAVIS, LORRAINE E GALENA LODGING VENTURES I 04/02/18 HAUSER LAW LLC LAWRENCE COZZI - LAW OFFICE 19WC015685 -C 485 19WC 16099 GARCIA, CUSTODIO MULLER PINEHURST DAIRY, I 10/30/17 MARKS INJURY LAW HENNESSY & ROACH PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 29 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 486 19WC 16305 LOCKIE, SANDRA FAIR OAKS HEALTH CARE CEN 07/08/18 BLACK & JONES ACCIDENT FUND HOLDINGS 487 19WC 16319 DAMKEN, JOHN CDV CORPORATION 02/11/19 ALEXANDER, PETER LTD. 488 19WC 16621 CROFT, MICHAEL FCA US LLC 02/28/19 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 489 19WC 16882 MATTOX, CYNTHIA HARLEM UNIT SCHL DISTRICT 05/29/19 MC HARGUE & JONES NYHAN BAMBRICK KINZIE & LOWR 490 19WC 17130 WENTLAND, ALBERT HORIZON CARPENTRY 02/20/19 BLACK & JONES WIEDNER & MCAULIFFE LTD 491 19WC 17150 ANDERSON, ERIK MEGAFAB 12/20/18 BLACK & JONES LAWRENCE COZZI - LAW OFFICE 492 19WC 17452 CLARK, DEON QPS EMPLOYMENT 06/04/19 DWORKIN AND MACIARIELLO WOLFE & JACOBSON, LTD 493 19WC 17712 PORTER, TREMAYNE LOVES TRAVEL STOP 05/06/19 DWORKIN AND MACIARIELLO ROSARIO CIBELLA 494 19WC 17844 PETERS, SHEREEN OLD NAVY 11/01/18 DWORKIN AND MACIARIELLO 495 19WC 17897 SCHROEDER, JORDAN ROCKFORD ICE HOGS 11/01/18 GORDON LAW OFFICES LTD HENNESSY & ROACH PC 496 19WC 17962 WAIBEL, SABRINA FCA US, LLC 02/07/19 BLACK & JONES WIEDNER & MCAULIFFE LTD 497 19WC 17966 MC QUALITY, CHAD ROSEWOOD CARE CENTER 01/18/19 BLACK & JONES 498 19WC 17973 SOWELL, STEWART ANDROID INDUSTRIES 02/15/19 BLACK & JONES WIEDNER & MCAULIFFE LTD 499 19WC 17976 CRAIG, CHARLES ROCK RIVER DISPOSAL 05/31/19 BLACK & JONES BRADY CONNOLLY & MASUDA PC 500 19WC 18094 PEARSON, THOMAS J SYNCREON NORTH AMERICA IN 12/06/18 TUITE LAW GAROFALO SCHREIBER STORM GRA 501 19WC 18137 MITCHELL, GEORGIA SNAK KING 02/28/19 DWORKIN AND MACIARIELLO GOLDBERG SEGALLA LLC 502 19WC 18235 HOLLOWAY, TRICI CHRYSLER 05/14/19 BRASSFIELD KRUEGER & RAMLO WIEDNER & MCAULIFFE LTD 503 19WC 18303 NEECE, MARTY SYNCREON 02/02/19 KATZ FRIEDMAN EAGLE ET AL

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 30 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 504 19WC 18505 HUNDLEY, DAVID J GENERAL TAYLOR 07/23/18 REESE & REESE RUSIN & MACIOROWSKI LTD 505 19WC 18559 TOWNSEND, MIESHA JAVON BEA HOSPITAL 02/01/19 DWORKIN AND MACIARIELLO 506 19WC 18654 STAGGS, BRIAN CHEMTOOL, INC. 02/08/19 HEDEEN, MICHAEL J PC 507 19WC 18778 LEMBKE, JAMESA HERITAGE CARPENTRY, INC 01/02/19 TUITE LAW KOPKA, PINKUS DOLIN, PC 19WC018789 -C 508 19WC 18939 GLOYD, CHARLES SUPERIOR JOINING TECH 04/09/19 DERANGO & CAIN 509 19WC 18949 EDWARDS, REGINA FCA US LLC 06/25/18 BLACK & JONES WILLIAMS MCCARTHY LLP 510 19WC 19155 KELLER, RANDALL ARKA EXPRESS, INC. 05/15/19 DEPAOLO & ZADEIKIS KRAKER FANNING & OLSEN 511 19WC 19377 MICHMERSHUIZEN, KYLE FCA US LLC 05/28/19 RIDGE & DOWNES WIEDNER & MCAULIFFE LTD 512 19WC 19392 CARLSON, JORDAN R&D THIEL 03/25/19 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 513 19WC 19431 STUNDZIA, OSKARAS CITY OF ROCKFORD POLICE D 11/09/18 REESE & REESE HEYL ROYSTER VOELKER & ALLEN 514 19WC 19518 ESCOBAR, CARLOS RAMON AXIUM FOODS INC 02/20/19 DWORKIN AND MACIARIELLO WARMOUTH LAW PC 515 19WC 19521 VARGAS, DAVID AMERICAN ALUMINUM EXTRUSI 06/20/19 ERIC H CHECK, LAW OFFICES KRAKER FANNING & OLSEN 516 19WC 19699 JOHNSON, DEVIN ANDROID INDUSTRIES 01/10/19 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 517 19WC 19809 DEBOER, KYLE BUCK SHOT RIDGE FARM AND 01/21/19 PIGNATELLI & ASSOCIATES INMAN & FITZGIBBONS 518 19WC 19891 CANCEL, SAMUEL SPG INTERNATIONAL 06/28/19 DWORKIN AND MACIARIELLO 519 19WC 20430 GOODALL, LAURA MEIJER 07/09/19 DWORKIN AND MACIARIELLO KOPKA, PINKUS DOLIN, PC 520 19WC 20454 WARMOTH, PAMELA E ECOLAB PRODUCTION LLC 10/02/18 TUITE LAW KEEFE CAMPBELL BIERY & ASSOC 521 19WC 20529 LEWIS, CHERYL YOUTH SERVICES NETWORK, I 02/16/19 LEONARD LAW GROUP LLC HENNESSY & ROACH PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 31 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 522 19WC 20713 NIERNBERG, AMY FCA US LLC 03/09/19 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 523 19WC 20771 THOMAS, PAMELA RIVER BLUFF NURSING HOME 03/24/19 BOWMAN & CORDAY WILLIAMS MCCARTHY LLP 524 19WC 20984 WASHINGTON, JASON EDWARD ROSE & SONS, LLC 06/05/19 ADRIAN MURATI 525 19WC 21040 ARAUJO, GORIS JONE'S NATURAL CHEWS 05/05/19 DWORKIN AND MACIARIELLO 526 19WC 21143 DELA ROSA, TAMMY FCA US, LLC 06/20/19 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 527 19WC 21241 PEREZ, LUIS MIGUEL ROCKFORD TOOLCRAFT 11/27/18 MICHELLE L. LANDON LLC NYHAN BAMBRICK KINZIE & LOWR 528 19WC 21279 RAMIREZ, JOSE D PIERCE DISTRIBUTION SERVI 05/07/19 BLACK & JONES WIEDNER & MCAULIFFE LTD 529 19WC 21282 PENHALLEGON, JAMES KOLB-LENA CHEESE COMPANY 05/19/18 BLACK & JONES KEEFE CAMPBELL BIERY & ASSOC 530 19WC 21393 EVANS, CHAD SULLIVAN'S FOODS 07/16/19 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 531 19WC 21530 VOSS, BRENT R MFC-RPC NEWCO, LLC 04/29/19 TUITE LAW 532 19WC 21664 MARTINEZ, AMY UPS CUSTOMER CENTER 06/20/19 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 533 19WC 21787 MAUERMAN, CATHY J DOLLAR TREE STORES, INC. 12/30/17 TUITE LAW LEAHY EISENBERG & FRAENKEL 534 19WC 21830 BECKON, RYAN WINNEBAGO COUNTY 02/07/19 BLACK & JONES WILLIAMS MCCARTHY LLP 535 19WC 21879 MARTINEZ, FROILAN OAKLEY SUB ASSEMBLY 06/17/19 MARTIN V KUGIA ACCIDENT FUND HOLDINGS 536 19WC 21911 ARNOLD, ANDREW AMERICAN ALUMINUM EXTRUSI 06/28/19 DWORKIN AND MACIARIELLO KRAKER FANNING & OLSEN 537 19WC 21983 HALL, MATTHEW ROCKFORD FOUNDRY 02/15/19 GESMER & REYNOLDS PC 538 19WC 22035 PERRY, TATYANA PINNACLE LOGISTICS 07/15/19 DWORKIN AND MACIARIELLO HENNESSY & ROACH PC 539 19WC 22189 DE LOS SANTOS, BENITO APA AZZ GALVANIZING 04/19/19 BLACK & JONES WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 32 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 540 19WC 22211 ABARCA, JUAN FIESTA MARKET 06/15/19 BLACK & JONES INMAN & FITZGIBBONS 541 19WC 22544 CURTIS, STEPHANIE SALVATIN ARMY 07/20/19 GESMER & REYNOLDS PC EVANS & DIXON 542 19WC 22703 TOBLER, BRIAN DAYTON FREIGHT 06/20/19 BLACK & JONES GANAN & SHAPIRO 19WC035596 -C 543 19WC 22891 ALMANZA, LUIS TAYLOR COMPANY 11/14/17 RUSIN & MACIOROWSKI LTD 544 19WC 22978 WOODCOCK, TIMOTHY R BOZEMAN ENTERPRISES, LLC 10/01/17 TUITE LAW 545 19WC 22993 BOGARDUS, JOHN ECOLAB 07/06/18 BLACK & JONES KEEFE CAMPBELL BIERY & ASSOC 546 19WC 22999 LEWANDOWSKI, JENNIFER MONDELEZ 08/05/17 BLACK & JONES 547 19WC 23008 MORALES, RAFAEL SPX FLOW INC 10/31/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 548 19WC 23011 CURRY, ALBERT FCA US LLC 08/23/17 BLACK & JONES WILLIAMS MCCARTHY LLP 549 19WC 23017 PELLEY, TYRAN RAYNER COVERING SYSTEMS, 01/30/18 BLACK & JONES 550 19WC 23043 SESTIC, ZEHRA ADVATABE VALET PARKING, I 07/12/19 GESMER & REYNOLDS PC 551 19WC 23103 DECKER, GERALD AMERICOLD LOGISTICS 03/28/19 CAPRON & AVGERINOS PC 552 19WC 23470 CARGILL, RYAN C USF HOLLAND, INC 11/20/18 ANESI OZMON RODIN NOVAK KO 553 19WC 23568 MERRILLS, HASHAUN UNITED DELIVERY SERVICE 08/02/19 DWORKIN AND MACIARIELLO 554 19WC 23820 MARTINEZ, AMY UPS 06/20/19 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 555 19WC 23823 WILSON, LINVAL MODERN PLATING 08/31/18 BLACK & JONES HOLECEK & ASSOCIATES 19WC023824 -C 556 19WC 23931 HALL, JEFFRY A COUNTY OF WINNEBAGO ILLIN 02/04/19 TUITE LAW WILLIAMS MCCARTHY LLP 557 19WC 23983 MILES-RIVERA, ROSA SPIDER CO 10/24/18 KATZ FRIEDMAN EAGLE ET AL

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 33 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 558 19WC 24167 HILL, SARA UPS ROCKFORD 06/08/19 MARTIN V KUGIA NYHAN BAMBRICK KINZIE & LOWR 559 19WC 24663 DELGADO, GUILLERMO ALTER TRADING CORP 04/24/19 BLACK & JONES MC ANDREWS & NORGLE LLC 560 19WC 24672 SEXTON, JOHNETTE RIVER BLUFF NURSING HOME 01/13/17 BLACK & JONES WILLIAMS MCCARTHY LLP 561 19WC 24677 BOEHNING, LUKE SYNCREON 06/12/19 BLACK & JONES KEEFE CAMPBELL BIERY & ASSOC 562 19WC 24778 ROLDAN, RODOLFO SYNCREON 06/25/19 KATZ FRIEDMAN EAGLE ET AL GAROFALO SCHREIBER STORM GRA 563 19WC 24911 RAMIREZ, JOSE M GUNITE CORPORATION 05/30/19 TUITE LAW RUSIN & MACIOROWSKI LTD 564 19WC 25057 WESSNER, HARLEY CITY OF ROCKFORD 03/23/19 FOOTE MIELKE CHAVEZ O'NEIL HEYL ROYSTER VOELKER & ALLEN 565 19WC 25070 CASTRO, JOHN JR. FCA US LLC 07/03/18 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 566 19WC 25298 FERRELL, ORION BRANNISHA DOMINO'S 07/26/19 STEVEN J MALMAN & ASSOCIAT INMAN & FITZGIBBONS 567 19WC 25348 SORRELLS, GARY FCA US LLC 05/14/19 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 568 19WC 25475 GOOD, ROY SYNCREON 04/02/19 BLACK & JONES KEEFE CAMPBELL BIERY & ASSOC 569 19WC 25560 COLEMAN, SANDRA FCA US, LLC 08/21/19 GESMER & REYNOLDS PC WILLIAMS MCCARTHY LLP 570 19WC 25775 JOHNSON, JOSHUA FATHER AND SON VENTURES L 07/30/19 DWORKIN AND MACIARIELLO 571 19WC 25882 TUCKER, LASHAWNDA SYNCREON 08/14/19 GESMER & REYNOLDS PC 572 19WC 25898 ROWE, ANGELA, F/K/A JOHNSON OIL COMPANY 02/10/17 BLACK & JONES GANAN & SHAPIRO 573 19WC 26164 ASKELAND, SUSAN ROCKFORD ELECTION COMMISS 02/21/17 BLACK & JONES KOPKA, PINKUS DOLIN, PC 574 19WC 26174 MCNEELY, MICHAEL COMED 10/16/18 BLACK & JONES HENNESSY & ROACH PC 575 19WC 26556 CIMINO, PATRICK DIAL MACHINE, INC. 02/28/19 JOSEPH MARCINIAK

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 34 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 576 19WC 26563 CROCKER, KAMARA UPS 10/01/18 NYHAN BAMBRICK KINZIE & LOWR 577 19WC 26564 WALLIS, VICTOR MCVEIGH'S TRUCK CENTER, I 08/31/16 NYHAN BAMBRICK KINZIE & LOWR 578 19WC 26708 ZAMBRANO, MARIA LUISA LA QUINTA INN & SUITES 05/28/19 DEPAOLO & ZADEIKIS 579 19WC 26799 NELSON, KAREN FLYING J TRUCK STOP 06/16/19 BLACK & JONES WIEDNER & MCAULIFFE LTD 580 19WC 26802 DUGGER, FRANKLIN USF HOLLAND 03/07/17 BLACK & JONES HENNESSY & ROACH PC 581 19WC 26806 FLORES, IGNACIO DIDIER GREENHOUSES 06/25/19 BLACK & JONES GAROFALO SCHREIBER STORM GRA 582 19WC 26842 HAYS, JEAN ANN ERJ DINING D.B.A. CHILIS 02/15/18 TUITE LAW HENNESSY & ROACH PC 583 19WC 26870 SPRING, SCOTT UTC AEROSPCE SYSTEMS/ 07/17/18 CLARK FROST RUSIN & MACIOROWSKI LTD 584 19WC 26993 CLAY, DEANNE BYRON SCHOOL DISTRICT #22 09/24/18 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 585 19WC 27059 MATSEY, VERONICA GENERATIONS AT NEIGHBORS 09/03/19 DWORKIN AND MACIARIELLO PAUL O WATKISS 586 19WC 27103 SANDOVAL, ANTONIO LA-TARA PIZZA, INC/ 12/20/18 LAWRENCE COZZI - LAW OFFICE 587 19WC 27135 GONZALEZ, EVA ROCKFORD TOOLCRAFT, INC 10/19/17 TUITE LAW NYHAN BAMBRICK KINZIE & LOWR 588 19WC 27157 MOORE, KAYETTA BERGSTROM 07/09/18 GESMER & REYNOLDS PC WOLFE & JACOBSON, LTD 589 19WC 27246 JOHNSON, CYNTHIA L HUGHES RESOURCES 03/13/19 GESMER & REYNOLDS PC SLAVIN & SLAVIN 590 19WC 27372 BELMONTES, ROGELIO ADVANCE MACHINIG & ENGINE 08/12/19 GESMER & REYNOLDS PC HENNESSY & ROACH PC 591 19WC 27440 BRYANT, JAMES FCA US LLC 06/07/18 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 592 19WC 27521 SWANSON, TIMOTHY FITZGERALD EQUIPMENT CO I 01/02/18 RIPES NELSON BAGGOT KALOBRAT 593 19WC 27617 JIMENEZ, GABRIEL FCA US LLC 07/10/19 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 35 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 594 19WC 28128 WASHINGTON, HENRIETTA ANDROID INDUSTRIES 02/23/18 DWORKIN AND MACIARIELLO 595 19WC 28246 VEUGELER, MATTHEW BLACK DIAMOND PLUMBING AN 04/30/18 TARADASH LAW OFFICE 596 19WC 28280 WALLACE, BRETT A WOODWARD INC 04/30/19 TUITE LAW HINSHAW & CULBERTSON 597 19WC 28366 BUCZKOWSKI, ANDRZEJ COTTA TRANSMISSION COMPAN 07/10/19 GESMER & REYNOLDS PC GAROFALO SCHREIBER STORM GRA 598 19WC 28480 SIMPSON, PAMELA IL STATE OF TOLL HWY AUTH @ 03/18/19 BAUM RUFFOLO & MARZAL LTD 599 19WC 28605 ROQUET, SUZANNE MCDONALD'S DBA TRIPPCO, L 07/01/19 BRASSFIELD KRUEGER & RAMLO GANAN & SHAPIRO 600 19WC 28609 WARREN, LANA MOSAIC 01/01/18 BLACK & JONES GAROFALO SCHREIBER STORM GRA 19WC028611 -C 601 19WC 28624 MUNOZ, ERNESTO JAVIER NORTHWEST PALLET SUPPLY C 08/19/19 BLACK & JONES WIEDNER & MCAULIFFE LTD 602 19WC 28663 SINGH, SURINDERPAL FCA US LLC 07/01/19 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 603 19WC 28878 KOLB, MICHAEL REYNOLD'S TRUCKING 02/09/19 BART DURHAM 604 19WC 29049 GREEN, PATRICK BRAND ENERGY SERVICES, LL 09/09/19 GWC INJURY LAWYERS LLC GOLDBERG SEGALLA LLC 605 19WC 29075 STARK, GLENN FCA US, LLC 01/07/19 WIEDNER & MCAULIFFE LTD 606 19WC 29268 ALLEN, TERRA M KRISTI NEUBAUER DBA FIRST 02/11/19 TUITE LAW WIEDNER & MCAULIFFE LTD 607 19WC 29284 PARNELLO, TINA WHITE POINT HOLDINGS 07/26/19 DERANGO & CAIN WIEDNER & MCAULIFFE LTD 608 19WC 29302 MCGUINESS, OWEN E CITY OF ROCKFORD 09/24/19 GESMER & REYNOLDS PC 609 19WC 29503 ALBANK, AHMED PIERCE DISTRIBUTION SRVCS 05/08/19 GESMER & REYNOLDS PC 610 19WC 29519 SANDERS, LAZUNDA ROCKFORD SCHOOL DIST 205 08/01/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 611 19WC 29627 FERNANDEZ, ALBERTO HARLEM SCHOOL DISTICT #12 08/06/18 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 36 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 612 19WC 29666 FURMAN, CRAIG LIEBOVICH BROS, INC 06/06/17 DWORKIN AND MACIARIELLO 613 19WC 29683 SANCHEZ, JEREMY RIVER CITY MILL WORK 09/16/19 BLACK & JONES 614 19WC 29687 GEIST, RICKY RL LEEK INDUSTRIES 12/01/18 BLACK & JONES 615 19WC 29690 SPANGLER, KENNETH QUALITY METAL FINISHING C 04/30/19 BLACK & JONES RIPES NELSON BAGGOT KALOBRAT 616 19WC 29860 WHITE, STANLEY MET LIFE AUTO & HOME INSU 02/19/19 RATHBUN CSEVENYAK & KOZOL 617 19WC 29929 MILLER, JEFFREY H CITY OF GALENA 08/20/18 NYHAN BAMBRICK KINZIE & LOWR 618 19WC 29983 MELENDEZ, AIXA YARIS CUPPACK PACKIGIN INC, A/K 10/07/19 STROM & ASSOC HENNESSY & ROACH PC 619 19WC 30114 COX, WILLIAM CATHOLIC DIOCESE OF ROCKF 09/13/19 MILLON & PESKIN LTD KEEFE CAMPBELL BIERY & ASSOC 620 19WC 30178 MCLIN, ROSEZETTA FCA US LLC 10/10/18 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 621 19WC 30402 PEDICINI, ALEXANDRA PINNACLE LOGISTICS 03/21/19 GESMER & REYNOLDS PC 622 19WC 30584 LAWRENCE, TANYA FAMILY DOLLAR 10/04/19 STEVEN J MALMAN & ASSOCIAT NYHAN BAMBRICK KINZIE & LOWR 623 19WC 30676 THORNTON, PARTENIA L SODEXO INC SDH EDUCATION 09/18/19 TUITE LAW 624 19WC 30949 EDWARDS, JAMES OWENS CORNING 10/21/19 DWORKIN AND MACIARIELLO 625 19WC 31067 ERDMIER, GREG GLEASON CUTTING TOOLS 11/06/18 GESMER & REYNOLDS PC LAWRENCE COZZI - LAW OFFICE 626 19WC 31109 CICCONE, BRIAN MAGNA EXTERIORS 10/03/19 BLACK & JONES POWER & CRONIN LTD 627 19WC 31313 CRADIC, BENJAMIN SHERWIN WILLIAMS COMPANY 09/08/19 GESMER & REYNOLDS PC 628 19WC 31361 ABARCA, JUAN FIESTA MARKET 06/15/19 BLACK & JONES INMAN & FITZGIBBONS 629 19WC 31493 RUSHING, RACHEL FCA US LLC 09/30/19 KATZ FRIEDMAN EISENSTEIN WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 37 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 630 19WC 31734 WARRINGTON, AMANDA D SUPERIOR AIR GROUND 09/07/19 TUITE LAW POWER & CRONIN LTD 631 19WC 31766 RALEIGH, TANYA ROCKFORD TOOL CRAFT 10/14/19 DWORKIN AND MACIARIELLO NYHAN BAMBRICK KINZIE & LOWR 632 19WC 31804 KISSICK, BRIAN FCA US LLC 08/09/19 BLACK & JONES 633 19WC 31818 MOATE, ONICA FCA US LLC 07/25/18 BLACK & JONES WIEDNER & MCAULIFFE LTD 634 19WC 31821 BOHN, JORDAN WARNER ROOFING 07/16/19 BLACK & JONES GANAN & SHAPIRO 635 19WC 31838 MARSCHALL, LISA UNITED PARCEL SVC 10/10/19 LAWFIRST NYHAN BAMBRICK KINZIE & LOWR 636 19WC 31958 WERNER, JACQUELINE GALENA MIDDLE SCHOOL 09/19/19 GWC INJURY LAWYERS LLC INMAN & FITZGIBBONS 637 19WC 32128 VILLA AVALOS, MARIANO LAKESHORE RECYCLING 08/01/19 LEONARD LAW GROUP LLC 638 19WC 32321 HUMPHREYS, KEVIN ADVANCED DISPOSAL 10/02/19 GWC INJURY LAWYERS LLC INMAN & FITZGIBBONS 639 19WC 32658 SCHEIDEGGER, LAURIE SWEDISH AMERICAN HOME 10/21/19 DWORKIN AND MACIARIELLO WILLIAMS MCCARTHY LLP 640 19WC 32964 AKRE, DAWN MCDONALDS CORP 11/01/18 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 641 19WC 32984 BRACY, LEE FAIRWAY FORD LINCOLN INC 09/01/19 BLACK & JONES KRAKER FANNING & OLSEN 642 19WC 32985 BRACY, LEE FAIRWAY FORD LINCOLN INC 10/18/19 BLACK & JONES KRAKER FANNING & OLSEN 643 19WC 32994 MILLER II, BENJAMIN AECOM 06/01/17 BLACK & JONES HENNESSY & ROACH PC 644 19WC 33321 GOEBEL, MELINDA SNAK KING 06/01/18 GOLDBERG SEGALLA LLC 645 19WC 33346 RAGLAND, LESLEY SUPERIOR AIR GROUND AMBUL 10/05/19 FRANKS, GERKIN & MCKENNA P POWER & CRONIN LTD 646 19WC 33416 ALDRIDGE, JEFF RRB FABRICATIONS 06/11/19 GESMER & REYNOLDS PC 647 19WC 33461 SZYMANSKI, KATELYN ESTWING MANUFACTURING CO 08/12/19 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 38 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 648 19WC 33557 SAENZ, ALICIA YANFENG AUTOMOTIVE INTERI 10/02/19 BLACK & JONES 649 19WC 33561 SYPHOMMARATH, VONGSAVANH ROCKFORD SPRING CO 06/01/19 BLACK & JONES KEEFE CAMPBELL BIERY & ASSOC 650 19WC 33860 HOLLIMAN, LATRESE UPS 11/19/19 DWORKIN AND MACIARIELLO NYHAN BAMBRICK KINZIE & LOWR 651 19WC 33953 BROOKS, ANTHONY J.B. HUNT 10/07/19 CHRISTOPHER FREEMAN 652 19WC 33974 GWALTNEY, MICHELLE SODEXO 11/04/16 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 653 19WC 34058 WILLIAMS, FORLICIA RUST-OLEUM CORPORATION 11/09/19 ANESI OZMON RODIN NOVAK KO 654 19WC 34153 PEOPLES, MARCUS J ROCKFORD POWER TRAIN 10/25/19 REESE & REESE JOSEPH MARCINIAK 655 19WC 34192 SANDERS, TAYLOR MARTIN AUTOMATIC INC 05/09/19 DWORKIN AND MACIARIELLO 656 19WC 34374 DECOTO, JAMES MR. BULTS, INC. 05/29/18 CARAS LAW GROUP 657 19WC 34397 EDWARDS, CHERYL FCA US LLC 09/25/18 KATZ FRIEDMAN EISENSTEIN WILLIAMS MCCARTHY LLP 658 19WC 34594 METRAS, JESSICA MCDONALD'S 11/24/19 DWORKIN AND MACIARIELLO NYHAN BAMBRICK KINZIE & LOWR 659 19WC 34706 BOLTON, AUBREE EASTER SEALS 09/06/19 GESMER & REYNOLDS PC 660 19WC 34751 GHAREEB, ISMAIL YANFENG AUTOMOTIVE INTERI 09/03/19 DWORKIN AND MACIARIELLO HENNESSY & ROACH PC 661 19WC 34753 DOMYSLAWSKI, JERZY USF HOLLAND 01/01/18 BLACK & JONES HENNESSY & ROACH PC 662 19WC 34763 DUGGER, FRANKLIN USF HOLLAND 09/23/19 BLACK & JONES HENNESSY & ROACH PC 663 19WC 34765 ROCHA, ROBERTO HENNIG INC 05/10/19 BLACK & JONES HENNESSY & ROACH PC 664 19WC 34766 LOCKETT, REGINALD RAYNOR COVERING SYSTEMS 10/10/19 BLACK & JONES BRADY CONNOLLY & MASUDA PC 665 19WC 34944 MAYTON, JUSTIN KURTZ PARAMEDICS SERVICE 05/11/17 GESMER & REYNOLDS PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 39 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 666 19WC 35117 ESCAMILLA, TIARA FCA ASSEMBLY PLANT 11/06/19 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 667 19WC 35123 MARKEN, KEVIN PEARL VALLEY FARMS, INC 04/29/19 DWORKIN AND MACIARIELLO KOPKA, PINKUS DOLIN, PC 668 19WC 35259 MAURER, MICHAEL NICOR GAS COMPANY 08/01/19 EAMES LAW GROUP LTD ASA LAW GROUP 669 19WC 35382 FISCHER, RAYMOND TRI-DIM FILTER CORP 09/18/19 BLACK & JONES 670 19WC 35386 RIVERA, MANUEL SAIA LTL FREIGHT 11/01/19 BLACK & JONES 671 19WC 35471 PATLAN BALDERAS, SERAFIN ELIZABETH ACOSTA 10/07/19 TUITE LAW 672 19WC 35553 MAINS, PAUL D MARKLEY INVESTIGATIONS IN 02/10/19 GESMER & REYNOLDS PC 673 19WC 35592 SAFRANEK, CRAIG MONDELEZ GLOBAL 10/15/19 BLACK & JONES WIEDNER & MCAULIFFE LTD 674 19WC 35599 POWELL, BARBARA ALDEN NELSON DEBES 07/16/19 BLACK & JONES 675 19WC 35641 CROSS, JEFFREY FCA US LLC 10/18/19 KATZ FRIEDMAN EISENSTEIN WIEDNER & MCAULIFFE LTD 676 19WC 35962 TURKES, ADEL WOODWARD, INC. 11/28/18 HINSHAW & CULBERTSON 677 19WC 35985 DYE, JESSICA YANFENG AUTOMOTIVE INTERI 06/30/19 DWORKIN AND MACIARIELLO HENNESSY & ROACH PC 678 19WC 35989 HERDT, EVON PINNACLE LOGISTICS 11/19/19 DWORKIN AND MACIARIELLO HENNESSY & ROACH PC 679 19WC 35994 BROME, LYNN COMMUNITY CARE SYSTEMS IN 11/04/19 BLACK & JONES LIVINGSTONE MUELLER ET AL 680 19WC 36033 MEWBLE, MARCUS PACCAR PARTS 07/29/19 DERANGO & CAIN 681 19WC 36143 BRUCE, SIDNEY CHRYSLER - FCA ASSEMBLY P 11/08/19 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 682 19WC 36206 CATTAGE, ISAISH M CITY OF ROCKFORD 09/14/19 THOMAS W DUDA HEYL ROYSTER VOELKER & ALLEN 683 19WC 36330 GUETSCHOW, JERRY LOVES PARK POLICE DEPT 11/20/19 RIDGE & DOWNES NYHAN BAMBRICK KINZIE & LOWR

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 40 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 684 19WC 36489 VOSS, DANA ROCKY HOLLOW INC 07/01/19 WILLIAMS MCCARTHY LLP 685 19WC 36505 RAPO, MARKO GRAND VICTORIAN OF ROCKFO 11/12/19 GESMER & REYNOLDS PC 686 19WC 36580 FRYE, WILLIAM DIAL MACHINE, INC 06/05/19 ACCIDENT FUND HOLDINGS 687 19WC 36672 WASHINGTON, JASON EDWARD ROSE & SONS LLC 11/12/19 ADRIAN MURATI 688 19WC 36898 BARKER, LINDA ROCKFORD AMBULATORY 10/01/19 GESMER & REYNOLDS PC 689 19WC 36909 PADILLA, EVERADO TRILOGY WAREHOUSE PARTNER 04/19/18 BLACK & JONES HENNESSY & ROACH PC 690 19WC 36910 ENGELKENS, SCOTT TITAN TIRE 12/02/19 DWORKIN AND MACIARIELLO KEEFE CAMPBELL BIERY & ASSOC 691 19WC 36931 YANCE, RENEE STATE OF ILLINOIS @ 11/12/19 GESMER & REYNOLDS PC 692 19WC 36976 GARCIA-HOLM, PETRA L ROCKFORD BOARD OF EDUCATI 10/15/19 TUITE LAW WIEDNER & MCAULIFFE LTD 693 19WC 37099 ELLER, JIMMY R TITAN TIRE COMPANY 10/15/19 REESE & REESE KEEFE CAMPBELL BIERY & ASSOC 694 19WC 37122 DUNCAN, KELSEY L FURST STAFFING SERVICES I 11/24/19 TUITE LAW ACCIDENT FUND HOLDINGS 695 19WC 37177 JAMES, KATRICIA ROCKFORD MASS TRANSIT DIS 11/05/19 DWORKIN AND MACIARIELLO 696 19WC 37249 GAGE, DARIUS PRO SOURCE 12/04/19 DWORKIN AND MACIARIELLO EVANS & DIXON 697 19WC 37392 COLLINSWORTH, ILANA PREFERRED HOME HEALTH CAR 07/26/19 BLACK & JONES RUSIN & MACIOROWSKI LTD 698 20WC 00051 ROGERS, MICHAEL AT&T 10/18/19 GWC INJURY LAWYERS LLC HENNESSY & ROACH PC 699 20WC 00428 PENN, BRANDON FCA US LLC 11/01/19 KATZ FRIEDMAN EISENSTEIN WIEDNER & MCAULIFFE LTD 700 20WC 00523 FERRELL, DENICE CANDLEWICK LAKE ASSOCIATI 09/04/19 GESMER & REYNOLDS PC 701 20WC 00597 MUNGER, MIKE FCA US LLC 12/18/19 KATZ FRIEDMAN EISENSTEIN WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 41 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 702 20WC 00732 SAYLOR, RODNEY CONSOLIDATED MECHANICAL, 01/09/19 O'CONNOR & NAKOS HOLECEK & ASSOCIATES 703 20WC 00769 EDGE, ETHAN WHITE PINES INN 10/22/19 BLACK & JONES ACCIDENT FUND HOLDINGS 704 20WC 00829 WILLIAMS, DANIEL ALTER TRADING-ROCKFORD 12/23/19 DWORKIN AND MACIARIELLO EVANS & DIXON 705 20WC 01069 NEWMAN, LINDA L CLUB DEMONSTRATION SERVIC 08/20/19 FRANKS & RECHENBERG KELLEY KRONENBERG 706 20WC 01173 BATES, DESMOND FCA US LLC 03/20/19 KATZ FRIEDMAN EISENSTEIN WILLIAMS MCCARTHY LLP 707 20WC 01192 MOORE, WENDY SAM'S CLUB 03/18/19 BLACK & JONES QUINTAIROS PRIETO WOOD & BOY 708 20WC 01272 BEYER, JACOB LAWN CAR BY WALTER 12/05/19 DWORKIN AND MACIARIELLO 709 20WC 01298 FLEMING, EVE OGLE COUNTY EDUCATIONAL C 11/14/19 GESMER & REYNOLDS PC 710 20WC 01538 MATLOCK, KEVIN GE AVIATION SYSTEMS, LLC 08/01/18 CLARK FROST RUSIN & MACIOROWSKI LTD 711 20WC 01666 BUCZKOWSKI, ANDRZEJ COTTA TRANSMISSION COMPAN 07/10/19 GESMER & REYNOLDS PC 712 20WC 01682 JONES, JEFFREY CUSTOM UNDERGROUND, INC 01/09/20 WILSON LAW OFFICES LLC STEPHEN P. KELLY 713 20WC 02008 CHANTHAPONE, SONENALINH S CITY OF ROCKFORD 12/16/19 THOMAS W DUDA 714 20WC 02151 MCALISTER, SANDRA FCA US LLC 12/16/19 KATZ FRIEDMAN EISENSTEIN WIEDNER & MCAULIFFE LTD 715 20WC 02237 WOLF, DANNY MORAN TRANSPORTATION CORP 12/24/19 DWORKIN AND MACIARIELLO RIPES NELSON BAGGOT KALOBRAT 716 20WC 02530 BOND, AKILAH SCHOOLWIDE, INC 11/13/19 O'CONNOR & NAKOS NYHAN BAMBRICK KINZIE & LOWR 717 20WC 02597 MALONE, ASHLEY NORTH BOONE SD UNIT #200 01/13/20 SEIDMAN MARGULIS & FAIRMAN GAROFALO SCHREIBER STORM GRA 718 20WC 02660 HAILE, KEITH FCA US LLC 11/05/19 KATZ FRIEDMAN EISENSTEIN WIEDNER & MCAULIFFE LTD 719 20WC 02764 MASSEY, MICHAEL GYPSUM EXPRESS LTD 01/27/14 HANNIGAN & BOTHA, LTD INMAN & FITZGIBBONS

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 42 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 720 20WC 02863 FOLTZ, ROD WALMART 12/23/19 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 721 20WC 03021 LAMBERT, ALFONZO SHERWIN-WILLIAMS COMPANY 10/03/19 GESMER & REYNOLDS PC 722 20WC 03053 COLEMAN, REGINA SPX FLOW HYDRAULIC TECHNL 04/12/19 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 723 20WC 03121 MCWILLIAMS, BECKY FIRST STUDENT 01/10/20 KATZ FRIEDMAN EISENSTEIN 724 20WC 03195 ROSANDER, STEVE KURTZ AMBULANCE SERVICES, 10/15/19 CLARK FROST WIEDNER & MCAULIFFE LTD 725 20WC 03201 BAKER, SHAWN SEBERT LANDSCAPING 01/12/20 BLACK & JONES RUSIN & MACIOROWSKI LTD 726 20WC 03204 MACIAS, CHRISTINO TODD TRANSIT 02/14/17 BLACK & JONES 727 20WC 03208 LOCKETT, COURTNEY FCA US LLC 09/11/19 BLACK & JONES WIEDNER & MCAULIFFE LTD 728 20WC 03228 STEPHENSON, JANENE ROSECRANCE HEALTH NETWORK 04/20/19 ROMANEK & ROMANEK 729 20WC 03235 SALLIS, GABRIELLE OUR CHILDREN'S HOMESTEAD 11/01/19 BLACK & JONES KOPKA, PINKUS DOLIN, PC 730 20WC 03257 NORTON, LEONARD PERFORMANCE FOODSERVICE 01/30/19 RIDGE & DOWNES 731 20WC 03337 MENDOZA, JUAN OLSON ALUMINUM CASTING 08/07/19 BLACK & JONES HOLECEK & ASSOCIATES 732 20WC 03384 PETERS JR, DUWAYNE CREATIVE BUILDING & REMOD 09/25/18 GESMER & REYNOLDS PC HENNESSY & ROACH PC 733 20WC 03517 WEKENMANN, MARY PCI PHARMA SERVICES 03/29/19 NASH LAW OFFICE PC 734 20WC 03654 HERRERA, JESUS MYERS INDUSTRIES, INC 04/15/19 TUITE LAW HENNESSY & ROACH PC 735 20WC 03702 GOODWIN, MICHAEL GUNITE 11/07/19 KATZ FRIEDMAN EISENSTEIN RUSIN & MACIOROWSKI LTD 736 20WC 03762 MC CANN, KIRSTEN MEIJER 12/17/19 BALKE & WILLIAMS KOPKA, PINKUS DOLIN, PC 737 20WC 03825 MEYERS, RICHARD WOODWARD, INC 01/14/20 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 43 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 738 20WC 03870 KLIMAN, BOB INGERSOLL CUTTING TOOL CO 08/14/19 HOLECEK & ASSOCIATES 739 20WC 03991 COCKERAM, LAURIE SPX FLOW HYDRAULIC TECH 08/09/19 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 740 20WC 04154 STRAVINSKAS, VITAS E TODD TRANSIT, INC 06/27/19 TUITE LAW 741 20WC 04203 PENDLETON, DARIUS FCA US, LLC 08/21/19 GESMER & REYNOLDS PC WILLIAMS MCCARTHY LLP 742 20WC 04252 SIKURA, TYLER ROCKFORD ICEHOGS 01/09/19 WOLFE LAW PC 743 20WC 04309 HERNANDEZ, JUAN PRESTIGE CONSTRUCTION & 09/30/19 DWORKIN AND MACIARIELLO 744 20WC 04516 REYES, ERNESTO IPSEN INTERNATIONAL 08/23/18 TUITE LAW 745 20WC 04668 HARRIS, JORDAN MAHER BROS TRANSFER & STO 06/11/19 VANDERGINST LAW PC QUINTAIROS PRIETO WOOD & BOY 746 20WC 04713 GILBERT, JEFFREY C WILLOW GLEN ACADEMY 04/19/19 REESE & REESE 747 20WC 04757 TONGSON, THERESA ANDROID INDUSTRIES 01/02/20 KATZ FRIEDMAN EISENSTEIN 748 20WC 04970 MENDEZ, MARIA PCI PHARMA SERVICES 07/03/19 GESMER & REYNOLDS PC 749 20WC 05012 KIMBALL, GUSTAVE ANTLER MANAGEMENT 02/08/18 EVANS & DIXON 750 20WC 05119 MCGRAIL, MATTHEW LEE COUNTY SHERIFF'S DEPT 02/27/17 BLACK & JONES RUSIN & MACIOROWSKI LTD 751 20WC 05168 LYONS, TALESHA EASTER SEALS 11/14/19 BLACK & JONES 752 20WC 05171 TIMMERMAN, MICHAEL PACCAR PARTS DIVISION 09/17/19 BLACK & JONES BRADY CONNOLLY & MASUDA PC 753 20WC 05174 HARKINS, SCOTT BIMBO BAKERIES USA 11/04/19 BLACK & JONES 754 20WC 05178 KRUSE, JOHN WASTE CONNECTIONS 03/14/17 BLACK & JONES WIEDNER & MCAULIFFE LTD 755 20WC 05251 RUSSELL, HEATHER ALLEGIANT AIR, LLC 11/11/19 GESMER & REYNOLDS PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 44 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 756 20WC 05361 WARMOTH, LISA UPS 02/05/20 DAVID W MARTAY NYHAN BAMBRICK KINZIE & LOWR 757 20WC 05409 MCALISTER, SANDRA FCA US LLC 04/25/19 KATZ FRIEDMAN EISENSTEIN WIEDNER & MCAULIFFE LTD 758 20WC 05430 SINGMOUANGTHONG, TOON CITY OF ROCKFORD POLICE D 02/01/20 GESMER & REYNOLDS PC HEYL ROYSTER VOELKER & ALLEN 759 20WC 05562 EPPERHART, SUSAN SYNCREON 03/07/19 KATZ FRIEDMAN EISENSTEIN 760 20WC 05565 RATTANASAVANH, MICHAEL J.F. ELECTRIC, INCORPORAT 01/11/20 KATZ FRIEDMAN EISENSTEIN 761 20WC 05677 MCGIRL, DAWN NEAL MAST AND SON, INC 07/18/19 GESMER & REYNOLDS PC HOLECEK & ASSOCIATES 762 20WC 05685 SUTTON, DELLA FAIRHAVEN CHRISTIAN RETIR 01/11/20 BLACK & JONES 763 20WC 05688 BOEKE, JESSICA STAR MANUFACTURING 05/23/12 BLACK & JONES 764 20WC 05702 DEERY, PAUL D CITY OF BELVIDERE 09/06/19 BOYD, SCOTT M NYHAN BAMBRICK KINZIE & LOWR 765 20WC 05733 CORNELIUS, DANIEL N TITAN TIRE CORP 11/15/19 REESE & REESE KEEFE CAMPBELL BIERY & ASSOC 766 20WC 05750 RODRIGUEZ, JOSE THOMPSON PIPE GROUP 02/22/20 GESMER & REYNOLDS PC LEAHY EISENBERG & FRAENKEL 767 20WC 05795 KLENZ, MORGAN TH FOODS 02/04/20 GESMER & REYNOLDS PC 768 20WC 05819 HARRIS, LA GWENDOLYN SUNRISE TRANSPORTATION 01/21/19 BLACK & JONES WIEDNER & MCAULIFFE LTD 769 20WC 05914 KRIEGER, KRISTIN LIFESCAPE COMMUNITY 12/02/19 GESMER & REYNOLDS PC 770 20WC 05926 CAPEZIO, BRIAN CITY OF ROCKFORD FIRE DEP 02/07/19 GESMER & REYNOLDS PC HEYL ROYSTER VOELKER & ALLEN 771 20WC 06044 GOMEZ, CESAR SPX FLOW 01/23/20 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 772 20WC 06154 KELLER, CHARLIE SUNRISE TRANSPORTATION 08/28/19 BLACK & JONES 773 20WC 06164 COPLAN, NATASHA D MENARD'S 02/12/20 REESE & REESE

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 45 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 774 20WC 06185 DAVIS, RONNY EMERSON ELECTRIC COMPANY 09/13/19 GESMER & REYNOLDS PC BRADY CONNOLLY & MASUDA PC 775 20WC 06213 SCHLUETER, BRENDA K EASTER SEALS 09/23/19 BLACK & JONES 776 20WC 06349 SINKO, SARA 425 MANUFACTURING INC. 09/04/19 BOTTO GILBERT 777 20WC 06398 LOPEZ, AHISSA WINNEBAGO COUNTY SPECIAL 10/18/19 REESE & REESE 778 20WC 06511 FULLER, ALEXANDER CITY OF ROCKFORD POLICE D 08/06/19 GESMER & REYNOLDS PC HEYL ROYSTER VOELKER & ALLEN 779 20WC 06540 BUSSAN, PHILIP TITAN TIRE CORPORATION 01/22/20 DWORKIN AND MACIARIELLO KEEFE CAMPBELL BIERY & ASSOC 780 20WC 06626 MACK, RICKISHA S GUNITE CORPORATION 11/14/19 TUITE LAW RUSIN & MACIOROWSKI LTD 781 20WC 06706 MATHIS, KONYA J WINNEBAGO COMM UNIT SCHOO * 09/04/19 TUITE LAW GAIDO & FINTZEN 782 20WC 06835 BANKS, JOHN ANDROID INDUSTRIES * 02/14/20 DWORKIN AND MACIARIELLO 783 20WC 06967 TURNER, KIMBERLEE STEVENS NURSING CENTER WA * 12/03/19 DWORKIN AND MACIARIELLO INMAN & FITZGIBBONS 784 20WC 06986 MINAKES, CHRISTOPHER ADVANCE AUTO PARTS * 08/26/17 ANKIN LAW OFFICE 785 20WC 07078 NAILL, ROBERT GUNITE CORPORATION * 03/15/17 CLARK FROST 786 20WC 07173 OLSON, PETER TAYLOR COMPANY * 11/13/17 BLACK & JONES EVANS & DIXON 787 20WC 07191 OQUINN, HAZEL UDL LABORATORIES INC * 01/14/20 BLACK & JONES 788 20WC 07357 POPPE, NOEL D LTM WATER TREATMENT INC * 10/05/18 WILLIAMS MCCARTHY LLP 789 20WC 07360 CASSIOPPI, JUDY DSI CORP * 07/22/19 BLACK & JONES ACCIDENT FUND HOLDINGS 790 20WC 07424 EDWARDS, JIMMIE SYNCREON * 11/01/17 BLACK & JONES KEEFE CAMPBELL BIERY & ASSOC 791 20WC 07434 WILLIAMS, KYLE TAYLOR PRODUCTS INC * 02/12/20 ANKIN LAW OFFICE

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 46 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 792 20WC 07896 HARRIS, FRANKLIN R&L CARRIERS, INC * 02/17/20 CAPRON & AVGERINOS PC KEEFE CAMPBELL BIERY & ASSOC 793 20WC 07930 MEDINA, ROBERTO LORENZO TREE SERVICE * 04/05/19 GESMER & REYNOLDS PC 794 20WC 07976 GRIDER, DAVE K & J FINISHING * 07/06/18 GESMER & REYNOLDS PC HOLECEK & ASSOCIATES 795 20WC 08149 DELGADO, ALFREDO BARNES INTL, INC * 03/11/19 FRANKS, GERKIN & MCKENNA P 796 20WC 08164 WITT, DILLON WOODWARD GOVERNOR CO * 09/12/19 BLACK & JONES 797 20WC 08186 CHRISTENSEN, PATRICK ARCO MACHINERY MOVERS * 12/26/19 KINNALLY FLAHERTY KRENTZ 798 20WC 08278 SWANSON, ELIZABETH L ENCOMPASS HLTH CORP AGENT * 07/15/19 TUITE LAW BRYCE DOWNEY & LENKOV LLC 799 20WC 08377 LUNDIN, TODD STANDARD FORWARDING * 02/24/20 BLACK & JONES 800 20WC 08386 MUSSER, MARJORIE (WIDOW O KOLB-LENA INC # * 03/31/17 TUITE LAW KEEFE CAMPBELL BIERY & ASSOC 801 20WC 08402 CRIEL, RONALD SWEDISH AMERICAN HOSPITAL * 02/13/20 BLACK & JONES WILLIAMS MCCARTHY LLP 802 20WC 08405 LLOYD, CHRISTIN WORLD WIDE TECH SVCS * 03/06/20 BLACK & JONES 803 20WC 08409 HYSER, MICHAEL USF HOLLAND * 08/22/19 BLACK & JONES 804 20WC 08416 HERNANDEZ JR, JOE EVOLUTION STAFFING INC * 02/27/20 TUITE LAW 805 20WC 08505 ROUSE, WILLIAM M FRONTIER AIRLINES * 11/03/18 EVANS & DIXON, LLC 806 20WC 08713 RAMOS, NOEMI BERGSTROM INC * 03/10/20 BLACK & JONES WOLFE & JACOBSON, LTD 807 20WC 08791 ROSIN, JEFF TITAN TIRE * 03/31/20 DWORKIN AND MACIARIELLO KEEFE CAMPBELL BIERY & ASSOC 808 20WC 08877 LEWIS, MAURICE CHRYSLER NKA FCA US LLC * 01/17/20 CULLEN HASKINS NICHOLSON 809 20WC 08976 FRAZIER, WALTER C SPEEDWAY AUTO MALL INC * 01/10/20 REESE & REESE

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 47 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 810 20WC 09073 FOULKER, KATHY AUNT MARTHA'S HEATH & WEL * 09/08/19 SHANNON LAW GROUP 811 20WC 09200 VENDEN, SUNSHINE SULLIVANS FOOD * 03/13/20 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 812 20WC 09579 JOHNSTON, TANNER AREA ERECTORS, INC * 10/17/19 ACCIDENT FUND HOLDINGS 813 20WC 09648 BAKER, AMBER FREEPORT SCHOOL DISTRICT * 04/04/19 GANAN & SHAPIRO 814 20WC 09685 JANSEN, JOEL SCOTT CONFER * 05/31/19 GILDEA, COGHLAN & REGAN LTD. 815 20WC 09761 KNAUP, FREDERICK B MONDELEZ INTERNATIONAL IN * 02/19/19 WIEDNER & MCAULIFFE LTD 816 20WC 09798 SEYMOUR, DEANNA GATEHOUSE MEDIA ILLINOIS * 04/11/19 BLACK & JONES KNELL LAW LLC 817 20WC 09803 MANDELKE, JONATHAN UPS * 07/10/19 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 818 20WC 09839 HEAD, DANIEL CHICAGO BAKING CO * 02/01/20 WOODRUFF JOHNSON POWER & CRONIN LTD 819 20WC 09941 ANDERSON, WILLIAM AT&T * 08/14/19 DWORKIN AND MACIARIELLO 820 20WC 10004 POFF, MICHAEL FRONTIER COMMUNICATIONS * 07/29/19 GESMER & REYNOLDS PC BRADY CONNOLLY & MASUDA PC 821 20WC 10045 POFF, MICHAEL FRONTIER COMMUNICATIONS * 12/06/19 GESMER & REYNOLDS PC BRADY CONNOLLY & MASUDA PC 822 20WC 10129 DELGADO, CARLOS FPM LLC * 03/12/20 EPSTEIN, JACK R LAW OFFICE 823 20WC 10206 STASTNY, SUSAN FREEPORT SD #145 * 08/29/18 GANAN & SHAPIRO 824 20WC 10304 ZITO, CARL LP & SONS * 11/17/18 DWORKIN AND MACIARIELLO HENNESSY & ROACH PC 825 20WC 10474 STOCKWELL, MATT NICOR * 04/24/20 DWORKIN AND MACIARIELLO RUSIN & MACIOROWSKI LTD 826 20WC 10528 YATES, JOSEPH D MEIBORG BROTHERS INC * 07/25/19 TUITE LAW WOLFE & JACOBSON, LTD 827 20WC 10575 PARKS, JACKIE LYNN QPS EMPLOYMENT GROUP * 12/12/18 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 ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 828 20WC 10586 HUGHES, SHELLY SUNRISE TRANSPORTATION * 11/12/19 BLACK & JONES 829 20WC 10595 SMITH, MYGUANDA PINNACLE LOGISTICS * 04/19/20 DWORKIN AND MACIARIELLO 830 20WC 10686 LARSON, JAY VIKING CHEMICAL * 03/13/20 GESMER & REYNOLDS PC BRADY CONNOLLY & MASUDA PC 831 20WC 10830 MANNING, BRIAN CHICAGO POWDERED METAL # * 04/26/17 CADY LAW FIRM, P.C. 832 20WC 11033 RAMIREZ-FERRELL, VICKIE LOWE'S HOME CENTERS LLC * 03/20/20 TUITE LAW 833 20WC 11132 MANIS, CHARLES ROCKFORD MASS TRANSIT DIS * 04/21/20 WHITESIDE & GOLDBERG LTD 834 20WC 11181 GONZALEZ, JORGE WALMART * 04/15/20 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE LTD 835 20WC 11240 ORIA, JOE CBIZ * 05/07/19 NASH LAW OFFICE PC EDWARD J. KOZEL 836 20WC 11423 CURRY, TERRY W BERNER FOOD & BEVERAGE IN * 04/30/20 TUITE LAW 837 20WC 11654 ALDAMA, GUILLERMO TODD TRANSIT, INC. * 07/15/19 BLACK & JONES 838 20WC 11657 BEARDSLEY, LINDSEY ARAMARK UNIFORM SERVICES * 11/01/19 BLACK & JONES INMAN & FITZGIBBONS 839 20WC 11717 MAUSEHUND, REBA U-HAUL MOVING & * 02/28/20 BLACK & JONES 840 20WC 11790 WHITE, JAMES PMI ENERGY SOLUTIONS * 02/17/20 VELLA & LUND 841 20WC 11895 KELLY, ROBB AREA ERECTORS * 12/04/17 HORWITZ HORWITZ & ASSOC ACCIDENT FUND HOLDINGS 842 20WC 12012 STEINBERG, KENNETH VIVINT SOLAR * 12/03/18 RANDALL A. WOLFF & ASSOC 843 20WC 12030 LORIA, PETER FOREST CITY INDUSTRIES * 07/18/18 EVANS & DIXON 844 20WC 12056 PRUNER, CURTIS ESTWING MANUFACTURING * 07/11/18 WIEDNER & MCAULIFFE LTD 845 20WC 12086 BUSSER, DARRYL HONEYWELL INTL INC * 04/23/18 HAUSER LAW LLC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 49 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 07/08/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 846 20WC 12102 MORHARDT, GARLAND CARDINAL GLASS * 12/17/19 GWC INJURY LAWYERS LLC 847 20WC 12118 CARMACK, MARY FCA US LLC * 09/21/19 BLACK & JONES 848 20WC 12157 VASQUEZ, STEVEN A CITY OF ROCKFORD FIRE DEP * 04/30/19 HEYL ROYSTER VOELKER & ALLEN 849 20WC 12289 SAVEDRA, MARK MEIBORG BROTHERS INC * 05/18/20 SEIDMAN MARGULIS & FAIRMAN