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ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 2 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 14 08WC 02277 BUSTAMENTE, LUCIANA TERESITA RESTAURANT W 12/19/07 CULLEN, HASKINS, NICHOLSON 15 08WC 27768 SALYER-ROBERTS, TAMMY AUTO ZONE 04/14/08 STEVEN J SEIDMAN LAW OFFIC GILDEA & COGHLAN 11WC037755 -C 16 08WC 32702 HUCKER, KURT GPW BUILDERS 01/18/08 RICHARD D HANNIGAN, LTD BRADY CONNOLLY & MASUDA PC 17 08WC 35482 RODRIGUEZ, CELESTINO L & M CORRUGATED 05/12/08 GOLDSTEIN FISHMAN BENDER E RODDY LAW LTD 18 08WC 51751 PADILLA, JOHN MIDWEST DECK-N-DOCK INC W 09/02/08 ANKIN LAW OFFICE STANCZAK LAW OFFICES 19 08WC 53741 CHARLIER, MONICA A ST OF IL DEPT OF W 10/09/08 TAMVAKIS, GEORGE L ASSISTANT ATTORNEY GENERAL 20 08WC 56379 FREIBERG, MICHAEL G LAKE COUNTY HEALTH DEPART 05/11/07 MARKHAM M JEEP & ASSOCIATE SMITH AMUNDSEN LLC 21 09WC 02346 KESSLER, DOUG WEBMD INC 02/07/07 MURPHY & MURPHY NYHAN BAMBRICK KINZIE & LOWR 22 09WC 05102 GUZMAN, ALICIA WILLIAMS ELECTRONIC 10/10/08 O'CONNOR & NAKOS NOBLE & ASSOCIATES PC 09WC005103 -C 09WC024600 -C WMS GAMING INC 12WC032181 -C 23 09WC 06084 CAFFERATA, SUZANLEE TOWNSHIP HIGH SCHOOL 113 09/26/08 MARSZALEK AND MARSZALEK WIEDNER & MCAULIFFE LTD 24 09WC 06388 RIZZO, JOHN TRANS FORCE INC 01/05/09 KATZ FRIEDMAN EAGLE ET AL THOMAS & ASSOCIATES 25 09WC 13346 JULIAN, SOFIA COMPELETE TEMPORARY LABOR 07/18/08 MARK A MORGENSTERN KOREY LAW LLC 26 09WC 24465 19B DONNER, TERESA VISTA MEDICAL CENTER EAST 11/10/08 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 27 09WC 31988 RUYAK, CHERYL LAKE VILLAGE SCHOOL DST # 02/13/09 BAUM RUFFOLO & MARZAL LTD COZZI & GOGGIN-WARD 15WC021355 -C 28 09WC 44349 OLSEN, EARL S VITALITY FOOD SERVICES 08/26/09 DAVID W MARTAY NYHAN BAMBRICK KINZIE & LOWR 29 09WC 53121 MC GRAW, CHARLYNE J KAVO DENTAL 11/25/09 LAW OFFICE PHILIP BLOMBERG HENNESSY & ROACH PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 3 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 30 10WC 06232 GIANNI, MARILU HEWITT ASSOCIATES 10/26/09 SLAVIN & SLAVIN GRANT & FANNING 31 10WC 13999 SMITH, SCOTT W G.E.S. INC 07/05/07 LINN, CAMPE & RIZZO LTD GILDEA & COGHLAN 10WC014112 -C 32 10WC 17121 NELSON, DONNA LAKE FOREST HOSPITAL 12/05/09 CULLEN HASKINS NICHOLSON NYHAN BAMBRICK KINZIE & LOWR 33 10WC 17906 HUEBNER, DAVID STERLING ENGINEERING, INC 03/18/10 LINN, CAMPE & RIZZO LTD WIEDNER & MCAULIFFE LTD 34 10WC 20662 19B JARERO, JORGE SMURFIT STONE 03/29/10 RICHARD D HANNIGAN, LTD GAROFALO SCHREIBER STORM 35 10WC 20856 ECHEVERRIA, VIRGINIA THE PARK AT VERNON HILLS 05/07/10 FRANK A SANTILLI & ASSOC THOMAS & ASSOCIATES 10WC039177 -C 36 10WC 23616 CORDOVA, CANDIDO COMMERCIAL PLASTICS COMPA 05/24/10 SALK, STEVEN B & ASSOC LTD STONE & JOHNSON CHARTERED 10WC023617 -C 37 10WC 26448 OCHOA, JOSE WILLIAMS ELECTRONICS & GA 02/22/10 STEVEN J SEIDMAN LAW OFFIC RUSIN MACIOROWSKI & FRIEDMAN 38 10WC 47524 MALUSKY, SARAH MUNDELEIN COMMUNITY BANK 08/27/10 NEWLAND NEWLAND & NEWLAND HOLECEK & ASSOCIATES 39 10WC 47989 NELSON, DONNA LAKE FOREST HOSPITAL 11/22/10 CULLEN HASKINS NICHOLSON NYHAN BAMBRICK KINZIE & LOWR 40 10WC 49197 JULIAN, SOPHIA MOST VALUABLE PERSONNEL 07/18/08 MARK A MORGENSTERN 41 11WC 00239 DALESSANDRO, MICHAEL F TH RYAN CARTAGE 10/05/10 BOUDREAU NISIVACO LLC HINSHAW & CULBERTSON 42 11WC 01134 DIAZ, JUAN MANUEL CHARLESTON BUILDING SERV W 11/08/10 KATZ FRIEDMAN EAGLE ET AL 43 11WC 04174 WOOD, RICHARD M MICHAEL PEMBROOK; INDIVID 08/09/10 LINN, CAMPE & RIZZO LTD 44 11WC 05392 CONTA, ASHLEY BATH & BODY WORKS 12/29/10 COHN & COHN BRYCE DOWNEY & LENKOV LLC 45 11WC 09284 RIOS, DAVID KILDEER COUNTRYSIDE 05/21/10 LEE A CAMPBELL LAW OFFICE WIEDNER & MCAULIFFE LTD 46 11WC 15870 ESPINOSA, CARMEN ADPRO HEALTH CARE SERVICE 04/08/11 LAW OFFICES OF RONALD B SK

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 4 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 47 11WC 19583 SHULTIS, KAREN YMCA EARLY HEAD START 04/19/11 EPSTEIN, JACK R LAW OFFICE STELLATO & SCHWARTZ 48 11WC 29140 BREWTON, CLARA BAXTER HEALTHCARE 04/23/11 DWORKIN AND MACIARIELLO MACIOROWSKI SACKMANN & ULRIC 49 11WC 30055 POSADAS, PAULA LB ANDERSEN 07/21/11 MARKHAM M JEEP & ASSOCIATE WIEDNER & MCAULIFFE LTD 50 11WC 31525 HAPP, LAWRENCE J WAUKEGAN SCHOOL DISTRICT 09/07/10 LINN, CAMPE & RIZZO LTD BRADY CONNOLLY & MASUDA PC 51 11WC 31703 KEENAN, RENEE LONG GROVE FIRE 11/23/10 THOMAS W DUDA RUSIN MACIOROWSKI & FRIEDMAN 52 11WC 32054 LENOX, SHAWN P INTEGRYS ENERGY GROUP 04/04/11 PERONA, PETERLIN, ANDREONI GAROFALO SCHREIBER STORM 53 11WC 36584 WILSON, LYLE ASPLUNDH TREE EXPERT CO 08/24/11 CULLEN HASKINS NICHOLSON KNELL & O'CONNOR 54 11WC 37496 PEAVEY, EDWARD LAKE COUNTY SHERIFF'S OFF 01/05/11 MARKHAM M JEEP & ASSOCIATE SMITH AMUNDSEN LLC 11WC037497 -C 55 11WC 40182 SEROLA, JOHN ECOLAB, INC 07/26/10 TODD SHIVERS KEEFE CAMPBELL & ASSOC LLC 11WC040183 -C 56 11WC 43167 TABAKA, MARIA CM PACKAGING INC 02/02/11 LEWIS & DAVIDSON, LTD HOLECEK & ASSOCIATES 57 11WC 46813 HOHS, CHARLES FINAL PHASE HOME IMPROVEM W 11/02/11 JORDAN FRANK 58 11WC 47377 CUNA, JOSE G PERFORMANCE FOOD GROUPº 09/13/11 DWORKIN AND MACIARIELLO BRYCE DOWNEY & LENKOV LLC 59 11WC 49088 WATTS, SHEVELLE STATE OF ILLINOIS @ 12/10/11 HORWITZ HORWITZ & ASSOC 12WC015723 -C ANN M KILEY CENTER 60 12WC 07522 HAYDEN, KEITH ILLINOIS TOLLWAY AUTHORIT 02/15/12 DUDLEY & LAKE LLC NYHAN BAMBRICK KINZIE & LOWR 61 12WC 08199 REICHEL, AMY N STATE OF ILLINOIS @ 02/14/12 DWORKIN AND MACIARIELLO MATTHEW LICAVOLI

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 5 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 62 12WC 08698 KOZLIK, JOHN ILLINOIS DEPARTMENT OF @ 08/29/11 HETHERINGTON KARPEL BOBBER MATTHEW LICAVOLI 63 12WC 09038 DOYLE, JANICE NORTHWESTERN LAKE FOREST 05/29/09 ROBERT J COZZI NYHAN BAMBRICK KINZIE & LOWR 12WC009039 -C 64 12WC 10217 CRUZ, LORENA PREFERRED MEALS SYSTEMS I 01/03/12 PATRICIA HARDIMAN LAW OFFI POWER & CRONIN LTD 65 12WC 10764 CZARNECKI, DARLENE ILLINOIS DEPT OF 02/16/12 JOHN F GREGORIO & ASSOC ASSISTANT ATTORNEY GENERAL 66 12WC 10861 MISEK, JOHN JR ILLINOIS TOLLWAY AUTHORIT 03/07/12 DUDLEY & LAKE LLC NYHAN BAMBRICK KINZIE & LOWR 67 12WC 11833 ANDERSON, RICARDO WAUKEGAN TOWNSHIP 11/11/11 COHN & COHN RUSIN MACIOROWSKI & FRIEDMAN 12WC011919 -C 68 12WC 12128 ORTIZ, ISIS PAYLESS SHOE SOURCE 08/16/11 SHELDON I MINKOW & ASSOCIA 69 12WC 13719 WEINGART, FRANCES L AMCOR FLEXIBLES 09/05/11 PARENTE & NOREM PC HOLECEK & ASSOCIATES 12WC013720 -C 12WC013721 -C 70 12WC 14731 YTURRALDE, ROBERT KENGENELK DELIVERLY SVC I 03/15/12 HANNIGAN & BOTHA, LTD NYHAN BAMBRICK KINZIE & LOWR 71 12WC 15747 MEADOWS, AMY CARSON PIRIE SCOTT II, IN 12/21/11 MARKHAM M JEEP & ASSOCIATE 13WC012320 -C

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 6 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 72 12WC 20727 MALDONADO, SALVADOR L A LANDSCAPE INC 11/01/09 CULLEN HASKINS NICHOLSON 73 12WC 21222 FLAMMINI, DONNA R VISTA MEDICAL CENTER EAST 08/27/10 MARK B PEAVEY, PC WIEDNER & MCAULIFFE LTD 12WC021223 -C 13WC018985 -C 13WC029756 -C 14WC004510 -C 14WC028449 -C 15WC014515 -C 74 12WC 26649 NAVARRETE, MARGARITA VISUAL PACK 07/05/12 JONATHAN SCHLACK KOREY COTTER HEATHER RICHARD 75 12WC 26893 PORCAYO, NICOLAS ROSBROUGH PARTNERS 06/07/12 THE ROMAKER LAW FIRM HANSON LAW OFFICE 76 12WC 30379 BLANCO, CARLOS FACILITEC CONTROL 03/01/12 AIOSSA LAW FIRM CHILTON YAMBERT PORTER LLP 77 12WC 30896 PEROTT, MARC MENARDS INC 08/20/12 PETER D CORTI LAW GROUP CHILTON YAMBERT PORTER LLP 13WC041850 -C 15WC015990 -C 78 12WC 33012 BAARTZ, BRIAN J S & L HOSPITALITY LLC 06/25/12 MAY & BUEGE COZZI & GOGGIN-WARD 79 12WC 34064 CIANGI, SALLY STATE OF ILLINOIS @ 02/16/10 KATZ FRIEDMAN EAGLE ET AL JORDAN FRANK 12WC034065 -C 80 12WC 35024 RAMIREZ, RENE ARCHITERRA INC DBA 08/13/12 JONATHAN SCHLACK 81 12WC 35125 CRUMP, WILLIAM ABBOTT LABORATORIES 03/13/12 DAVID W MARTAY HENNESSY & ROACH PC 12WC035126 -C 82 12WC 36720 ROSA, SYNDER I PARKER HAMMIFIN CORPORATI 08/07/12 MAY & BUEGE RUSIN & MACIOROWSKI LTD 83 12WC 38405 ANGELI, MIKE MIDWEST COPIER EXCHANGE 02/12/11 BRISKMAN BRISKMAN GREENBER HEYL ROYSTER VOELKER & ALLEN 84 12WC 38431 19B NAST, NICKI EYE SPECIALISTS OF CHICAG 10/11/12 SMOLER LAW OFFICE, PC NYHAN BAMBRICK KINZIE & LOWR

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 7 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 85 12WC 39144 COLLINS, CARY (AS EXECUTO BELL ENTERTAINMENT # 08/04/02 MARSZALEK AND MARSZALEK 86 12WC 40418 NAGEL, RAY INTERSTATE BRANDS 10/04/12 GOLDBERG WEISMAN & CAIRO L SCOPELITIS GARVIN LIGHT 12WC040419 -C 87 12WC 41543 ARTAC, JEFF NORTH SHORE GAS CO 10/04/12 ELFENBAUM EVERS & AMARILIO GAROFALO SCHREIBER STORM 88 12WC 43177 SHAPE, KEVIN CITI CARE TRANSPORTATION @ W 12/11/12 STEIN & CHERNEY LTD DWORKIN AND MACIARIELLO 89 12WC 43944 GALLUP, JAMISON AT&T 09/27/12 MARKHAM M JEEP & ASSOCIATE INMAN & FITZGIBBONS 90 12WC 44153 HOPKINS, ROCHELE CHICAGO BREAD 09/11/12 ANKIN LAW OFFICE COZZI & GOGGIN-WARD 91 12WC 44331 MENDEZ, JOSE A COLEMAN CABLE 04/06/11 JONATHAN SCHLACK GRANT & FANNING 92 13WC 00365 TUROVITZ, BARBARA SOURCE INTERLINK 06/08/11 PETER C KOPOULOS GAROFALO SCHREIBER STORM 93 13WC 01790 RITTHALER, PETER NOLAND SALES CORP 08/24/12 HANNIGAN & BOTHA, LTD KEEFE CAMPBELL & ASSOC LLC 94 13WC 03031 TOUSI, SAEID O'HARE MIDWAY 01/04/13 CULLEN HASKINS NICHOLSON LAW OFFICES JOSEPH MARCINIAK 95 13WC 03150 PRUDHOMME, DANYELL R HAIRCUTTERY 06/24/12 LINN, CAMPE & RIZZO LTD 96 13WC 03654 FREEMAN, DAVID E CITY OF WAUKEGAN 03/29/10 THOMAS W DUDA NYHAN BAMBRICK KINZIE & LOWR 97 13WC 04243 LENOX, SHAWN INTEGRYS ENERGY GROUP 08/07/12 PERONA, PETERLIN, ANDREONI 98 13WC 05519 VILLARREAL, ALI D NORTHERN ILLINOIS MACK 05/31/12 LINN, CAMPE & RIZZO LTD HEYL ROYSTER VOELKER & ALLEN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 8 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 99 13WC 05634 PARISI, MARY K THE MERIT CLUB 09/19/11 LINN, CAMPE & RIZZO LTD CASSANO & ASSOCIATES 100 13WC 05970 KOCH, JAMES P VILLAGE OF VERNON HILLS 08/29/12 LINN, CAMPE & RIZZO LTD NYHAN BAMBRICK KINZIE & LOWR 13WC005972 -C 14WC005707 -C 14WC005714 -C 15WC007039 -C 15WC007234 -C 15WC038477 -C 101 13WC 06523 SANCHEZ, HUGO F WINDRIDGE BUILDERS INC 02/15/13 ACEVES & PEREZ PC KEEFE CAMPBELL & ASSOC LLC 102 13WC 06903 19B BARNA, BRIAN BUFFALO GROVE 05/30/12 CAPRON & AVGERINOS PC RUSIN MACIOROWSKI & FRIEDMAN 103 13WC 07788 SPENCER, ARLETHA R LAKE BLUFF HOME CARE SOLU 07/12/12 ALAN A BLUM, PC SPIEGEL & CAHILL, PC 104 13WC 07994 STOKES, ANITA A CITY OF WAUKEGAN 11/07/11 LINN, CAMPE & RIZZO LTD NYHAN BAMBRICK KINZIE & LOWR 14WC005722 -C 105 13WC 08735 HOPF, MICHAEL FEDEX EXPRESS 07/06/12 EPSTEIN, JACK R LAW OFFICE HANSON LAW OFFICE 13WC008741 -C 106 13WC 08967 KINNEY, DARRYL STACK ON PRODUCTS INC 11/02/12 VASILATOS & COTTER LLC LAW OFFICE OF PAUL O WATKISS 13WC038853 -C 13WC038854 -C 14WC013310 -C 15WC008592 -C 15WC018524 -C 16WC000649 -C 16WC000651 -C 107 13WC 09158 SHRAKE, KENNETH HOBART 01/07/13 HANNIGAN & BOTHA, LTD HENNESSY & ROACH PC 108 13WC 10065 GROTH, DIANE THE THURBER COMPANY 04/20/12 NEWLAND & NEWLAND RUSIN MACIOROWSKI & FRIEDMAN 109 13WC 11024 RIVERA, MIQUEL CDW 08/15/12 DUDLEY & LAKE LLC HENNESSY & ROACH PC 110 13WC 11403 MOORE, TARNISHA MOTOROLA MOBILITY 04/25/12 HANNIGAN & BOTHA, LTD BRADY CONNOLLY & MASUDA PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 9 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 111 13WC 11947 KORNSTEIN, RICHARD PEP BOYS 11/30/12 MARKHAM M JEEP & ASSOCIATE CHILTON YAMBERT PORTER LLP 112 13WC 12028 HELGESEN, KYLE CITY OF ZION POLICE DEPT 09/11/12 MARKHAM M JEEP & ASSOCIATE RUSIN MACIOROWSKI & FRIEDMAN 14WC011363 -C 113 13WC 12249 AVILA, MINERVA ACE LASER TEK INC 03/29/13 JOHN S. ELIASIK HANSON LAW OFFICE 114 13WC 13353 LAZAR, LLENE CHASE BANK 01/03/13 CULLEN HASKINS NICHOLSON NYHAN BAMBRICK KINZIE & LOWR 115 13WC 13365 MONTIEL, MIRNA QPS EMPLOYMENT GROUP 08/01/12 MARSZALEK AND MARSZALEK WOLFE & JACOBSON, LTD 116 13WC 13842 IRBY, SHARMAN ADA MCKINLEY 07/05/12 ANKIN LAW OFFICE GAROFALO SCHREIBER STORM 117 13WC 13930 SOTELO, FELIPE DOLLAR JUNCTION & MORE IN 03/22/13 DAVID W MARTAY 118 13WC 14072 PIOTROWSKI, RICHARD COSTCO WHOLESALE 03/04/12 LINN, CAMPE & RIZZO LTD GANAN & SHAPIRO 119 13WC 15047 LUDVIGSEN, KEVIN S MECHANICAL INC 03/26/13 JOHN F GREGORIO & ASSOC HOLECEK & ASSOCIATES 120 13WC 15370 SOMOZA, HELEN M COMMUNITY ACTION 05/17/12 HANNIGAN & BOTHA, LTD 121 13WC 15839 PRENDERGAST, JASON KOHLS DEPT STORE INC #035 10/31/12 HOEY & FARINA GEORGE BRUGESS 122 13WC 15891 MENDOZA, RAUL LAKE COUNTY FOREST 11/29/12 LINN, CAMPE & RIZZO LTD RUSIN MACIOROWSKI & FRIEDMAN 123 13WC 16184 AYALA, JOSE COLEMAN CABLE INC 12/06/10 POSTERLI, OSCAR GRANT & FANNING 124 13WC 17595 PICARD, SHANICE T DENTAL DREAMS 04/30/12 PAUL A COGHLAN & ASSOC LAW OFFICES OF EDWARD J. KOZ 125 13WC 20475 PHELPS, MYRON ANN KILEY 05/28/13 WOODRUFF & JOHNSON ASSISTANT ATTORNEY GENERAL 14WC027387 -C 126 13WC 20587 VEIT, DANIEL R LAKESIDE PEST CONTROL 09/04/12 LINN, CAMPE & RIZZO LTD GANAN & SHAPIRO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 10 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 127 13WC 20886 SZUBINSKI, SHARON MILAN BANQUEST 12/30/12 THERMAN LAW OFFICES LAW OFFICES JOSEPH MARCINIAK 128 13WC 21451 ULLOA, AMADO PSSI 09/11/12 MC HARGUE, JAMES P LAW OFF HEYL ROYSTER VOELKER & ALLEN 13WC021456 -C 129 13WC 22076 CAMPBELL, ZIYETTA M ST OF ILL DEPT OF HUMAN S @ 05/19/13 GALLAGHER, DONALD V MATTHEW LICAVOLI 130 13WC 22685 VELOZ, ANA RLC ENTERPRISES INC 05/28/13 FERRIS THOMPSON & ZWEIG 131 13WC 24270 GOLDEN, CHRISTINE HIGHLAND PARK HOSPITAL 06/25/13 KATZ FRIEDMAN EAGLE ET AL KEEFE CAMPBELL & ASSOC LLC 132 13WC 24462 GRUND, JONNIE R & M CONSULTING LLC 03/11/13 DWORKIN AND MACIARIELLO HOLECEK & ASSOCIATES 133 13WC 25544 OSORIO, ENRIQUE LUDLOW MANUFACTURING 03/07/13 JONATHAN SCHLACK HEYL ROYSTER VOELKER & ALLEN 13WC040110 -C 134 13WC 26136 RODRIQUEZ, ISIDRO ECHO INC 03/01/13 FERRIS THOMPSON & ZWEIG STONE & JOHNSON CHARTERED 135 13WC 26206 CRONIN, JASON ARROW PLUMBING 10/11/12 HANNIGAN & BOTHA, LTD RIPES NELSON BAGGOT KALOBRAT 136 13WC 26426 MENDOZA, FRANCISCO ARAMARK 10/30/12 LEONARD LAW GROUP LLC INMAN & FITZGIBBONS 137 13WC 26537 DOTSON, JEWELL BATH AND BODY WORKS 01/02/13 COHN & COHN GALLIANNI DOELL & COZZI LTD 138 13WC 26628 BARRERA, CLARA BETTY SCHWARTZ'S 06/25/13 MARTIN L GLINK LAW OFFICE RUSIN MACIOROWSKI & FRIEDMAN 139 13WC 26745 VASQUEZ, MOISES ALAN M LANDSCAPING 03/05/13 MC HARGUE, JAMES P LAW OFF RUSIN MACIOROWSKI & FRIEDMAN 140 13WC 26920 BAIR, COURTNEY L JEWEL INC 07/19/13 LINN CAMPE & RIZZO LTD 141 13WC 27373 RANGEL, LORENA MVP STAFFING INC 07/09/13 CULLEN HASKINS NICHOLSON KOREY COTTER HEATHER RICHARD 142 13WC 28082 LAGOS, RAUL UNISTAFF, INC 05/03/13 LAW OFFICE HUGO ORTIZ WIEDNER & MCAULIFFE LTD 143 13WC 29472 JOZEFOWICZ, EDWARD ABBOTT 02/07/13 BAUM RUFFOLO & MARZAL LTD WIEDNER & MCAULIFFE LTD 144 13WC 29547 GIGNAC, MICHAEL E W S WELDING SUPPLY 05/15/13 GANAN & SHAPIRO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 11 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 145 13WC 29620 GARCIA, MARIA E MAID BRIGADE W 03/07/13 CULLEN HASKINS NICHOLSON 146 13WC 29912 NELSON, DONNA LAKE FOREST HOSPITAL 09/09/13 CULLEN HASKINS NICHOLSON BRAUN LORENZ & BERGIN PC 147 13WC 29932 OCHS, THOMAS J II AMN HEALTHCARE 02/07/13 O'CONNOR & NAKOS ADELSON TESTAN & BRUNDO 148 13WC 29956 GULIO, ANDREW J AMLI RESIDENTIAL 08/01/13 ATSAVES, LOUIS G LTD RIPES NELSON BAGGOT KALOBRAT 149 13WC 30545 RICHARDS, BRIAN STACK-ON PRODUCTS COMPANY 08/20/13 MARKHAM M JEEP & ASSOCIATE 150 13WC 30669 PEREZ, YOLANDA THE VISUAL PAK COMPANIES 08/15/13 GOLDBERG WEISMAN & CAIRO L KOREY COTTER HEATHER RICHARD 15WC001109 -C 151 13WC 31920 MARTINEZ, VERONICA SILVERADO 07/26/13 DWORKIN AND MACIARIELLO THOMAS & PORTELA 152 13WC 32022 WILLKOMM, SARAH BAXTER HEALTHCARE CORPORA 02/15/12 DOUGLAS RALLO PC MACIOROWSKI SACKMANN & ULRIC 153 13WC 32697 VALENTINE, TIMOTHY NORTHSHORE UNIVERSITY HEA 07/16/13 LOCASCIO, MARK A LTD 154 13WC 32787 PRICE, RICHARD L CAREY ELECTRIC INC 08/08/13 GOLDBERG WEISMAN & CAIRO L THOMAS & PORTELA 155 13WC 32815 REIDY, PATRICK J CON WAY FREIGHT INC 10/19/11 KELLY & KING 156 13WC 34731 KUHNLE, PAUL HYDRAFORCE INC 08/15/11 NEWLAND & NEWLAND 157 13WC 34923 SALGADO, RAPHAEL SOUTHEAST SERVICE CORP 04/02/13 LINN, CAMPE & RIZZO LTD 158 13WC 34967 19B MATUTE, ANGEL J MVP 09/05/13 FERRIS THOMPSON & ZWEIG KOREY RICHARDSON LLC 159 13WC 35006 SZALAJ, GREGORY SUNSET FOODS 09/22/13 WILLIAMS, ROBERT B LAW OFF KEEFE CAMPBELL & ASSOC LLC 16WC005509 -C 160 13WC 35168 RUIZ, JOEL VALUE CITY FURNITURE 09/13/13 JONATHAN SCHLACK HOLECEK & ASSOCIATES 161 13WC 35862 AMEZQUITA-MARTINEZ, MARIA FLEXIBLE STAFFING 05/27/13 JEROME FOREMAN & ASSOCIATE 162 13WC 37383 ORTIZ, JOSE WEST MACHINE PRODUCTS INC 10/22/13 GOLDBERG WEISMAN & CAIRO L

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 12 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 163 13WC 37604 HANSEN, HOWARD P HOME DEPOT 05/09/13 SLAVIN & SLAVIN MC ANDREWS & NORGLE LLC 164 13WC 38260 LIMON, ANA MCDONALDS 2224 09/13/13 ROSS J HELFAND GANAN & SHAPIRO 165 13WC 39188 SILVA-MORALES, GABRIEL LEIDERS PRAIRIE VIEW GARD 05/15/13 KATZ FRIEDMAN EAGLE ET AL 166 13WC 39281 IBARRA, BERNARDINO RED COAT FARM 10/31/13 LINN, CAMPE & RIZZO LTD COZZI & GOGGIN-WARD 167 13WC 39284 IBARRA, BERNARDINO RED COAT FARM 05/08/13 LINN, CAMPE & RIZZO LTD 168 13WC 39369 LEVI, NAOMI DEERFIELD ANIMAL HOSPITAL 11/06/13 ROSENBERG & ROSENBERG PC RUSIN & MACIOROWSKI LTD 169 13WC 39510 SUAREZ, ANGELA MARIA (WID PRECISION PARTNERS 09/04/13 BAUM RUFFOLO & MARZAL LTD HOLECEK & ASSOCIATES 15WC002919 -C 170 13WC 39519 PIERRE, RENETRICE ST OF IL DEPT OF KILEY 08/22/13 CORNFIELD & FELDMAN ASSISTANT ATTORNEY GENERAL 171 13WC 40206 SAENZ, ENRIQUE COOK ILLINOIS CORPORATION 11/07/13 FERRIS THOMPSON & ZWEIG GALLIANNI DOELL & COZZI LTD 172 13WC 40735 FLOHR, HOPE (AS NEXT FRIE ACE HARDWARE # 10/16/13 HANNIGAN & BOTHA, LTD RUSIN MACIOROWSKI & FRIEDMAN 173 13WC 42402 GUTIERAREZ, ROCIO GOODWILL TALENT BRIDGEP 11/08/13 ANKIN LAW OFFICE ACCIDENT FUND HOLDINGS 174 14WC 00189 19B HASKINS, ROBERT STATION IMAGING 08/09/12 LIPKIN & HIGGINS LAW OFFIC KNELL & O'CONNOR 175 14WC 00222 GREEN, LETORIA M ST OF IL DHS 10/08/13 GALLAGHER, DONALD V ASSISTANT ATTORNEY GENERAL 176 14WC 01489 SANCHEZ, JUVENTINO JUAN ALEMAN 12/08/13 JONATHAN SCHLACK 177 14WC 01982 MONTEMAYOR, SYLVIA A VONCO PRODUCTS, LLC 03/12/12 COLLISON LAW OFFICES HOLECEK & ASSOCIATES 178 14WC 02096 ROSARIO, JORGE JR UNISTAFF INC 11/21/13 WIEDNER & MCAULIFFE LTD 179 14WC 02316 GARCIA, JOSE A JOHNSON TREE EXPERT 06/28/12 ACEVES & PEREZ PC BRADY CONNOLLY & MASUDA PC 180 14WC 02509 19B WALLACE, CAROLYN FEDEX GROUND 12/23/13 SEIDMAN MARGULIS & FAIRMAN SCOPELITIS GARVIN LIGHT

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 13 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 181 14WC 02696 ABDAGIC, NEVZETA KENALL MANUFACTURING 10/05/12 CULLEN HASKINS NICHOLSON NYHAN BAMBRICK KINZIE & LOWR 182 14WC 02896 PONCE-GARCIA, JOSE VAL'S FRESH MARKET 01/08/14 ARGIONIS & ASSOCIATES LLC BRADY CONNOLLY & MASUDA PC 183 14WC 02912 MORENO, AUGUSTINO LIGHTSCAPE INC 05/01/13 JONATHAN SCHLACK RUSIN MACIOROWSKI & FRIEDMAN 184 14WC 03476 RAWLEY, SCOTT USF HOLLAND 08/08/13 ROSENBERG & ROSENBERG PC HENNESSY & ROACH PC 185 14WC 03671 SWANSON, MICHAEL J CITY OF HIGHLAND PARK 09/03/13 DOUGLAS RALLO PC 186 14WC 03882 ZAMICHE, FAHIM J.M.E. MARKETING INC 10/25/13 MEYERS & FLOWERS 187 14WC 04597 JOHNSON, YOSHIKA SAFEWAY TRANSPORATION 01/23/14 HOLECEK & ASSOCIATES 188 14WC 05710 NOVARRO, DALE J COUNTY OF LAKE 12/23/13 BAUM RUFFOLO & MARZAL LTD 189 14WC 06337 JUAREZ, REYNA C MEDLINE INDUSTRIES INC 02/07/12 JAUREGUI & ASSOCIATES 190 14WC 06564 MAIER, ANNE-MARIE MILLBURN DISTRICT 24 12/10/10 WOLFE LAW PC WIEDNER & MCAULIFFE LTD 14WC014359 -C 16WC008319 -C 191 14WC 06738 WEISS, PAUL HIGHLAND PARK FORD 12/17/13 DWORKIN AND MACIARIELLO GANAN & SHAPIRO 14WC006739 -C 192 14WC 06755 RUIZ, JOSE COYOTE CONSTRUCTION, LLC 12/06/13 LINN, CAMPE & RIZZO LTD WIEDNER & MCAULIFFE LTD 193 14WC 07070 BRCIK, MICHAEL G VASO JOVIC DBA ALEXANDRA 09/29/13 CRONIN & PETERS LAW OFFICES DEBORAH SCHAEFER 194 14WC 07366 SIEGEL, JEAN LAKE ZURICH LEXINGTON HEA 02/16/14 SOSTRIN AND SOSTRIN PC KEEFE CAMPBELL & ASSOC LLC 14WC023867 -C

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 14 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 195 14WC 07568 PARDA, GRAZYNA WOLLYS CLEANING SERVICES 01/24/14 CHEPOV & SCOTT LLC 196 14WC 07633 HENRIKSEN, HENRY FEDERAL EXPRESS 11/23/12 LINN, CAMPE & RIZZO LTD HANSON LAW OFFICE 15WC038921 -C FED EX 197 14WC 07906 PODRAZA, RADOSLAW LARSEN MANUFACTURING 02/17/14 THERMAN LAW OFFICES HOLECEK & ASSOCIATES 198 14WC 08074 IRIGOYEN, URIEL PLEXUS 01/15/14 AIOSSA LAW FIRM NYHAN BAMBRICK KINZIE & LOWR 199 14WC 08147 HAHLE, JAMES P ROUNDY'S INC 12/27/11 TAMVAKIS, GEORGE L BRYCE DOWNEY & LENKOV LLC 200 14WC 08532 MIRELES-PAREDES, JOEL MC DONALD'S #7323 02/07/14 KENNETH B GORE, LTD NYHAN BAMBRICK KINZIE & LOWR 201 14WC 08554 HERNANDEZ, LUCIO SUPER FRESH MARKET 02/17/14 202 14WC 09015 ESTEBAN, CARLOS LAWN MAN SERVICE 04/26/13 CULLEN HASKINS NICHOLSON 203 14WC 09550 CLEMENS, VINCENT WAUCONDA FIRE 09/27/11 MARKHAM M JEEP & ASSOCIATE RUSIN MACIOROWSKI & FRIEDMAN 204 14WC 09813 BALDERRAMA, MAURO MVP STAFFING, INC 03/05/14 CULLEN HASKINS NICHOLSON KOREY RICHARDSON LLC 205 14WC 10423 SANCHEZ, ALEXIS PRESTAGE PROPERTY 04/29/13 ROSS J HELFAND GANAN & SHAPIRO 206 14WC 10870 VASQUEZ, LILIA BRENTWOOD NORTH HEALTHCAR 06/23/11 VASILATOS & COTTER LLC 207 14WC 12236 PEREZ-WHEELER, BELINDA LAKE COUNTY HEALTH DEPT 11/01/13 CHARLES LEVY & ASSOC LTD SMITH AMUNDSEN LLC 208 14WC 12461 LOPEZ, SANTIAGO CITY OF WAUKEGAN 12/08/13 LINN, CAMPE & RIZZO LTD NYHAN BAMBRICK KINZIE & LOWR 14WC012462 -C 209 14WC 12597 RODRIGUEZ, AZUCENA HOLIDAY INN 03/11/14 HOLECEK & ASSOCIATES 210 14WC 13523 MAXWELL, BROCK DORMA AUTOMATIC 02/18/14 HANNIGAN & BOTHA, LTD 211 14WC 13685 GOMEZ, EVERARDO PUGSLEY & LA HAIE LTD 06/30/11 MARKHAM M JEEP & ASSOCIATE RIPES NELSON BAGGOT KALOBRAT 212 14WC 14398 CLEMENS, VINCENT WAUCONDA FIRE PROTECTION 08/05/13 MARKHAM M JEEP & ASSOCIATE RUSIN MACIOROWSKI & FRIEDMAN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 15 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 213 14WC 14473 RODRIQUEZ, ISIDRO ECHO, INC 04/15/14 FERRIS THOMPSON & ZWEIG 214 14WC 14556 AHUMADA, VIVIAN LABOR SOLUTIONS 11/18/13 215 14WC 14578 NASR, WAFAA COMMUNITY ACTION PARTNERS 10/03/12 DUDLEY & LAKE LLC STELLATO & SCHWARTZ 216 14WC 15358 CISNEROS, ADALBERTO JOEL KENNEDY CONSTRUCTING 02/25/14 WITTER LAW OFFICE CHILTON YAMBERT PORTER LLP 217 14WC 15795 EVANS, ASHLEY ANN KILEY DEVELOPMENTAL C 03/05/14 LAW OFFICE ANTHONY ESPOSIT ASSISTANT ATTORNEY GENERAL 218 14WC 15832 CONN, DEBRA B JEWEL FOODS 12/18/13 LINN, CAMPE & RIZZO LTD 219 14WC 16139 JOHNSON, DIVINE THE WEALSHIRE 02/11/14 DWORKIN AND MACIARIELLO 220 14WC 16163 TRASKA, DANIEL W LETECH, INC. 03/03/14 LINN, CAMPE & RIZZO LTD RUSIN MACIOROWSKI & FRIEDMAN 221 14WC 16461 BOONE, JONATHAN THE PLUMBER DOCTOR W 04/27/14 WOODRUFF & JOHNSON 222 14WC 16787 CALLAHAN, SAMUEL IMPERIAL GUARD & DETECTIV 09/22/13 HANNIGAN & BOTHA, LTD HOLECEK & ASSOCIATES 223 14WC 17121 ALVAREZ, DELIA SAM'S CLUB 03/07/14 HANNIGAN & BOTHA, LTD WIEDNER & MCAULIFFE LTD 224 14WC 17289 MORRISON, ANTIONETTE BAXTER HEALTH CARE 04/22/14 DWORKIN AND MACIARIELLO MACIOROWSKI SACKMANN & ULRIC 225 14WC 17334 DOMINQUEZ, MARTIN KEY LIME COVE 03/24/14 HORWITZ HORWITZ & ASSOC 226 14WC 17908 SCOTT, ERIC DEPARTMENT OF HUMAN SERVI @ 12/28/13 THE MACK LAW GROUP PC ASSISTANT ATTORNEY GENERAL 227 14WC 18114 CUARENTA, ALFONSO INTERNATIONAL PRECISION C 05/19/14 STROM, NEAL B LAW OFFICES JOSEPH MARCINIAK 228 14WC 18274 BERTONCINI, VINCE AMERITEMP GROUP 04/08/14 ANGELINI & ORI LLC 229 14WC 18407 RATAJCZYK, MICHAEL LAKELAND AUTOBODY INC 12/26/12 ROSS TYRRELL LAW OFFICES JOSEPH MARCINIAK 230 14WC 18796 ARROYO, FELIX CARTER HOFFMANN LLC 05/21/14 HANNIGAN & BOTHA, LTD WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 16 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 231 14WC 18942 ROBERTS, DEBRA BAXTER HEALTHCARE CO 03/19/14 BUDIN LAW OFFICES MACIOROWSKI SACKMANN & ULRIC 232 14WC 19542 GALLEGO, PEDRO VOLKSWAGEN CREDIT INC 01/11/13 ROMANEK & ROMANEK GAROFALO SCHREIBER STORM 233 14WC 19923 HOFF, JOHN JOSEPH SAFE TRAVEL 02/02/13 COHN & COHN HENNESSY & ROACH PC 234 14WC 19990 GRIMSIC, KENNETH COUNTY OF LAKE HEALTH DEP 08/30/13 MARKHAM M JEEP & ASSOCIATE WOLFE & JACOBSON, LTD 235 14WC 20132 SHIN, IK VOICE TRANS INC 05/10/14 LEO ALT 236 14WC 20490 HERNANDEZ, ROSALIA WILLIAMS ELECTRONIC GAMES 05/30/14 ILLINOIS INJURY LAWYERS RUSIN MACIOROWSKI & FRIEDMAN 14WC030899 -C 237 14WC 20673 DOMINGUEZ, DIXIANA LIZETH ELITE STAFFING INC 05/30/14 PARENTE & NOREM PC MARC CAIRO 238 14WC 21051 TENTLER, DAVID KNAUZ MOTOR SALES INC 02/24/14 MARKHAM M JEEP & ASSOCIATE GANAN & SHAPIRO 239 14WC 21258 LOCKWOOD, CHARLES NFI INDUSTRIES 05/12/14 HORWITZ HORWITZ & ASSOC MACIOROWSKI SACKMANN & ULRIC 14WC035277 -C 240 14WC 21429 CARRENO, MARIA BEL RESOURCES, INC. 11/14/13 FERRIS THOMPSON & ZWEIG 241 14WC 22105 GUADARRAMA, JOSEFINA DUNKIN DONUTS 04/23/14 242 14WC 22237 CAZARES, JULIA ECHO INCORPORATED 03/28/14 THE ROMAKER LAW FIRM WIEDNER & MCAULIFFE LTD 243 14WC 22973 PARDO, JOSEPH MARIANO'S FRESH MARKET 12/16/11 CULLEN HASKINS NICHOLSON BRYCE DOWNEY & LENKOV LLC 244 14WC 23094 GLATZ, MARY ANN JEWEL FOOD STORES INC 09/25/12 GRAHAN J. JEEP QUINTAIROS PRIETO WOOD & BOY 14WC023095 -C 245 14WC 23173 TEASLEY, THOMAS J ZION SOLUTIONS 06/11/14 RUBIN LAW GROUP 246 14WC 23428 WONNELL, NORMAN LEE THOMAS HAMILTON ROOFING 12/02/13 LAW OFFICES TIMOTHY LAMPIN 247 14WC 23564 NASH, KURT SR CITY OF NORTH CHICAGO 12/28/11 COLLISON & O'CONNOR

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 17 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 248 14WC 23979 DELGADO, ELIZABETH STAFFING NETWORK LLC 02/15/14 STROM, NEAL B SLAVIN & SLAVIN 249 14WC 23999 MERCIER, PAMELA MENARDS 06/19/14 TARADASH LAW OFFICE 250 14WC 24080 LARSON, RANDY PACE 04/30/14 BRISKMAN BRISKMAN GREENBER POWER & CRONIN LTD 15WC010160 -C 251 14WC 24148 WEBB, DAVID GERBER COLLISION & GLASS 06/09/14 LAW OFFICES PETER LEKAS HOLECEK & ASSOCIATES 252 14WC 24292 REED, MICHAEL D CITY OF WAUKEGAN 06/04/14 LINN, CAMPE & RIZZO LTD NYHAN BAMBRICK KINZIE & LOWR 14WC024347 -C 253 14WC 24300 KREUSER, LUZ M CANCER TREATMENT 05/30/13 LINN, CAMPE & RIZZO LTD GAROFALO SCHREIBER STORM 254 14WC 24336 SJODIN, DONNA JONES LANG LASALLE 03/14/14 MARSZALEK AND MARSZALEK LAW OFFICES JOSEPH MARCINIAK 255 14WC 24442 ALVAREZ, ISMAEL SEB SERVICES OF NEWYORK, 06/30/14 HORWITZ HORWITZ & ASSOC SCOPELITIS GARVIN LIGHT 256 14WC 24891 19B SCHMIDT, MICHELENE SENIOR SILVERADO LIVING 01/30/15 STEVEN J TENZER, LTD RUSIN & MACIOROWSKI LTD 15WC005245 -C 257 14WC 25037 ESCOBAR, JOSE DORMA AUTOMATIC 07/17/14 AIOSSA LAW FIRM 258 14WC 25166 HAGEN, JOHN MENARD INC 06/28/14 THOMAS J POPOVICH CHILTON YAMBERT PORTER LLP 259 14WC 25296 JAKUBIAK, ROMAN COST OF WISCONSIN INC 05/05/14 CUSHING LAW OFFICES 260 14WC 25425 RAMIREZ, BLANCA COUNTYARD MARIOTT 06/07/13 POSTERLI, OSCAR NYHAN BAMBRICK KINZIE & LOWR 261 14WC 25901 MUN, JOHN WM MEYERS & SON 05/19/14 TOPPER & WEISS LTD 262 14WC 26083 PARHAM, VICTORIA ILLINOIS CENTRAL SCHOOL B 05/12/14 SHELDON I MINKOW & ASSOCIA MACIOROWSKI SACKMANN & ULRIC 263 14WC 26211 WIETING, WILLIAM HOME DEPOT 07/11/12 GOLDBERG WEISMAN & CAIRO L ADELSON TESTAN & BRUNDO 14WC026212 -C 14WC026213 -C 264 14WC 26259 HERNANDEZ, LAURA COMFORT SUITES 11/19/13 STROM, NEAL B INMAN & FITZGIBBONS

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 18 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 265 14WC 26565 MELCHOR, AUGUSTIN PATRICK SCALZO INDIVIDU & 05/29/14 LINN, CAMPE & RIZZO LTD 266 14WC 27131 VASQUEZ, JAIME MANEVAL CONSTRUCTION COMP 08/04/14 HANNIGAN & BOTHA, LTD BRADY CONNOLLY & MASUDA PC 267 14WC 27479 RAMIREZ, JOSE JUAN TOBY'S TAVERN 06/15/14 268 14WC 27565 AYALA, ANDRES JB BRICKWORKS INC 11/04/13 HANNIGAN & BOTHA, LTD WIEDNER & MCAULIFFE LTD 269 14WC 28067 MISEK, JOHN ILLINOIS TOLLWAY 06/04/14 HANNIGAN & BOTHA, LTD NYHAN BAMBRICK KINZIE & LOWR 14WC028068 -C 14WC035134 -C 270 14WC 28084 WHITTAKER, ZACKERY PAULY HONDA AND PAULY ACU 11/07/13 GANAN & SHAPIRO 271 14WC 29164 HERNANDE, LAURA COMFORT 08/02/14 FERRIS THOMPSON & ZWEIG 272 14WC 29165 CERVANTES, DAVID CDW LLC 06/11/14 FERRIS THOMPSON & ZWEIG HENNESSY & ROACH PC 273 14WC 30610 NUNEZ, NORMA A-S MEDICAL SOLUTIONS 12/12/12 THE ROMAKER LAW FIRM LAW OFFICES OF EDWARD J. KOZ 274 14WC 30701 HAUBER, JOHN K VILLAGE OF BUFFALO GROVE 01/01/01 CULLEN HASKINS NICHOLSON POWER & CRONIN LTD 275 14WC 30929 MARTINEZ, NORA JST CORP 01/27/14 LEONARD LAW GROUP LLC HENNESSY & ROACH PC 276 14WC 31010 CADETTE, STEVE GOODWILL INDUSTRIES 08/22/14 DWORKIN AND MACIARIELLO ACCIDENT FUND HOLDINGS 14WC031011 -C 277 14WC 31049 PETERMAN, LISA WINTRUST FINANCIAL CORPOR 08/16/13 NILSON STOOKAL GLEASON CAP HOLECEK & ASSOCIATES 278 14WC 31164 GALVEZ, JOSE MOST VALUABLE PERSONNEL 07/01/14 FERRIS THOMPSON & ZWEIG KOREY RICHARDSON LLC 279 14WC 31197 HOPKINS, BRENDA L J C PENNEY 04/21/14 LINN, CAMPE & RIZZO LTD QUINTAIROS PRIETO WOOD & BOY 280 14WC 31450 GROVER, ROBERT W LAKE SHORE BEVERAGE, INC 06/24/14 LINN, CAMPE & RIZZO LTD ASHER, RAYMOND L LTD 281 14WC 31494 SIPOS, JUANITA STAR WELLS BLOOMFIELD 10/08/13 VRDOLYAK LAW GROUP LLC WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 19 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 282 14WC 31925 CONTRERAS, LUIS PETCO 01/08/14 DOUGLAS RALLO PC 283 14WC 32766 PAVON, ANA TAKEDA PHARMACEUTICAL CO 11/13/13 SMOLER LAW OFFICE, PC HENNESSY & ROACH PC 14WC033690 -C 284 14WC 32782 BENES, FRANK STATE OF ILLINOIS @ 05/05/14 GOLDBERG WEISMAN & CAIRO L ASSISTANT ATTORNEY GENERAL 285 14WC 32859 ROSALES, PAOLA ACCURATE PERSONNEL LLC 09/05/14 CULLEN HASKINS NICHOLSON 286 14WC 32886 MCCARROLL, DEBRA GOODWILL INDUSTRIES 09/04/14 ANKIN LAW OFFICE NOLAN, JOHN O JR 287 14WC 33080 TELLEZ, ROSENDO SEBERT LANDSCAPING INC 07/22/14 AIOSSA LAW FIRM WIEDNER & MCAULIFFE LTD 288 14WC 33349 GRAF, L KELLY HBS MANAGEMENT CORP 08/09/13 LINN, CAMPE & RIZZO LTD 289 14WC 33352 CASTRO, JUANA LABOR SOLUTIONS 05/12/14 LINN, CAMPE & RIZZO LTD KLAUKE LAW GROUP LLC 290 14WC 33919 ANTONIO, CRISTOPHER DEBDOUB CLEANING SERVICES 09/16/14 291 14WC 34012 MOORE, CHARMAINE MARIANOS 09/19/14 THE ROMAKER LAW FIRM BRYCE DOWNEY & LENKOV LLC 292 14WC 34257 ESCUTIA, MARIA GRAND AVENUE DONUTS INC 09/15/14 JONATHAN SCHLACK BRYCE DOWNEY & LENKOV LLC 14WC034258 -C 293 14WC 34333 ROSEN, PHILLIP INSURANCE SERVICE CENTER 04/15/14 STROM, NEAL B NYHAN BAMBRICK KINZIE & LOWR 14WC034334 -C 294 14WC 35160 MITCHELL, KEVIN P ROE AUTOMOTIVE, INC. 07/14/14 LINN, CAMPE & RIZZO LTD BRADY CONNOLLY & MASUDA PC 295 14WC 35637 SPINLER, LANCE MORTON METALEX NORTH MFG 09/01/14 DWORKIN AND MACIARIELLO COZZI & GOGGIN-WARD 296 14WC 35820 SIEGAL, JEFFREY TOWNSHIP DISTRICT HIGH 11/17/11 KREITER, BYCK & ASSOC LLP WIEDNER & MCAULIFFE LTD 14WC035821 -C 297 14WC 35887 OCAMPO, JUAN SCOTT BYRON & COMPANY INC 07/10/14 CULLEN HASKINS NICHOLSON NYHAN BAMBRICK KINZIE & LOWR 298 14WC 36112 POMOZY, ATTILA USA OVERSEAS WIRELESS CAB 06/12/14 NEWLAND & NEWLAND GANAN & SHAPIRO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 20 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 299 14WC 36459 HILLIGOSS, ANDREY MEDICAL EXPRESS AMBULANCE 09/04/14 300 14WC 36575 CRUZ, JUAN LUIS ACCURATE PERSONNEL 07/03/14 LAW OFFICES LEONARDO MORAL GRANT & FANNING 301 14WC 37036 TALAVERA, LUIS RAMON ULINE INC 04/14/14 DEPAOLO ZADEIKIS GORE GANAN & SHAPIRO 302 14WC 37160 KREJCI, CELIA SUNRISE SENIOR LIVING 04/22/13 ANTHONY J MAY 303 14WC 37269 ZAMORA, ARTEMIO LANDSCAPE CONCEPTS MNGMT 09/09/14 HANNIGAN & BOTHA, LTD KEEFE CAMPBELL & ASSOC LLC 304 14WC 37839 GENTZEN, JULIE A ROUND LAKE SCHOOL 09/05/14 ANESI OZMON RODIN NOVAK KO NYHAN BAMBRICK KINZIE & LOWR 305 14WC 37982 TAPIA, MARIA LORENA ECHO INC 08/09/12 AIOSSA LAW FIRM 306 14WC 38156 WEISKE, PHIL UNIVERSAL PLUMBING, INC. 08/15/14 CRAIG L MANCHIK & ASSOC. BRADY CONNOLLY & MASUDA PC 307 14WC 38905 ELLIOTT, PAMELA S ABBOTT LABORATORIES 07/01/14 LAW OFFICE ILONKA ULRICH WIEDNER & MCAULIFFE LTD 308 14WC 39162 MOORE, WILBERT GOODWILL INDUSTRIES 10/24/14 DWORKIN AND MACIARIELLO ACCIDENT FUND HOLDINGS 309 14WC 39909 CHARO, RUBEN AMCOR FLEXIBLES 07/31/14 DWORKIN AND MACIARIELLO HOLECEK & ASSOCIATES 310 14WC 40326 VASQUEZ, JOSEFINA ABBVIE 07/16/14 GOLDBERG WEISMAN & CAIRO L HENNESSY & ROACH PC 311 14WC 40412 BROTAN, BOBBY BUCHANAN ENERGY 08/25/14 RUBIN LAW GROUP RODDY LAW LTD 14WC041554 -C 312 14WC 41250 YOUSIF, ANDY ARAMARK 10/23/14 KALOGERAKOS & ASSOC 313 14WC 41523 PETERSON, RALPH LAMBENT TECHNOLOGIES CORP 02/27/13 314 14WC 42232 HUMBRACHT, ALBERT PIZZA HUT/F.M.I. W 01/15/14 RAYMOND M SIMARD, PC 315 14WC 42542 MARTINEZ, JUAN SON CROP DBA ROSATIS PIZZ 01/09/14 FERRIS THOMPSON & ZWEIG 316 14WC 42797 RYBARCZYK, GREGORY JR THE COCA COLA COMPANY INC 11/13/14 GRAHAM J. JEEP BRADY CONNOLLY & MASUDA PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 21 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 317 14WC 42838 MANGES, JOSEPH E VILLAGE OF GRAYSLAKE 07/11/13 LINN, CAMPE & RIZZO LTD RUSIN & MACIOROWSKI LTD 318 14WC 43279 ESPINOZA, ESTEBAN LEWIS PRODUCE MARKET 11/25/14 POSTERLI, OSCAR KOPKA, PINKUS & DOLIN, PC 319 14WC 43641 VUONG, MILAGRO STAFFING DIMENSIONS 04/09/12 FERRIS THOMPSON & ZWEIG LAW OFFICES FRANCESCA LARSEN 14WC043642 -C 14WC043643 -C 320 15WC 00152 BUTCHER, CAROL ADLAI E STEVENSON H S 10/09/14 SEIDMAN MARGULIS & FAIRMAN NYHAN BAMBRICK KINZIE & LOWR 321 15WC 00656 BROWN, CHAD FED EX 12/15/14 ANKIN LAW OFFICE SCOPELITIS GARVIN LIGHT 322 15WC 00786 ZUNIGA, ADOLFO A DIVINCI PAINTERS INC 12/23/14 GOLDSTEIN AIOSSA & GOOD 323 15WC 00878 RODRIGUEZ, KRISTINE VAL'S FRESH MARKET 11/20/14 WILLIAMS, ROBERT B LAW OFF GAROFALO SCHREIBER STORM 324 15WC 01335 JACKSON, WILLIAM L ARAMARK 12/19/14 ANKIN LAW OFFICE 325 15WC 01861 LARSEN, AMY THE ALLENDALE ASSOCIATION 01/01/13 MURPHY & MURPHY 326 15WC 02479 NADULEK, JACK CIRCLE K, INC. 07/01/14 STORTO FINN & ROSINSKI NYHAN BAMBRICK KINZIE & LOWR 327 15WC 02640 FLORES, ADRIAN HORIZONS HOLDINGS LLC 07/07/14 DOUGLAS RALLO PC COZZI & GOGGIN-WARD 328 15WC 03162 TALAVERA, LUIS R ULINE INC 07/10/13 DEPAOLO ZADEIKIS GORE GANAN & SHAPIRO 329 15WC 03353 AQUINO, FELIX WALKER BROTHERS, THE ORIG 01/01/15 FERRIS THOMPSON & ZWEIG 330 15WC 03460 BUHNERKEMPER, MAURICE NORTH SHORE SANITARY DIST 08/18/14 LANNON LANNON & BARR LTD RUSIN & MACIOROWSKI LTD 331 15WC 03733 MONETTE, THOMAS MOST VALUABLE PERSONNEL 11/07/14 GRIMES, G DOUGLAS KOREY RICHARDSON LLC 332 15WC 04066 DEMAIN, DANIEL J MBA TRANSPORT LTD 10/30/14 HANNIGAN & BOTHA, LTD ALLEN KOPET & ASSOCIATES 333 15WC 04500 COLEMAN, TANISHA HELP-AT-HOME, INC 11/30/14 LEO ALT COZZI & GOGGIN-WARD 334 15WC 04861 PRICE, ANTHONY CALVIN KINGWIRE 11/24/14 COLLISON & O'CONNOR LAW OFFICES OF EDWARD J. KOZ

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 22 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 335 15WC 05730 PETERSON, ANTHONY VANTAGE SPECIALTY CHEMICA 01/01/15 336 15WC 06336 MARTINEZ, ITZEL XCEL STAFFING SOLUTIONS 10/03/14 LINN, CAMPE & RIZZO LTD KOREY RICHARDSON LLC 337 15WC 06342 BROWN, MICHAEL T WALMART 07/30/13 LINN, CAMPE & RIZZO LTD QUINTAIROS PRIETO WOOD & BOY 338 15WC 06355 DE JESUS, HERNANDEZ VELAZ LABOR SOLUTIONS, INC. 08/25/14 LINN, CAMPE & RIZZO LTD NEWLAND & NEWLAND 339 15WC 06465 BLAIR, REGINA K. SIX FLAGS GREAT AMERICA 08/07/13 DWORKIN AND MACIARIELLO 340 15WC 06774 QUEZADA, MARTIN ZION SOLUTIONS LLC 02/04/15 HORWITZ HORWITZ & ASSOC QUINTAIROS PRIETO WOOD & BOY 341 15WC 06813 CARRILLO, DOLORES AMCOR FLEXIBLES HEALTH CA 09/12/14 DWORKIN AND MACIARIELLO 342 15WC 07014 EDMONDS, JEFFREY SCHMIDT STEEL 12/12/14 ANESI OZMON RODIN NOVAK KO HENNESSY & ROACH PC 343 15WC 07041 LANGE, JAMES A VILLAGE OF GURNEE 08/21/14 LINN, CAMPE & RIZZO LTD ANCEL GLINK DIAMOND BUSH & E 344 15WC 07415 SALDANA, EDGAR LAKESIDE INSULATION LLC 05/09/14 GRAHAM J. JEEP GRANT & FANNING 345 15WC 07469 BIGGS, CHESTER AUTO EXPO DETAILING INC 02/22/15 ROBERT EDENS BRADY CONNOLLY & MASUDA PC 346 15WC 07478 LANG, JOHN WASTE MANAGEMENT 01/05/15 GOLDBERG WEISMAN & CAIRO L 347 15WC 07802 GERATY, CHRIS BEST BUY STORES 11/12/14 HANNIGAN & BOTHA, LTD 348 15WC 07893 PEREZ, ALEJANDRO OUTBACK STEAKHOUSE 01/16/15 JOEL BELL 349 15WC 08024 JARABA, JOHANNA MARIANI LANDSCAPE 04/28/14 MC HARGUE, JAMES P LAW OFF 350 15WC 08269 MANDUJANO, MARIA G PRESBYTERIAN HOMES 06/16/12 POSTERLI, OSCAR NYHAN BAMBRICK KINZIE & LOWR 15WC008270 -C 351 15WC 08334 CAMARGO, CASIMIRO LENO'S CERAMIC & TILE MAR W 02/19/15 MC HARGUE, JAMES P LAW OFF 352 15WC 08529 BETTS, DON GURNEE DODGE 02/14/15 DWORKIN AND MACIARIELLO ROSARIO CIBELLA

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 23 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 353 15WC 08545 DALTON, SHAUN R ELITE STAFFING 02/21/15 LEE A CAMPBELL LAW OFFICE GAROFALO SCHREIBER STORM 354 15WC 09206 ESTATE OF DEGAND, RICHARD THE GROVE AT THE LAKE # 02/26/15 DAVID J. BAWCUM BRADY CONNOLLY & MASUDA PC 355 15WC 09342 ALLEN, JENNIFER DEB SHOPS, INC. 03/10/13 MARKHAM M JEEP & ASSOCIATE 356 15WC 09475 SANCHEZ, ADRIAN XCEL STAFFING SOLUTIONS 02/27/15 JONATHAN SCHLACK KOREY RICHARDSON LLC 357 15WC 09536 KAMPENDAHL, KURT E AT & T INC 02/22/15 GOLDBERG WEISMAN & CAIRO L 358 15WC 09876 HALLORAN, ROBERT JC PENNY CORP INC 01/03/15 DUDLEY & LAKE LLC ADELSON TESTAN & BRUNDO 359 15WC 10051 DELEON, CLAUDIA ANDREWS & STAFF FORCE 03/17/15 BOGUSZ & BOGUSZ LTD SLAVIN & SLAVIN 360 15WC 10262 SUNDBLOM, CHERYL FREMONT SCHOOL DISTRICT 7 03/20/15 KEATING LAW OFFICE POWER & CRONIN LTD 361 15WC 10272 JOHNSTON, DEBRA R THE GROVE AT THE LAKE 11/23/14 HANNIGAN & BOTHA, LTD BRADY CONNOLLY & MASUDA PC 362 15WC 10492 SAMSON, KELLEY SEDGEBROOK 01/16/14 WHITESIDE & GOLDBERG LTD WOLFE & JACOBSON, LTD 363 15WC 10676 CORRALES, MARIA GREAT LAKES RESOURCES 03/12/15 FERRIS THOMPSON & ZWEIG HOLECEK & ASSOCIATES 364 15WC 11112 MEDINA, SAMUEL EAGLE TRUCK WASH 03/18/15 DWORKIN AND MACIARIELLO HOLECEK & ASSOCIATES 365 15WC 11388 YU, JONATHAN PEAPOD, INC 12/16/14 CULLEN HASKINS NICHOLSON LITCHFIELD CAVO 366 15WC 11485 ARROYO, PERLA SMALLEY STEEL RING CO 03/23/15 LUIS A ACEVES & ASSOC 367 15WC 11551 LANZEROTTI, KRISTEN ANTIOCH SCHOOL DISTRICT 3 11/10/14 MARKS & ASSOCIATES ANCEL GLINK DIAMOND BUSH & E 368 15WC 12023 MC CORKHILL, SHAWN E PRAXAIR 10/21/14 LINN, CAMPE & RIZZO LTD HENNESSY & ROACH PC 369 15WC 12089 GARCIA, EMPERATRIZ ECHO INC 04/16/13 FERRIS THOMPSON & ZWEIG 370 15WC 12326 BARAJAS, JOSEPHINA THE CLEANING AUTHORITY 11/24/14 LAW OFFICES LEONARDO MORAL BRADY CONNOLLY & MASUDA PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 24 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 371 15WC 12435 VELASCO, JAVIER SELECT REMEDY 08/22/14 JOHN S. ELIASIK LEAHY EISENBERG & FRAENKEL 372 15WC 12540 SCHWAB, MICHAEL HAYES MACHANICAL 03/09/15 LINN, CAMPE & RIZZO LTD GAROFALO SCHREIBER STORM 373 15WC 12578 PEREZ, JUAN WILLIAMS CUSTOM CARPENTRY 03/18/15 LAW OFFICE EDWARD RUEDA BRADY CONNOLLY & MASUDA PC 374 15WC 13259 ACOSTA, SANDRA LONG GROVE CONFECTIONERY 03/09/15 MC HARGUE, JAMES P LAW OFF GANAN & SHAPIRO 15WC031333 -C 375 15WC 13401 PEREZ, BERTHA ABBVIE 10/20/13 WIEDNER & MCAULIFFE LTD 376 15WC 14052 CAMPOS, KATHRYN JEWISH COMMUNITY CENTER 11/25/14 RICHARD O. GREENFIELD LAW OFFICES JOSEPH MARCINIAK 377 15WC 14119 SCALES, SAM IDOT 03/30/15 ILLINOIS ATTORNEY GENERAL 378 15WC 14250 ALVAREZ, MARIA ILLINOIS CENTRAL SCHOOL B 02/26/15 ANTHONY J MAY MACIOROWSKI SACKMANN & ULRIC 379 15WC 14319 JIMENEZ-ALVAREZ, MARIA D MVP 03/05/14 ANTHONY J MAY KOREY RICHARDSON LLC 380 15WC 14491 VELAZQUEZ, JOSE DE JESUS LABOR SOLUTIONS, LLC 03/02/15 LINN, CAMPE & RIZZO LTD 381 15WC 14528 PROCHNOW, GREGORY ILLINOIS TOLLWAY @ 03/12/15 HANNIGAN & BOTHA, LTD NYHAN BAMBRICK KINZIE & LOWR 382 15WC 14861 CLEMENS, VINCENT WAUCONDA FIRE 02/27/15 MARKHAM M JEEP & ASSOCIATE RUSIN & MACIOROWSKI LTD 383 15WC 15255 PETT, RON LAKE COUNTY SHERIFF'S OFF 02/28/14 STANCZAK LAW OFFICES SMITH AMUNDSEN LLC 384 15WC 15453 SALEK, KRZYSTOF VAL'S CONSTRUCTION INC 12/16/14 GROSZEK LAW FIRM RUSIN & MACIOROWSKI LTD 385 15WC 15869 STORMES, EARL STACK-ON 04/21/15 ANTHONY ESPOSITO HEYL ROYSTER VOELKER & ALLEN 386 15WC 16415 ALVARADO, SERGIO ACCURATE PERSONNEL 05/07/15 HANNIGAN & BOTHA, LTD GRANT & FANNING 387 15WC 16649 EASTON, CAROL SIEMENS 02/06/15 ROBERT H HANAFORD KOPKA, PINKUS DOLIN, PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 25 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 388 15WC 16991 EARL, ANISHA TOPLINE TRANSPORATION 05/14/15 AIOSSA LAW FIRM RUSIN & MACIOROWSKI LTD 389 15WC 16995 PEAK, LUCELLA A NOSCO, INC. 12/15/14 GREG TUITE & ASSOC WOLFE & JACOBSON, LTD 15WC030173 -C 390 15WC 17023 OLEJNICZAK, JOHN WALKERS SERVICE 01/25/15 DAVID W MARTAY LAW OFFICES JOSEPH MARCINIAK 391 15WC 17169 WATSCHKE, CHRIS HIGHLAND PARK AUTOMOTIVE, 12/30/14 MARKHAM M JEEP & ASSOCIATE 392 15WC 17320 AREVALO, ROGER LA FITNESS 03/26/15 JAMES ELLIS GUMBINER & ASS COZZI & GOGGIN-WARD 393 15WC 17729 MANDELL, BOBBE EQUINOX 02/15/15 SOSTRIN AND SOSTRIN PC 394 15WC 18096 KATRALIS, IRENE CITY OF WAUKEGAN 02/03/15 DUDLEY & LAKE LLC BERNARD WYSOCKI & ASSOCIATES 395 15WC 18120 DELCUADRO, FERNANDO STATE OF IL DEPT OF 03/19/15 ANKIN LAW OFFICE ASSISTANT ATTORNEY GENERAL 396 15WC 18200 MILLER, STACY E/ WFF FACILITY SERVICES 05/14/13 ANTHONY J MAY 397 15WC 18662 RUPRECHT, ADAM P.S. DEMOLITION INC 12/26/13 CULLEN HASKINS NICHOLSON RUSIN & MACIOROWSKI LTD 398 15WC 18745 WYLEGALA, JOANNE GAP, INC/OLD NAVY 03/17/15 CAPRON & AVGERINOS PC ROBERT L. SMITH 399 15WC 18965 BOOTHE-ANDERSON, MARIE L. ENERGY SOLUTIONS, INC. 02/19/13 LINN, CAMPE & RIZZO LTD 400 15WC 19212 HERNANDEZ, ROMULO ECHO INC 10/21/14 CHEPOV & SCOTT LLC 401 15WC 19373 POWERS, TINA M BARTON OF ZION, INC. 01/28/15 LINN, CAMPE & RIZZO LTD BRADY CONNOLLY & MASUDA PC 402 15WC 19391 REINHARD, TIMOTHY ENERGY SOLUTIONS 01/26/15 GOLDBERG WEISMAN & CAIRO L QUINTAIROS PRIETO WOOD & BOY 403 15WC 19513 FOSCO, AMANDA M COUNTY OF LAKE 05/09/15 LINN, CAMPE & RIZZO LTD SMITH AMUNDSEN LLC 15WC019993 -C 404 15WC 19787 ACOSTA, ANTONIO EDDY'S TREE SERVICE 04/27/15 DAVID J. BAWCUM GANAN & SHAPIRO 405 15WC 19869 JEFFREY, BURKE LAKE COUNTY ILLINOIS 12/08/12 BAUM RUFFOLO & MARZAL LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 26 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 406 15WC 19975 JONES, GREDEL KILEY DEVELOPMENTAL CENTE 03/27/15 DWORKIN AND MACIARIELLO ASSISTANT ATTORNEY GENERAL 407 15WC 20030 GARDANIER, RONALD IDOT @ 03/09/15 GRAHAM J. JEEP ASSISTANT ATTORNEY GENERAL 408 15WC 20109 ALVAREZ, FELIX RUPRECHT CO 04/22/15 SALK, STEVEN B & ASSOC LTD COZZI & GOGGIN-WARD 409 15WC 20362 WINKLER, GIANENA WALGREENS 01/20/14 DWORKIN AND MACIARIELLO GILDEA & COGHLAN 410 15WC 20577 SARMIENTO, ALLAN MBA BUILDING SUPPLIES 05/28/15 MARKS & ASSOCIATES HOLECEK & ASSOCIATES 411 15WC 20957 ANDERSON, MARTHA BEL RESOURCE INC. 05/19/15 BAUM RUFFOLO & MARZAL LTD 412 15WC 21002 ROSALES, PABLO KRUGEL COBBLES 05/08/14 SEIDMAN MARGULIS & FAIRMAN GAROFALO SCHREIBER STORM 413 15WC 21239 EISENBERG, MARK R BAXTER INTERNATIONAL INC 06/27/13 MACIOROWSKI SACKMANN & ULRIC 414 15WC 21341 OTAHAL, JILL WAUKEGAN PUBLIC SCHOOL DI 07/16/13 LAW OFFICE OF SCOTT B SHAP BRADY CONNOLLY & MASUDA PC 415 15WC 21817 GONZALEZ, EVERARDO NORTHSTAR GROUP SERVICES 05/18/15 LINN, CAMPE & RIZZO LTD THOMAS & PORTELA 416 15WC 21878 DEANDA, MARIA LIBERTYVILLE MANOR 05/25/15 DWORKIN AND MACIARIELLO KEEFE CAMPBELL & ASSOC LLC 417 15WC 22239 BRANDON, CHRISTEL E. ULTA SALON, COSMETICS 02/02/13 LEE A CAMPBELL LAW OFFICE RUSIN & MACIOROWSKI LTD 418 15WC 22439 LOPEZ, SUSANA KALLE USA INC. 05/08/15 CHEPOV & SCOTT LLC HOLECEK & ASSOCIATES 419 15WC 22571 BLANCAS, JORGE POTBELLY SANDWICH SHOP 03/11/15 LARRY FLEISCHER & ASSOCIAT COZZI & GOGGIN-WARD 420 15WC 22941 DEALMONTE-ROJO, CAIN ATR TRANSMISSION REMANUFA 06/06/15 LAW OFFICE EDWARD RUEDA ROSARIO CIBELLA 421 15WC 22983 NEWBERRY, ANTHONY ROYER ASPHALT PAVING 06/11/15 HORWITZ HORWITZ & ASSOC GOLDBERG SEGALLA LLC 422 15WC 23024 DEAND, MARIA LIBERTYVILLE MANOR 05/25/15 JEROME FOREMAN & ASSOCIATE 423 15WC 23254 HACKERT, JASON SEARS 02/02/15 HANNIGAN & BOTHA, LTD GAROFALO SCHREIBER STORM

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 27 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 424 15WC 23366 TELLEZ, MARIBEL ZELLER PLASTIK INC 06/05/15 LANNON LANNON & BARR LTD GRANT & FANNING 425 15WC 23504 QASUM, FATMEH KENTUCKY FRIED CHICKEN 07/11/15 AMBROSE BUTZEN LAW GROUP HENNESSY & ROACH PC 426 15WC 23783 FRELAS, MARZENA STAFFING DIMENSION OF 03/13/15 MICHALSKI & GUBERNAT LAW OFFICES FRANCESCA LARSEN 427 15WC 23814 ZIMMERMAN, CATHERINE E KOHLS DEPARTMENT STORE 08/12/14 HANNIGAN & BOTHA, LTD HENNESSY & ROACH PC 428 15WC 23992 MCDUFFIE, SHAWN ABBOTT LABORATORIES 02/02/15 NEWLAND & NEWLAND HENNESSY & ROACH PC 429 15WC 24077 RIVERA, LINDA GARCIA WILLIAMS ELECTRONIC GAMES 11/05/14 COLLISON & O'CONNOR 430 15WC 24189 JUAREZ, ROSARIO ANDREWS STAFFING INC 07/31/15 FERRIS THOMPSON & ZWEIG 431 15WC 24275 COLE, JERRY J.B. HUNT 07/27/15 POLLANS, LANNIE A LTD 432 15WC 24338 MIRELES, JUAN I&L CONSULTING 04/02/15 RUEDA, IVAN A LITCHFIELD CAVO 433 15WC 24382 OSORIO, GERONIMO ENRICO MOSCONI LANDSCAPE W 07/23/15 CHEPOV & SCOTT LLC 434 15WC 24646 MCCLAY, DASHANA AON HEWITT 03/03/15 EFTEKHARI LAW OFFICES BRADY CONNOLLY & MASUDA PC 435 15WC 25646 CARDONA, FERMIN MANFREDINI LANDSCAPING-DE 07/06/15 DWORKIN AND MACIARIELLO RODDY LAW LTD 436 15WC 25706 RODRIGUEZ, JOSEFINA AKA COMMERCIAL PLASTICS DBA X 11/04/14 JONATHAN SCHLACK ACCIDENT FUND HOLDINGS 437 15WC 25774 WATSCHKE, DIANNA CONSOLIDATED PATHOLOGY 07/07/15 MARKHAM M JEEP & ASSOCIATE 438 15WC 26170 JACKSON, MARY HERITAGE WOODS OF GURNEE 06/29/15 DWORKIN AND MACIARIELLO SLAVIN & SLAVIN 439 15WC 26291 CLEGGETT, CHARMAINE TRADER JOE'S 05/28/15 DWORKIN AND MACIARIELLO MC ANDREWS & NORGLE LLC 440 15WC 26650 TORRES, MARIO ANN M. KILEY CENTER/ @ 01/15/14 LINN, CAMPE & RIZZO LTD ILLINOIS ATTORNEY GENERAL 441 15WC 26662 OCHOA, MARIA G. COLEMAN CABLE - SOUTHWIRE 04/20/15 LINN, CAMPE & RIZZO LTD GANAN & SHAPIRO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 28 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 442 15WC 26774 SCHLENDER, NINA STARBUCKS COFFEE COMPANY 07/08/15 LAW OFFICES PETER LEKAS BRADY CONNOLLY & MASUDA PC 443 15WC 26946 GEZZER, ROBERT J COBBLESTONE OVENS INC 12/22/14 LINN, CAMPE & RIZZO LTD COZZI & GOGGIN-WARD 444 15WC 26949 SIMS, ROY L ARAMARK INC 02/19/15 LINN, CAMPE & RIZZO LTD 445 15WC 26952 KLAUSS, RYAN M INTERPLEX INDUSTRIES INC 05/28/15 LINN, CAMPE & RIZZO LTD THOMAS & PORTELA 446 15WC 27085 ROBLES, CESAR COLEMAN CABLE INC 08/06/15 ANKIN LAW OFFICE GANAN & SHAPIRO 447 15WC 27242 BUNCH, CHARLES W. JR. Z & L MACHINING INC 06/15/15 GOLDBERG WEISMAN & CAIRO L GANAN & SHAPIRO 448 15WC 27400 SCHURMAN-PARKER, EVELYN T DYNAPAR 10/01/14 SOSTRIN AND SOSTRIN PC 449 15WC 27696 KARANTZIS, ELLEN LLOYD SIGMAN, D.D.S., LTD 03/17/15 BURNETT & CARON, LTD INMAN & FITZGIBBONS 450 15WC 27937 HAMILTON, TNEL NOSCO 06/22/15 AIOSSA LAW FIRM 451 15WC 28224 SMITH, RAYMOND SOUTHWIRE 08/15/15 AIOSSA LAW FIRM GANAN & SHAPIRO 452 15WC 28391 GUZMAN, ROBERTO PACE BUS COMPANY 08/05/15 LEE, MARK N LAW OFFICE POWER & CRONIN LTD 453 15WC 28510 GIELCZYNSKI, JOANNA NORTHWESTERN LAKE 06/03/15 ARGIONIS & ASSOCIATES LLC 454 15WC 28786 STARZEC, DARIUSZ TED'S TUCKPOINTING 08/14/15 CULLEN HASKINS NICHOLSON 455 15WC 28812 JONES, CHANTOUN WAUKEGAN PARK DISTRICT 06/05/15 DUDLEY & LAKE LLC HENNESSY & ROACH PC 456 15WC 28870 ESCOBAR, CRUZANN ACCURATE PERSONNEL SERVIC 07/18/15 JOHN S. ELIASIK 457 15WC 29048 GREEN, ROBERT BRIAN PARK DISTRIC OF 03/08/13 SHELDON I MINKOW & ASSOCIA HENNESSY & ROACH PC 458 15WC 29305 GARIBAY, JUAN PABLO G T LANDSCAPING LLC 05/19/15 CULLEN HASKINS NICHOLSON 459 15WC 29502 WHITE, RODNEY ALERIS INTERNATIONAL 08/01/15 KATZ FRIEDMAN EAGLE ET AL BRADY CONNOLLY & MASUDA PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 29 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 460 15WC 29622 ROSENDAHL, BRUCE SUPERMIX CONCRETE LLC 07/20/15 LANCASTER, DEBORAH 461 15WC 29707 SANCHEZ, MARLEN COUNTY OF LAKE 06/26/15 DOUGLAS RALLO PC WOLFE & JACOBSON, LTD 15WC029708 -C 462 15WC 29874 CASTILLO, ROSIBEL MEDLINE INDUSTRIES, INC 06/15/15 JOHN S. ELIASIK GAROFALO SCHREIBER STORM 15WC029875 -C 463 15WC 30017 BRINGER, JEFFREY REX ELECTRIC & 12/10/14 CAPRON & AVGERINOS PC INMAN & FITZGIBBONS 464 15WC 30257 AREVALO, RONY HN PRECISION 08/20/15 POLANSKY & CICHON CHTD 465 15WC 30432 DUCHITANGA, JUAN BRADLEY MARSHALL ROOFING 07/24/15 COSTA IVONE LLC 466 15WC 30516 GONZALEZ, ANA CARELIA A L HANSEN MANUFACTURING 01/27/15 JONATHAN SCHLACK RUSIN & MACIOROWSKI LTD 467 15WC 30577 GARCIA, LUIS SULLIVAN'S STEAKHOUSE 07/27/15 DWORKIN AND MACIARIELLO HENNESSY & ROACH PC 468 15WC 30965 AYALA, FERNANDO QUALITY LABOR SERVICES 08/02/15 COSTA IVONE LLC KOREY RICHARDSON LLC 469 15WC 30992 CERVANTES, OMAR THE WEALSHIRE 04/18/15 STROM, NEAL B BRADY CONNOLLY & MASUDA PC 470 15WC 31296 COMBS, JAMES ROTO ROOTER 08/15/15 HERRERA LAW CENTER WIEDNER & MCAULIFFE LTD 471 15WC 31597 DAVIS, MARY EMCO CHEMICAL DISTRIBUTOR 03/11/15 ANKIN LAW OFFICE 15WC031600 -C 472 15WC 31655 CASTILLO, PETER J RUNDY'S/MARIANO'S 09/14/15 GOLDBERG WEISMAN & CAIRO L BRYCE DOWNEY & LENKOV LLC 473 15WC 31823 MACALALAD, ISAGANI STAPLES, INC. 07/09/15 STEVEN M SELAN HENNESSY & ROACH PC 474 15WC 32035 FINE, VICKI NORTHSHORE SCHOOL DIST 11 03/02/15 KARCHMAR & STONE WIEDNER & MCAULIFFE LTD 475 15WC 32168 RADDATZ, FRED W. FAMILY DOLLAR 05/07/15 SCOTT BARBER 476 15WC 32341 MALDONADO, JOHN THE HOME DEPOT USA INC 03/11/15 GOLDBERG WEISMAN & CAIRO L ADELSON TESTAN & BRUNDO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 30 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 477 15WC 32672 RODRIGUEZ, MARIA CATERINA FOODS 09/30/15 JONATHAN SCHLACK LAW OFFICES JOSEPH MARCINIAK 478 15WC 32766 JEWEL, MICHAEL VACATION VILLAGE ASSO 08/06/15 NYHAN BAMBRICK KINZIE & LOWR 479 15WC 32870 KARP, SUSAN ABBOTT LABORATORIES 03/18/15 CORBOY & DEMETRIO PC HENNESSY & ROACH PC 480 15WC 33094 GUTIERREZ, GERARDO PERSONNEL STAFFING GROUP 08/14/15 DWORKIN AND MACIARIELLO 481 15WC 33277 PATTEN, MICHAEL J DEERFIELD/BANNOCKBURN 05/04/13 LINN, CAMPE & RIZZO LTD RUSIN & MACIOROWSKI LTD 482 15WC 33489 PERSCHNICK, JACOB JDM CONSTRUCTION 09/20/15 WHITESIDE & GOLDBERG LTD 483 15WC 33571 WRIGHT, ETHANIEL RUPRECHT CO 09/22/15 DWORKIN AND MACIARIELLO COZZI & GOGGIN-WARD 484 15WC 33632 HANSEN, TONI A JEWEL, INC./ 05/19/15 LINN, CAMPE & RIZZO LTD 485 15WC 33710 OWEN, TIFFANY SELECT STAFFING 06/23/15 MARKHAM M JEEP & ASSOCIATE LEAHY EISENBERG & FRAENKEL 486 15WC 33868 BELLINO, DOMINICK J CITY OF LAKE FOREST 05/24/15 LINN, CAMPE & RIZZO LTD 487 15WC 33891 LARSON, LISA A. UNITED AIRLINES 05/15/14 LINN, CAMPE & RIZZO LTD 488 15WC 33894 WOLFE, JUSTIN L. VILLAGE OF LINCOLNWOOD 10/03/14 LINN, CAMPE & RIZZO LTD RIPES NELSON BAGGOT KALOBRAT 489 15WC 34027 GALVAN, ANA MARIA STEINHAFELS, INC. 05/13/15 FERRIS THOMPSON & ZWEIG 490 15WC 34228 RIZVI, SHAHINA ZEBRA TECHNOLOGIES CORP 03/03/15 GRAHAM J. JEEP POLSINELLI PC 491 15WC 34245 BERNARD, THOMAS A & H CONSTRUCTION, LLC 10/06/15 GOLDBERG WEISMAN & CAIRO L 492 15WC 34659 BROWN, BONNIE J OAK GROVE SCHOOL DISTRICT 07/27/14 COLLISON LAW OFFICES NYHAN BAMBRICK KINZIE & LOWR 493 15WC 35129 SANDBERG, DOUGLAS ABBOTT LABORATORIES 09/16/14 DOUGLAS RALLO PC WIEDNER & MCAULIFFE LTD 494 15WC 35150 RUDNIK, DIANA DURHAM SCHOOL SERVICES 10/20/15 SEIDMAN MARGULIS & FAIRMAN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 31 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 495 15WC 35362 LEVITT, TOBEY JEWISH COUNCIL YOUTH SERV 03/02/15 CAPRON & AVGERINOS PC RUSIN & MACIOROWSKI LTD 496 15WC 35480 MELTON, HENRY CHICAGO BEARS FOOTBALL 11/04/12 WOLFE LAW PC MC ANDREWS & NORGLE LLC 15WC035481 -C 497 15WC 35544 HOFF, KAREN L WASTE MANAGEMENT 06/10/15 LINN, CAMPE & RIZZO LTD 498 15WC 35610 SORAPARU, WARREN A FEDERAL EXPRESS CORP 09/22/14 LAW OFFICE DAVID W CLARK HANSON LAW OFFICE 499 15WC 35647 JACKSON, GEORGE CORNFIELDS, INC. 09/24/15 TAMVAKIS, GEORGE L WIEDNER & MCAULIFFE LTD 500 15WC 35695 RAMOS DE GAONO, MIGDALIA CHICAGO MARRIOTT 10/10/15 ACEVES & PEREZ PC 501 15WC 35774 CARTER, BEN FOX LAKE FIRE FROT DIST 10/23/14 SCOTT BARBER RUSIN & MACIOROWSKI LTD 502 15WC 35801 JUAREZ, YVONNE JST CORPORATION 03/04/14 DOUGLAS RALLO PC 503 15WC 35889 HAKE, SANDRA PREGIS CORPORATION 01/05/15 MILLON & PESKIN LTD COZZI & GOGGIN-WARD 504 15WC 36038 BAIN, TIMOTHY CLASSIC WINDOWS INC 10/06/15 HORWITZ HORWITZ & ASSOC RUSIN & MACIOROWSKI LTD 505 15WC 36117 GUZMAN, RAFAEL BRANDONISIO & CO 08/14/15 ARGIONIS & ASSOCIATES LLC 506 15WC 36752 RAMIREZ, GREGORIO TERMAX, CO. 06/24/15 MC HARGUE, JAMES P LAW OFF HOLECEK & ASSOCIATES 507 15WC 36810 HOWE, CHARLES INSTALLATION SPEICALISTS, 08/11/15 GALLIANI DOELL & COZZI LTD 508 15WC 36822 RUIZ, HUGO PUGSLEY & LAHAIE 11/04/15 STROM, NEAL B WIEDNER & MCAULIFFE LTD 509 15WC 36979 DUBIENSKI, SEBASTIAN TOP LINE CONSTRUCTION COR 11/04/15 MICHALSKI & GUBERNAT HEYL ROYSTER VOELKER & ALLEN 510 15WC 37150 BABNIK, SCOTT LAKE COUNTY 06/30/15 FOOTE MIELKE CHAVEZ & O'NE WOLFE & JACOBSON, LTD 511 15WC 37277 HARRIS-WRIGHT, MARVA MVP 09/04/13 LEONARD LAW GROUP LLC KOREY RICHARDSON LLC 512 15WC 37429 BLAZE, SHEILA ABBVIE INC 08/27/14 OSVALDO RODRIGUEZ PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 32 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 513 15WC 37532 CARMONA, ERNESTO GUSTAVO GUARDA LANDSCAPING W 09/14/15 FERRIS THOMPSON & ZWEIG 514 15WC 37628 TAMAYO, IRMA MEDLINE INDUSTRIES 06/20/15 SOSTRIN AND SOSTRIN PC GAROFALO SCHREIBER STORM 515 15WC 37658 TODOROVA, OLGA RELIABLE HOME CARE PROVID 06/06/15 MINKOW DOMIN 516 15WC 37739 COULMAN, PETER UNITED CANVAS INC 08/20/15 BRISKMAN BRISKMAN GREENBER 517 15WC 37772 CASTRO, EVER QUALITY LABOR SERVICES 09/24/15 COSTA IVONE LLC KOREY RICHARDSON LLC 518 15WC 38141 MUNOZ, YESENIA CRACKER BARREL OLD COUNTR 01/27/15 BAUM RUFFOLO & MARZAL LTD 519 15WC 38412 VALADEZ, MARGARITA BROWN PAPER GOODS CO 09/29/15 POSTERLI, OSCAR 520 15WC 38787 PORCAYO, NICOMEDES MOST VALUABLE PERSONNEL 04/27/15 POSTERLI, OSCAR KOREY RICHARDSON LLC 521 15WC 38897 EVANS, ASHLEY ANN KILEY CTR 04/26/15 ANTHONY ESPOSITO ILLINOIS ATTORNEY GENERAL 522 15WC 38917 FOHLMEISTER, MICHELLE K NATIONAL HOME HEALTH 04/14/14 LINN, CAMPE & RIZZO LTD KEEFE CAMPBELL & ASSOC LLC 523 15WC 38920 FOHLMEISTER, MICHELLE K GLEN HEALTH & HOME MGMT 08/26/15 LINN, CAMPE & RIZZO LTD LAW OFFICES FRANCESCA LARSEN 524 15WC 38929 POUNDS, ROBERT W CITY OF NORTH CHICAGO 09/27/15 LINN, CAMPE & RIZZO LTD 525 15WC 38932 WOOD, TERRY B FREEMONT PUBLIC LIBRARY 12/11/13 LINN, CAMPE & RIZZO LTD GILDEA & COGHLAN 526 15WC 38935 BOSTIC, BILLY J VILLAGE OF FOX LAKE 08/09/15 LINN, CAMPE & RIZZO LTD INMAN & FITZGIBBONS 527 15WC 39047 REYES, ALBERTO TERMAX CORPORATION 11/13/15 JAMES ELLIS GUMBINER & ASS 528 15WC 39072 GUERRERO, JOSE L. RETANA CONTRACTORS 11/13/15 ARGIONIS & ASSOCIATES LLC COZZI & GOGGIN-WARD 529 15WC 39420 ONOFRE-LAZARO, ROGELIO CATERING BY MICHAEL'S INC 10/04/15 EFTEKHARI LAW OFFICES 530 15WC 39519 ARIAS, SERGIO MEDLINE INSDUSTRIES 03/20/15 SOSTRIN AND SOSTRIN PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 33 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 531 15WC 39631 DEBOSSCHERE, ROSEMARIE JEWEL FOOD STORES, INC. 04/01/15 COMPTON LAW GROUP BRADY CONNOLLY & MASUDA PC 532 15WC 39698 THREAT, ERIC J ALLENDALE ASSOC 06/15/15 LINN, CAMPE & RIZZO LTD 533 15WC 39716 VALESCO, RAFAEL GLENBROOK GROUP INC 10/17/15 GOLDBERG WEISMAN & CAIRO L LAW OFFICES OF EDWARD J. KOZ 534 15WC 39763 GANDHI, VALMIK SHREE SINATH ENTERPRISE I 10/29/15 LEONARD LAW GROUP LLC 535 15WC 39955 CARDONA, ALEJANDRO VILLAGE OF LIBERTYVILLE 09/18/13 FOOTE MIELKE CHAVEZ & O'NE RUSIN & MACIOROWSKI LTD 536 15WC 39956 CARDONA, ALEJANDRO VILLAGE OF LIBERTYVILLE 10/05/15 FOOTE MIELKE CHAVEZ & O'NE RUSIN & MACIOROWSKI LTD 537 15WC 39984 TERMINI, MARGARET AON HEWITT NAVIGATORS INS 11/22/14 GORDON LAW OFFICES LTD 538 15WC 41128 BARRIOS, JORGE ACCURATE PERSONNEL 10/21/15 DEPAOLO ZADEIKIS GORE MC ANDREWS & NORGLE LLC 539 15WC 41274 MCCLENDON, DORIS ALICE'S DISCOVERY CENTER/ 01/29/15 ROSS TYRRELL LAW OFFICES JOSEPH MARCINIAK 540 15WC 41489 LUCIO, SANDRA LAKE CTY CLERK OF CIRCUIT 06/24/15 STELZMAN, RUTH 15WC041490 -C 541 15WC 41544 LENHARDT, EILEEN AMERICAN FAMILY INSURANCE 01/07/13 BOGUSZ & BOGUSZ LTD 542 15WC 42181 PELLACK, CINDY WIFE & NEX PRESBYTERIAN HOMES-LAKE F 11/24/15 TARADASH LAW OFFICE NYHAN BAMBRICK KINZIE & LOWR 543 15WC 42318 GIL, RAMON DON FLORE CO 06/19/15 DOUGLAS RALLO PC 544 15WC 42378 GARCIA, CECILIO MILIEU DESIGN LLC 10/20/14 DAVID J. BAWCUM QUINTAIROS PRIETO WOOD & BOY 545 15WC 42537 CABRERA, CHRISTINE THE THERAPY TREE, LLC. 12/14/15 HANNIGAN & BOTHA, LTD INMAN & FITZGIBBONS

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 34 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 546 16WC 00086 HOHNSON, DYLAN J DISCOUNT TIRE 11/20/15 ANTHONY ESPOSITO 547 16WC 00122 LOBO, ALEJANDRO DUBLE TREE - MUNDELEIN 11/04/15 SALK, STEVEN B & ASSOC LTD COZZI & GOGGIN-WARD 16WC000166 -C DOUBLE TREE MUNDELEIN 548 16WC 00131 SCHEJBAL, SONIA NEW ALBERTSON'S INC JEWEL * 11/07/14 DUDLEY & LAKE LLC BRADY CONNOLLY & MASUDA PC 549 16WC 00559 CABRAL, CARLOS EXPRESS PERSONNEL PROS IN 08/10/15 LINN, CAMPE & RIZZO LTD MC ANDREWS & NORGLE LLC 550 16WC 00864 SOTELO, LAUREN GLENKIRK 10/15/15 HANNIGAN & BOTHA, LTD 551 16WC 00904 PALENCIA, SOFIA ADVANCED CLEANING SYSTEMS 12/14/15 COSTA IVONE LLC WOLFE & JACOBSON, LTD 552 16WC 01218 CARRASCO, JOSE R AMB ROOFING 12/04/15 TAMVAKIS, GEORGE L KEEFE CAMPBELL & ASSOC LLC 553 16WC 01255 PITTS, ROBERT A ABBVIE 11/16/15 DOUGLAS RALLO PC HENNESSY & ROACH PC 554 16WC 01349 CARREON, JOSE BIG BOULDER PARTNERS LLC 01/07/16 COVEN LAW GROUP 555 16WC 01390 SALGADO, CELESTINO ABBOTT LABS 07/30/15 TOPPER & WEISS LTD WIEDNER & MCAULIFFE LTD 556 16WC 01488 HERNANDEZ-MARTINEZ, OCTAV POST & PICKETT LLC 12/07/15 DUDLEY & LAKE LLC RUSIN & MACIOROWSKI LTD 557 16WC 01743 JONES, CARNELL NYPRO 01/18/13 GRIMES, G DOUGLAS RUSIN & MACIOROWSKI LTD 558 16WC 01770 WILSON, MELANIE KIDDIE KOTTAGE CHILD CARE 04/22/13 BRUCE RAFALSON LTD LAW OFFICES JOSEPH MARCINIAK 559 16WC 01797 CRUZ, ABRAHAM N XPO LOGISTICS 10/21/15 LINN, CAMPE & RIZZO LTD 560 16WC 01867 YADANZA, PAMELA NORTH SHORE HOSPITAL 11/03/14 DWORKIN AND MACIARIELLO KEEFE CAMPBELL & ASSOC LLC 561 16WC 02134 TROPPLE, ROBERT MUNDELEIN SCHOOL DISTRICT 08/11/15 DUDLEY & LAKE LLC ANCEL GLINK DIAMOND BUSH & E 562 16WC 02271 KETCHERSID, TERRY MIDWEST PRINTED CIRCUITS 11/24/15 ROBERT EDENS BRADY CONNOLLY & MASUDA PC 563 16WC 02280 REDDEN, KATIE SCARAMOUCHE ENTERPRISES L 01/16/16 MURPHY & MURPHY

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 35 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 564 16WC 02482 SIWEK, MAGDALENA ANIAS POLISH DELI 08/07/15 RICHARD E ALEKSY ROSARIO CIBELLA 565 16WC 02723 VASQUEZ-GARCIA, MARIA EUS SURESTAFF, INC 01/14/16 SALK, STEVEN B & ASSOC LTD KEEFE CAMPBELL & ASSOC LLC 566 16WC 02934 NEE, MARTY ERIC WINOGRAD 01/25/16 567 16WC 02958 HAMANN, TIMOTHY VILLAGE OF GURNEE 01/07/15 DUDLEY & LAKE LLC ANCEL GLINK DIAMOND BUSH & E 568 16WC 03117 DOMERCHIE, ADAM LAKE COUNTY SHERIFF 10/20/15 MARSZALEK AND MARSZALEK SMITH AMUNDSEN LLC 569 16WC 03251 VAZQUEZ, ISIDRO PEREA LEWIS PRODUCE MARKET #2 12/30/15 SALK, STEVEN B & ASSOC LTD GANAN & SHAPIRO 570 16WC 03283 SMITH, ANDRE LAKESIDE TRANSPORTATION 11/10/15 VASILATOS & COTTER LLC 571 16WC 03290 DEMARR, EVAN SKIDMASTER 01/28/16 DWORKIN AND MACIARIELLO 572 16WC 03366 DIAZ, IMELDA ADDUS HOME CARE 01/16/16 KARCHMAR & STONE HENNESSY & ROACH PC 573 16WC 03418 OCHOA, ERNESTO LURVEY LANDSCAPE SUPPLY 09/03/14 CULLEN HASKINS NICHOLSON RUSIN & MACIOROWSKI LTD 574 16WC 03516 SPAYER, STEVEN DORMA USA INC 11/18/15 MARKER & ASSOCIATES 575 16WC 03612 AMADOR, NELSON DC TRICORE INC 01/19/16 CULLEN HASKINS NICHOLSON HENNESSY & ROACH PC 576 16WC 03682 LEBBINI, MAURINE AON 07/30/15 DWORKIN AND MACIARIELLO BRADY CONNOLLY & MASUDA PC 577 16WC 03953 WADOLOWSKA, REGINA BERNADETTE CLEANING SERVI W 01/26/16 KATZ FRIEDMAN EAGLE ET AL 578 16WC 03987 SANDRE, PAULA MARIANO'S 12/18/15 O'CONNOR & NAKOS BRYCE DOWNEY & LENKOV LLC 579 16WC 04015 DIAZ, DIGNA E ANDREW STAFFING 11/25/15 CULLEN HASKINS NICHOLSON 580 16WC 04084 CASTRO, JUANA LABOR SOLUTIONS 11/17/15 LINN, CAMPE & RIZZO LTD KLAUKE LAW GROUP LLC 581 16WC 04168 HOPPE, LYNDA SEDGBROOK RETIREMENT COMM 11/25/15 DEPAOLO ZADEIKIS GORE WOLFE & JACOBSON, LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 36 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 582 16WC 04255 MATA, JOSE DE JESUS PET FACTOR 01/12/15 HANNIGAN & BOTHA, LTD ALLEN & NEWMAN 583 16WC 04738 CERVANTES, ESPERANZA COLEMAN CABLE LLC 11/03/15 LINN, CAMPE & RIZZO LTD GANAN & SHAPIRO 584 16WC 04790 AQUIRIANO, DILMA ANDREWS STAFFING INC 11/22/15 LAW OFFICE OF SCOTT B SHAP SLAVIN & SLAVIN 585 16WC 04849 LOPEZ, ADRIAN J.P. GRAHAM TRANSPORT INC 07/16/15 CHEPOV & SCOTT LLC MCANANY VANCLEVE & PHILLIPS 586 16WC 04966 HENRY, IRIS ZION ELEMENTARY SCHOOL 10/27/15 ROM LAW NYHAN BAMBRICK KINZIE & LOWR 16WC005941 -C 587 16WC 04999 MEZA, YANET ECHO INC 01/15/16 VRDOLYAK LAW GROUP LLC WIEDNER & MCAULIFFE LTD 588 16WC 05064 BERENI, ROLAND ABBOTT LABORATORIES 12/10/12 DWORKIN AND MACIARIELLO HENNESSY & ROACH PC 589 16WC 05175 RAMIREZ, WILBUR I PHOENIX LOCAL MOVERS 07/13/15 DEPAOLO ZADEIKIS GORE LAW OFFICES JOSEPH MARCINIAK 590 16WC 05208 ALVARDO, JOSE AVERUS FIRE PROTECTION 01/30/16 MARKS & ASSOCIATES RUSIN & MACIOROWSKI LTD 591 16WC 05217 LARA, SANDRA ANDREWS STAFFING 01/29/16 FERRIS THOMPSON & ZWEIG SLAVIN & SLAVIN 592 16WC 05497 SOSNOSKI, MELISSA COUNTRY FIRE PROTECTION D 10/04/14 DUDLEY & LAKE LLC RUSIN & MACIOROWSKI LTD 593 16WC 05607 MEDINA, ALEJANDRA BURGER KING 01/14/16 HART & DAVID LLP 594 16WC 05824 GWINN, LA ANGEL SILVERADO HIGHLAND PARK 01/26/16 DWORKIN AND MACIARIELLO 595 16WC 05940 STRONG, ARTHUR B CITY OF NORTH CHICAGO 10/25/15 LINN, CAMPE & RIZZO LTD HENNESSY & ROACH PC 596 16WC 05943 ZERVAS, DEAN V NEMERA, INC 11/21/15 LINN, CAMPE & RIZZO LTD 597 16WC 06003 BABCOCK, FRANK CLARENCE DAVIDS & CO. 08/12/14 STEVEN M SELAN MC ANDREWS & NORGLE LLC 598 16WC 06061 HEINY, MARK R LAKE COUNTY SHERIFF'S OFF 01/11/16 FOOTE MIELKE CHAVEZ & O'NE WOLFE & JACOBSON, LTD 599 16WC 06405 RAMOS, DIEGO EGG HARBOR CAFE 04/12/15 LARRY FLEISCHER & ASSOCIAT GANAN & SHAPIRO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 37 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 600 16WC 06517 ROEDL, GLORIA GRANT COMMUNITY HS 12/11/13 LEO ALT NYHAN BAMBRICK KINZIE & LOWR 601 16WC 06569 DICKSON, PETER C. COUNTY OF LAKE 10/07/15 LINN, CAMPE & RIZZO LTD WOLFE & JACOBSON, LTD 602 16WC 06575 BARRIENTOS, SANTIAGO R. GOODWILL INDUSTRIES OF 04/08/14 LINN, CAMPE & RIZZO LTD ACCIDENT FUND HOLDINGS 603 16WC 06581 BUCKLEY, RODNEY A GRAYSLAKE FIRE PROTCTION 08/31/15 LINN, CAMPE & RIZZO LTD RUSIN & MACIOROWSKI LTD 604 16WC 06866 ZASLAVSKIY, YEFIM WHELAN SECURITY OF IL,INC 01/15/16 LAW OFFICES YEVGENIY VAYSM HENNESSY & ROACH PC 605 16WC 07002 NEGRON, MARTA CARDINAL HEALTH 09/17/14 COHN & COHN HENNESSY & ROACH PC 606 16WC 07261 GUZMAN, YOLANDA NEMERA 10/16/15 JONATHAN SCHLACK HENNESSY & ROACH PC 607 16WC 07345 SILVA, ROSA E PEOPLE LINK STAFFING 02/03/16 THOMAS J STIBERTH LAW OFFI WOLF LAW LTD 608 16WC 07642 FLETCHER, LISA WALGREENS 01/26/16 GOLDSTEIN BENDER & ROMANOF GILDEA & COGHLAN 609 16WC 07670 MORENO, DANIEL UPS 09/04/15 LEONARD LAW GROUP LLC NYHAN BAMBRICK KINZIE & LOWR 610 16WC 07686 RUSSELL, MAESHAA ADVOCATE CONDELL HOSPITAL 12/03/15 BRISKMAN BRISKMAN GREENBER NYHAN BAMBRICK KINZIE & LOWR 611 16WC 08082 LAYBURN, JAMES TOSHIBA BUSINESS SOLUTION 12/11/15 COLLISON LAW OFFICES 612 16WC 08181 TATE, SHELIA FOSS PARK DISTRICT 02/26/16 BRISKMAN BRISKMAN GREENBER RUSIN & MACIOROWSKI LTD 613 16WC 08247 YERUSHALMI, RAYMOND PLEXUS CORP 11/23/15 LINN, CAMPE & RIZZO LTD NYHAN BAMBRICK KINZIE & LOWR 614 16WC 08261 GLINIEWICZ, MICHAEL VILLAGE OF ANTIOCH 07/04/15 LINN, CAMPE & RIZZO LTD RUSIN & MACIOROWSKI LTD 615 16WC 08282 BURNS, KEVIN L NEW ALBERTSON'S INC/JEWEL 09/03/14 LINN, CAMPE & RIZZO LTD BRADY CONNOLLY & MASUDA PC 616 16WC 08403 BEARD, MOLLI IL BONE & JOINT INSTITUTE 09/04/15 BRILL & FISHEL LAW OFFICES OF EDWARD J. KOZ 617 16WC 08451 SCHREINER, ROBERT NEWPORT TWNSHP FIRE DIST 03/22/15 MEYERS & FLOWERS RUSIN & MACIOROWSKI LTD

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ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 52 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 867 16WC 31519 O'NEIL, JUSTIN JGS MARINE LLC DBA MASTER 02/11/16 GRAHAM J. JEEP WOLF LAW LTD 868 16WC 31548 WIGDZINSKI, ADAM FIBERTEX CO 09/26/16 TAMVAKIS, GEORGE L 869 16WC 31657 COLLINS, JUDY WALMART 07/15/16 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 870 16WC 31842 EDMUNDS, JENNIFER THE BON TON STORES 09/23/16 STEIN & CHERNEY LTD 871 16WC 31943 HANDYSIDE, JOEAN WALGREENS 01/16/15 BERNARD WYSOCKI & ASSOCIAT GILDEA & COGHLAN 872 16WC 31966 BRAGE, CRYSTAL ALDI 06/21/16 GESMER LAW OFFICES, PC 873 16WC 32020 NASH, CORNELL AEROTEK, INC 11/16/15 DISPARTI LAW GROUP PA WIEDNER & MCAULIFFE LTD 874 16WC 32047 POST, CELENE ARAMARK EDUCATION, INC 05/19/16 LINN, CAMPE & RIZZO LTD 875 16WC 32050 GRAHAM, JUSTIN J GURNEE FIRE PROT DISTRICT 08/22/16 LINN, CAMPE & RIZZO LTD 876 16WC 32094 VEGA, GASPAR TRIALTA CONSTRUCTION, INC 11/06/14 LAW OFFICE OF SCOTT B SHAP 877 16WC 32186 PENA, GLORIA ACCURATE PERSONNEL LLC 08/09/16 FIORETTI & DESJARDINS LTD MC ANDREWS & NORGLE LLC 878 16WC 32292 RODRIGUEZ, MAURICIO D HORIZON CARTAGE, INC 10/03/16 MARKHAM M JEEP & ASSOCIATE INMAN & FITZGIBBONS 879 16WC 32336 SALGADO, LINO B NUWAVE, LLC 11/24/15 CULLEN HASKINS NICHOLSON NYHAN BAMBRICK KINZIE & LOWR 880 16WC 32443 RODRIGUEZ, DIMAS ROCCO FIORE & SONS INC # 08/01/16 CAPRON & AVGERINOS PC RUSIN & MACIOROWSKI LTD 881 16WC 32485 TRUJILLO, VICTORIA BRIGHTSTAR US 07/12/16 ARGIONIS & ASSOCIATES LLC POWER & CRONIN LTD 882 16WC 32539 FLYNN, DALE IDOT @ 05/19/16 WOODRUFF & JOHNSON ILLINOIS ATTORNEY GENERAL 883 16WC 32711 HALL, JOHN JONES LANG LASALLE 10/10/16 NEWLAND & NEWLAND 884 16WC 32829 GOLDMAN, PETER J VILLAGE OF OAKWOOD HILLS 10/14/16 FIGLIOLI, DAVID

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ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 54 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 903 16WC 34568 JOHNSON, SHANEQUIA SIX FLAGS GREAT AMERICA 10/31/16 DAVID W MARTAY BRADY CONNOLLY & MASUDA PC 904 16WC 34600 BRYANT, DAVID G AT & T 08/05/15 LINN, CAMPE & RIZZO LTD 905 16WC 34655 KENT, STEVEN R FINISHMASTER, INC 08/09/16 ANKIN LAW OFFICE HENNESSY & ROACH PC 16WC034656 -C 906 16WC 34876 MURRILLO, NORMA KENALL 06/10/16 FERRIS THOMPSON & ZWEIG HOLECEK & ASSOCIATES 16WC034877 -C 907 16WC 34991 RAMOS-RUIZ, JOSEFINA HAFEEZ ENTERPRISES, INC 09/12/16 ALBERT R. PINO LAW OFFICE 908 16WC 35034 ECKEL, CARL AMERIT FLEET SOLUTIONS IN 02/14/16 MATTHIAS D. GILL 909 16WC 35160 HORAK, BOGDAN SHERMAN MECHANICAL, INC 08/19/16 NEWLAND & NEWLAND ACCIDENT FUND HOLDINGS 910 16WC 35274 VILLA, NOEL SWEET TOMATOES 11/27/15 LINN, CAMPE & RIZZO LTD 911 16WC 35303 ANTUNEZ, JAMIE WOODLAND FOODS, LTD 09/15/16 DISPARTI LAW GROUP PA 912 16WC 35334 MILLER, JUANITA GOODWILL STORES 10/27/16 CULLEN HASKINS NICHOLSON HOLECEK & ASSOCIATES 913 16WC 35371 MUNOZ, FRANCISCA HUGHES ENTERP INC DBA BLU 07/05/16 LINN, CAMPE & RIZZO LTD 914 16WC 35374 VEGA, MARIA LABOR SOLUTIONS 02/24/16 LINN, CAMPE & RIZZO LTD 915 16WC 35377 GUTIERREZ-REMIREZ, FLOREN ANDREWS STAFFING 09/02/16 LINN, CAMPE & RIZZO LTD 916 16WC 35397 POLANCO, MARISOL CUBESMART 10/03/16 MILLON & PESKIN LTD 917 16WC 35481 MARTIN, RYAN DOMINOS PIZZA 10/08/16 ARGIONIS & ASSOCIATES LLC 918 16WC 35560 UPHOFF, CARL GRANT COMMUNITY HIGH SCHO 11/10/16 DUDLEY & LAKE LLC 919 16WC 35587 PATTERSON, LEONARD COUNTY OF LAKE 01/10/16 LINN, CAMPE & RIZZO LTD WOLFE & JACOBSON, LTD 920 16WC 35652 VEGA, MARIA LABOR SOLUTIONS 04/15/16 LINN, CAMPE & RIZZO LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 55 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 921 16WC 35789 ADKINS, DENNIS B WASTE MANAGEMENT, INC 11/02/16 LINN, CAMPE & RIZZO LTD 922 16WC 36045 GOLDMAN, SHERI THE GAP INC, C/O CT CORP 11/12/16 PAUL W GRAUER & ASSOC 923 16WC 36156 NANI, KATHRYN GOLD STANDARD ENTERPRISES 09/29/16 CAPRON & AVGERINOS PC COZZI & GOGGIN-WARD 924 16WC 36237 FICKENSHER, LAURA INSIGHT GLOBAL/MEDLINE 11/05/16 DUDLEY & LAKE LLC 925 16WC 36268 CHUNG HONG KIM, RICHARD LAKE CITY CLEANERS 08/05/16 WOLFE LAW PC 926 16WC 36446 VANTREESE, MICHAEL MEINEKE CAR CARE CENTER 11/17/16 DWORKIN AND MACIARIELLO HOLECEK & ASSOCIATES 927 16WC 36587 GAROLIS, CYNTHIA ABBOTT LABORATORIES 10/25/16 MC HARGUE, JAMES P LAW OFF WIEDNER & MCAULIFFE LTD 928 16WC 36615 PANDO, ALLEN E FEDEX 11/14/16 FRANKS & RECKENBERG 929 16WC 36699 JOHNSON, DAVID COMMONWEALTH EDISON 02/29/16 KATZ FRIEDMAN EAGLE ET AL RUSIN & MACIOROWSKI LTD 930 16WC 36762 NERHEIM, JAY STEFFEN WAUKEGAN TIRE & SUPPLY 10/19/16 LINN, CAMPE & RIZZO LTD BRADY CONNOLLY & MASUDA PC 931 16WC 36790 VEGA, BALOMERO WALMART 01/02/16 MAURICE E DUSKY PC GANAN & SHAPIRO 932 16WC 36838 BROCK, JEFFREY PAPA JOHN'S 10/12/16 WOODRUFF & JOHNSON 933 16WC 36948 RIOS, MARCOS ROCCO FIORE & SONS, INC 09/01/16 CULLEN HASKINS NICHOLSON 934 16WC 37029 HAMIL, SHERRI WALMART 09/05/16 MILLON & PESKIN LTD GANAN & SHAPIRO 935 16WC 37205 GONZALEZ, ANTONIO THERMASEAL/LAKESIDE INSUL 07/25/16 HANNIGAN & BOTHA, LTD RODDY LAW LTD 936 16WC 37262 SALAZAR, JUAN QUALITY LABOR STAFFING 08/19/16 DOUGLAS RALLO PC ROBERT L. SMITH 937 16WC 37334 SCARTON, LIN MIDWEST AIR TECHNOLOGIES/ 03/18/14 CULLEN HASKINS NICHOLSON 938 16WC 37381 PEREZ-MARTINEZ, HIPOLITO SHUR-WAY MOVING & CARTAGE 11/18/15 AIOSSA LAW FIRM HENNESSY & ROACH PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 56 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 939 16WC 37726 STONE, LORRAINE M PEAPOD LLC 09/15/16 HANNIGAN & BOTHA, LTD LITCHFIELD CAVO 940 16WC 37950 KOZDRONKIEWICZ, RYSZARD KOVACS DECORATING & REMOD * 10/09/16 KATZ FRIEDMAN EAGLE ET AL 941 16WC 38007 PERFECTO, JONATHAN DWA TRANS INC * 08/30/16 LAW OFFICE OF ROBERT J. IR HENNESSY & ROACH PC 942 16WC 38058 KWIECIEN, SANDRA CF INDUSTRIES HOLDINGS IN * 07/25/16 CORBOY & DEMETRIO PC NYHAN BAMBRICK KINZIE & LOWR 943 16WC 38107 MCNUTT, KAREN MEIJER * 12/10/16 DWORKIN AND MACIARIELLO KOPKA, PINKUS & DOLIN, PC 944 16WC 38199 ZAVALA, RAUL FISH LAKE BEACH INC * 06/24/15 EFTEKHARI LAW OFFICES RIPES NELSON BAGGOT KALOBRAT 945 16WC 38302 PORTH, BRUCE ZION SOLUTIONS LLC * 04/08/15 HORWITZ HORWITZ & ASSOC 946 16WC 38327 HILBRANT, STACE HIGHLAND PARK POLICE DEPA * 11/03/16 SANDMAN LEVY & PETRICH 947 16WC 38401 GUZMAN, ROSALINDA ACCURATE PERSONNEL & * 09/09/16 LARRY FLEISCHER & ASSOCIAT 948 16WC 38423 SANDERS, JOHN UPS CARTAGE SERVICES * 12/14/13 GOLDBERG WEISMAN & CAIRO L ASA LAW GROUP 949 16WC 38458 DAVIS, MARY EMCO CHEMICAL DISTRIBUTOR * 11/17/16 ANKIN LAW OFFICE 950 16WC 38569 ELLIS, BRENTHIA L LAKE COUNTY * 07/29/16 ANKIN LAW OFFICE HENNESSY & ROACH PC 951 16WC 38620 SOLIS, MARTHA MCDONALD'S * 03/01/15 CULLEN HASKINS NICHOLSON 952 16WC 38656 DEJESUS, WILFREDO HOMEOWNERS BARGAIN OUTLET * 08/23/16 VOGG, MARK J LAW OFFICE 953 16WC 38731 THOMPSON, KIRK FLEXIBLE STAFFING SVC, IN * 12/19/16 STEVEN J TENZER, LTD WIEDNER & MCAULIFFE LTD 954 16WC 38748 HERNANDEZ, LORENZO ROLLING LANDSCAPES INC * 07/02/16 LAW OFFICES MICHAEL HELLMA 955 16WC 38866 MITTLEMAN, TIMOTHY GEORGE GARNER CYCLERY * 02/19/15 SLAVIN & SLAVIN LAW OFFICES JOSEPH MARCINIAK 956 16WC 38955 CONTRERAS, JOSE DAVEY TREE EXPERT COMPANY * 10/20/16 DAVID W MARTAY

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 57 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 957 16WC 39135 LAKOSKE, STEVEN NORTH CHICAGO * 01/12/16 ASHER, RAYMOND L LTD GILDEA & COGHLAN 958 16WC 39153 ROBERTS, GARY CITY OF ZION * 07/22/15 LINN, CAMPE & RIZZO LTD RUSIN & MACIOROWSKI LTD 959 16WC 39154 LICHWALT, THOMAS P VERNON HILLS PARK DISTRIC * 08/17/16 LINN, CAMPE & RIZZO LTD HENNESSY & ROACH PC 960 16WC 39263 GUZMAN, FERNANDO GARDEN FRESH MARKET * 09/15/16 BAUM RUFFOLO & MARZAL LTD 961 16WC 39371 GJERMANI, KALIOPI SODEXO INC * 09/20/16 CORNFIELD & FELDMAN 962 16WC 39463 FERRIER, HUGH D MARIANO'S-BUFFALO GROVE * 11/10/16 GOLDBERG WEISMAN & CAIRO L 963 17WC 00110 CHACON, DAVID NOSCO * 08/15/16 ROSENBERG EISENBERG ASSOC GAROFALO SCHREIBER STORM 964 17WC 00165 LEIGH, TINA WAUCONDA SCHOOL DISTRICT * 11/07/16 HANNIGAN & BOTHA, LTD NYHAN BAMBRICK KINZIE & LOWR 965 17WC 00191 COOPRIDER, LINDA ABBVIE * 12/15/16 DUDLEY & LAKE LLC 966 17WC 00216 NYGARD, KARL J HOLOGIC, INC * 11/16/16 LINN, CAMPE & RIZZO LTD HOLECEK & ASSOCIATES 967 17WC 00267 ARRINGTON, SHIRLEY TUCKER MARKETING GROUP IN * 10/13/16 ANKIN LAW OFFICE 968 17WC 00352 CORCORAN, LAURA D & W FINE PACK * 03/21/16 MC HARGUE, JAMES P LAW OFF 969 17WC 00493 KUKREJA, SHAMA SPECTRUM RETIREMENT COMMU * 11/30/16 SEIDMAN MARGULIS & FAIRMAN 970 17WC 00695 RIVAS, MARIA TARGET * 06/26/15 FERRIS THOMPSON & ZWEIG 971 17WC 00738 HOOD, JOHN W KABBES ENGINEERING * 02/01/16 LAW OFFICES OF EDWARD J. KOZ 972 17WC 00803 ROJAS, ZAIDA BAYSIDE TERRACE, LLC * 03/09/16 DWORKIN AND MACIARIELLO 973 17WC 00919 MCNEIL, KELLIE CARDINAL HEALTH * 06/04/13 HANNIGAN & BOTHA, LTD 974 17WC 00923 RAIFORD, ADRIAN D WOODY'S 3 IN 1, INC. * 06/02/16 HANNIGAN & BOTHA, LTD QUINTAIROS PRIETO WOOD & BOY

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 58 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 975 17WC 01038 GUERRERO, STEPHANIE COUNTY OF LAKE * 12/06/16 DAVID J. BAWCUM SMITH AMUNDSEN LLC 976 17WC 01190 SHIPP, MARKITA ADA S MCKINLEY COMMUNITY * 11/23/16 POLANSKY & CICHON CHTD 977 17WC 01268 ELEZ, ILBER SOPHISTICATED SPORTS CARS * 06/13/16 ROMANUCCI & BLANDIN 978 17WC 01453 BOGOJEVIC, GORAN NAPLETON CADILLAC * 12/01/16 CAPRON & AVGERINOS PC 979 17WC 01488 WAGNER, CASSANDRA KHAYAT GROUP DBA * 12/28/16 MARKS & ASSOCIATES BRADY CONNOLLY & MASUDA PC 980 17WC 01568 JOHNSON, LORETTA N PEARSON, INC * 02/17/16 LINN, CAMPE & RIZZO LTD 981 17WC 01729 GAWRON, TROY J UPS * 11/08/16 LINN, CAMPE & RIZZO LTD ASA LAW GROUP 982 17WC 01771 URIBE, FERNANDA PARAMOUNT BUILDING SOLUTI * 09/07/16 LARRY FLEISCHER & ASSOCIAT 983 17WC 01848 BAARTZ, TRACY NOSCO INC * 08/17/16 MARKHAM M JEEP & ASSOCIATE 984 17WC 01871 HERNANDEZ, JOSE RUPRECHT CO * 01/12/17 COSTA IVONE LLC 985 17WC 01967 NELSON, MICHAEL D COUNTY OF LAKE * 11/07/16 LINN, CAMPE & RIZZO LTD 986 17WC 02134 PIFKE, WILLIAM STRITAR CONSTRUCTION DBA * 05/06/16 HANNIGAN & BOTHA, LTD 987 17WC 02136 PIFKE, WILLIAM STRITAR CONSTRUCTION DBA * 02/01/15 HANNIGAN & BOTHA, LTD RUSIN & MACIOROWSKI LTD 988 17WC 02217 OUSLEY, CHAUNNA INPAX SHIPPING SOLUTIONS, * 03/18/16 ACCIDENT FUND HOLDINGS 989 17WC 02291 ASLATT, WILLIAM BURGER EXCAVATION * 10/24/16 FINE, MARK S LAW OFFICES 990 17WC 02439 SANCHEZ, JACINTA MENDOZA II GROCERY * 12/25/16 ZANCK COEN WRIGHT & SALADI WIEDNER & MCAULIFFE LTD 991 17WC 02471 MC PHERSON, WILLIAM SCOOBEEZ INC * 11/25/16 BOWMAN & CORDAY 992 17WC 02691 WING JR, ROBERT NORTH SHORE WATER * 08/02/16 JOHN M BORCIA LAW OFFICE

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 59 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 04/21/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 993 17WC 02907 AMOS, RICKY R MANPOWER US INC * 12/06/16 ANKIN LAW OFFICE WIEDNER & MCAULIFFE LTD 994 17WC 02916 WALSH, NOLAN A MOD SUPER FAST PIZZA LLC * 11/06/16 ANKIN LAW OFFICE COZZI & GOGGIN-WARD 995 17WC 02955 LONG, DONALD POLY-CLIP SYSTEM CORP * 07/25/14 HANNIGAN & BOTHA, LTD LAW OFFICES OF EDWARD J. KOZ 996 17WC 03131 TSEGMID, CHIMGEE FREEDOM HOME CARE * 01/18/17 DWORKIN AND MACIARIELLO 997 17WC 03258 TAYLOR, ROSANNE SAIA * 06/16/16 MARKS & ASSOCIATES 998 17WC 03309 BELLINO, DOMINICK J CITY OF LAKE FOREST * 09/15/16 LINN, CAMPE & RIZZO LTD 999 17WC 03385 WHITE, CYNTHIA M TERRACE NURSING HOME * 09/21/16 LINN, CAMPE & RIZZO LTD 1000 17WC 03420 LEWINSKI, MARIUSZ ILLINOIS DEPARTMENT @ * 12/27/16 ALEKSY BELCHER 1001 17WC 03504 BAHENA, PENNY S JEWEL INC D/B/A * 10/14/16 LINN, CAMPE & RIZZO LTD 1002 17WC 03511 YOUNUS, KHADIJA WALMART * 11/29/16 CULLEN HASKINS NICHOLSON GANAN & SHAPIRO 1003 17WC 03589 NEWMAN, KURT VILLAGE OF GRAYSLAKE POLI * 10/23/16 RUBIN MACHADO ROSENBLUM 1004 17WC 03661 PLAZA, JESUS TAPIA COMCAST * 10/09/16 LARRY FLEISCHER & ASSOCIAT POWER & CRONIN LTD 1005 17WC 03669 BEHNKE, DANA BIMBO BAKERIES, USA * 10/30/16 HANNIGAN & BOTHA, LTD KRALOVEC & MARQUARD 1006 17WC 03780 CHAVEZ, VERONICA UNISTAFF PRO * 07/20/16 CHEPOV & SCOTT LLC 1007 17WC 03832 STOYKOV, STEFAN HUNT MILITARY COMMUNITIES * 05/22/16 HORWITZ HORWITZ & ASSOC 1008 17WC 03901 GOMEZ, ARMANDO RICK'S AUTO CARE & COLLIS * 03/11/16 COSTA IVONE LLC 1009 17WC 03938 FLEISCHMAN, RALPH MENCONI TERRAZZO, LLC * 10/07/16 THERMAN LAW OFFICES 1010 17WC 04036 ROYAL, EDDIE CHIAGO BEARS FOOTBALL * 08/25/15 WOLFE LAW PC MC ANDREWS & NORGLE LLC

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