ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 1 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 1 00WC 55876 SCHAEFER, DAWN H TARGET STORES 01/13/00 RICHARD E ALEKSY HOLECEK & ASSOCIATES 2 02WC 01185 BONET, TINA MOTHER AND NA DELTA CARPENTRY INC # 11/21/01 CULLEN, HASKINS, NICHOLSON LAW OFFICE IZZO CAPUANI SHIE 3 04WC 25884 SUBLEWSKI, JOSEPH S NELSON FIRE PROTECTION 03/23/04 HEALY SCANLON LAW FIRM GRANT & FANNING 08WC049776 -C 08WC049777 -C 08WC049778 -C 4 04WC 27286 ANDERSON, JENNIFER CRYSTAL LAKE POLICE DEPAR 06/04/04 FIGLIOLI, DAVID RUSIN MACIOROWSKI & FRIEDMAN 5 05WC 01841 DOMBROWSKI, EDWARD WHITE HEN PANTRY 07/08/04 ANESI OZMON RODIN NOVAK KO LAW OFFICES OF EDWARD J. KOZ 05WC001842 -C 6 08WC 55633 MENA, ERNESTO TARGET MANUFACTURING 10/03/08 JAMES ELLIS GUMBINER & ASS LAW OFFICES JOSEPH MARCINIAK 7 09WC 25163 COTE, RAYMOND MODINE MANUFACTURING 05/03/09 TARADASH LAW OFFICE GAROFALO SCHREIBER STORM 12WC031260 -C 8 09WC 27641 BURKEMPER, SCOTT ALGONQUIN LITH FIRE PROT 03/31/09 THOMAS W DUDA RUSIN MACIOROWSKI & FRIEDMAN 9 09WC 44593 VALDEZ, AURORA WALMART 05/07/09 BLACK & JONES GANAN & SHAPIRO 16WC029827 -C 16WC029828 -C 10 09WC 51792 19B KOCH-HAGER, MICHELE LAKE BARRINGTON WOODS 11/18/09 DUDLEY & LAKE LLC COZZI & GOGGIN-WARD 11 10WC 04807 SILVA, ANA AUTOTROL CORPORATION 01/11/10 CULLEN HASKINS NICHOLSON ALLEN KOPET & ASSOCIATES 12 10WC 06650 CYGNAR, JAMES S VILLAGE OF CARY 01/10/10 RICHARD O. GREENFIELD RUSIN MACIOROWSKI & FRIEDMAN 11WC043163 -C 13WC032356 -C 13 10WC 09954 MEDINA, MARCO AFFINIA 01/25/10 GOLDSTEIN BENDER & ROMANOF MACIOROWSKI SACKMANN & ULRIC 13WC020611 -C 14WC005523 -C BRAKE PARTS SPECIAL AC DEL

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 14 10WC 12280 WALSH, BARBARA CENTEGRA HEALTH SYSTEM 03/24/09 LINN, CAMPE & RIZZO LTD MACIOROWSKI SACKMANN & ULRIC 15 10WC 28824 SCHROEDER, ADRIAN COUNTRY GAS-DIVISION OF I 12/29/09 BAUM RUFFOLO & MARZAL LTD BRADY CONNOLLY & MASUDA PC 10WC028825 -C 16 10WC 47695 MC ANDREW, KATHLEEN MEIJER INC 05/29/10 TARADASH LAW OFFICE NYHAN BAMBRICK KINZIE & LOWR 13WC024935 -C 17 10WC 48170 VASQUEZ, JOHN EDWARD PUDLO D/B/A @ W 09/23/10 FRANKS, GERKIN & MCKENNA P 18 10WC 48339 BALLSCHMIEDE, ROBERT LOWES CO INC 02/04/09 FRANKS, GERKIN & MCKENNA P INMAN & FITZGIBBONS 19 11WC 00509 GREEN, STEVEN TNT CONSTRUCTION CO INC 01/18/08 HORWITZ HORWITZ & ASSOC RUSIN MACIOROWSKI & FRIEDMAN 20 11WC 03191 HENRIQUES, KARLA MCDONALDS CORP 04/12/10 FRANKS, GERKIN & MCKENNA P NYHAN BAMBRICK KINZIE & LOWR 21 11WC 05697 ROCHA, ESTELA TJX COMPANIES, INC 10/15/10 BOTTO GILBERT GEHRIS BRADY CONNOLLY & MASUDA PC 13WC036208 -C 22 11WC 09286 KIESER, RICKY UNION FIRE DEPARTMENT 09/24/09 HANNIGAN & BOTHA, LTD RUSIN MACIOROWSKI & FRIEDMAN 23 11WC 14291 AZZANO, MICHAEL SNAP ON TOOLS 01/16/11 HORWITZ HORWITZ & ASSOC GILDEA & COGHLAN 24 11WC 25398 BELLANTE, CHRISTIAN LDI INDUSTRIES 06/08/11 PRESBREY & ASSOC INC HOLECEK & ASSOCIATES 25 11WC 26729 KINDGREN, JUSTIN R CORPORATE SERVICES INC 06/28/11 COHN LAMBERT RYAN & SCHNEI KNELL & O'CONNOR 26 11WC 33048 POPADUYUK, VOLODYMYR TROPICAL ENVIRONMENTAL 06/24/11 CHEPOV & SCOTT LLC COZZI & GOGGIN-WARD 27 11WC 36249 19B SCIMECA, VICTOR R VILLAGE OF HEBRON 02/03/11 LINN, CAMPE & RIZZO LTD NYHAN BAMBRICK KINZIE & LOWR 28 11WC 36420 JASIEWICZ, ANDRZEJ AMERICAN PACKAGING MACHIN 07/20/10 BELLAS & WACHOWSKI CASSANO & ASSOCIATES 29 11WC 43077 DRIPPS, DAVID SUPER MIX/SPRING GROVE DI 09/28/11 HANNIGAN & BOTHA, LTD NYHAN BAMBRICK KINZIE & LOWR 30 11WC 47012 CARLSON, KENNETH SPORTDECALS, INC. 08/03/11 MARTIN L GLINK LAW OFFICE GANAN & SHAPIRO

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 31 11WC 47376 19B OGLE, RICHARD CATALENT PHARMA SOLUTINS 09/09/11 HANNIGAN & BOTHA, LTD LITCHFIELD CAVO 32 12WC 01592 JORDAN, ZACHARY ROBERTS EXTERIOR SERVICES 11/23/11 ATSAVES, LOUIS G LTD WIEDNER & MCAULIFFE LTD 33 12WC 02911 LOCKWOOD, STEVEN R DIVERSA PACK 10/24/11 LINN, CAMPE & RIZZO LTD BRYCE DOWNEY & LENKOV LLC 34 12WC 04410 MARQUEZ, MARGARITA WEBER STEPHAN PRODUCTS 01/13/12 LEONARD LAW GROUP LLC LAW OFFICES JOSEPH MARCINIAK 35 12WC 10650 MUNOZ, PEDRO, JR CURRAN CONTRACTING 10/22/11 LINN, CAMPE & RIZZO LTD GAROFALO SCHREIBER STORM 36 12WC 15788 FLORES, EZEQUIEL B B & P DRYWALL & CONSTRUCT 08/16/11 SOSTRIN AND SOSTRIN PC KNELL & O'CONNOR 37 12WC 22078 ESQUIVEL, ROGELIO VG PALLETS INC 06/12/12 BOTTO GILBERT LAW OFFICES JOSEPH MARCINIAK 38 12WC 28417 MARTIN, CHERYL M COLONIAL FUNERAL HOME 04/14/11 HANNIGAN & BOTHA, LTD GANAN & SHAPIRO 39 12WC 29591 PALACIOS, JUAN WEBER STEPHEN PRODUCTS 07/01/12 COLLISON & O'CONNOR LTD LAW OFFICES JOSEPH MARCINIAK 40 12WC 33120 HALTERMAN-AHRENS, MISTY ALDI, INC. 04/02/12 TARADASH LAW OFFICE MACIOROWSKI SACKMANN & ULRIC 41 12WC 35519 PAREDES, JULIO MORNING STAR CHURCH 05/16/12 FOHRMAN, DONALD W & ASSOCS GANAN & SHAPIRO 42 12WC 39282 GIBSON, KEVIN COSTCO 10/01/11 NEWLAND & NEWLAND GANAN & SHAPIRO 13WC021897 -C 43 12WC 40216 PONTANINI, ANTHONY ACME REFINING 07/05/12 BRISKMAN BRISKMAN GREENBER GANAN & SHAPIRO 44 12WC 41282 TILLMAN, CARDELL JOE DALY W 10/03/12 BLACK & JONES 45 13WC 00424 MADSEN, RENEE S COSTCO 11/13/12 CRONIN & PETERS GANAN & SHAPIRO 46 13WC 02332 LARSEN, NANCY JEWEL FOOD STORES 12/15/12 GOLDBERG WEISMAN & CAIRO L BRADY CONNOLLY & MASUDA PC

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 47 13WC 08458 DECHOW, LARRY FOX LAKE HARBOR MARINA 05/12/12 ANESI OZMON RODIN NOVAK KO ROBERT L. SMITH 48 13WC 09453 CLAUDIO, PETRA VEER HOSPITALITY ALGONQUI 10/06/12 LEONARD LAW GROUP LLC RIPES NELSON BAGGOT KALOBRAT 14WC003142 -C 49 13WC 11071 HEREDIA, MANUEL TC INDUSTRIES INC 10/13/12 HANNIGAN & BOTHA, LTD HENNESSY & ROACH PC 50 13WC 12363 FLORES, ELOISA METRO STAFF, INC. 10/05/12 KATZ FRIEDMAN EAGLE ET AL HENNESSY & ROACH PC 51 13WC 15191 HOLTZ, CHARLES MCHENRY COMMUNITY 10/24/12 TARADASH LAW OFFICE NYHAN BAMBRICK KINZIE & LOWR 52 13WC 15577 DIAZ KRISTA KELLY SERVICES 03/20/13 DWORKIN AND MACIARIELLO NYHAN BAMBRICK KINZIE & LOWR 53 13WC 17612 HOMOLA, CATHERINE M FEDEX 02/09/13 MARTIN V KUGIA HANSON LAW OFFICE 54 13WC 19674 SCHOENNEMAN, DARIN JANI KING OF ILLINOIS 05/02/13 BRILL & FISHEL COZZI & GOGGIN-WARD 55 13WC 20462 VASQUEZ, AMELIA BERRY PLASTICS CORP 02/16/13 GOLDSTEIN BENDER & ROMANOF HENNESSY & ROACH PC 56 13WC 29645 DAVILA, VANESSA SILGAN PLASTICS 12/31/12 HANNIGAN & BOTHA, LTD BRADY CONNOLLY & MASUDA PC 15WC011899 -C 57 13WC 31024 REYNOSO, FRANCISCA CLAUSSEN PICKLE COMPANY 03/07/11 GOLDBERG WEISMAN & CAIRO L RUSIN MACIOROWSKI & FRIEDMAN 58 13WC 31025 REYNOSO, FRANCISCA CLAUSSEN PICKLE COMPANY 08/15/12 GOLDBERG WEISMAN & CAIRO L RUSIN MACIOROWSKI & FRIEDMAN 59 13WC 31297 LANDREY, AMBER CHICK FIL A AND BEN MOORE 08/25/12 STEVEN J TENZER, LTD RUSIN MACIOROWSKI & FRIEDMAN 13WC031298 -C 60 13WC 31532 GARRIDO, GLORIA WALNUT GROVE FARMS 06/11/13 JONATHAN SCHLACK HOLECEK & ASSOCIATES 61 13WC 31779 JAWORSKI, JEFFREY ILLINOI STATE TOLL HIGHWA 08/18/13 FRANKS, GERKIN & MCKENNA P GANAN & SHAPIRO 62 13WC 34914 HANEY, MELISSA J CENTEGRA HEALTH SYSTEMS 09/04/05 MADSEN SUGDEN & GOTTEMOLLE MACIOROWSKI SACKMANN & ULRIC 63 13WC 36857 KARL, MARGARET APTARGROUP INC 08/29/13 HORWITZ HORWITZ & ASSOC HENNESSY & ROACH PC

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 64 13WC 42120 KRIKORIAN, MARY L STTE OF ILLINOIS @ 10/07/13 MADSEN SUGDEN & GOTTEMOLLE ASSISTANT ATTORNEY GENERAL 65 14WC 03168 KRAUCHUNAS, MELISSA LILLY ORTEGA 12/09/13 FRANKS, GERKIN & MCKENNA P 66 14WC 03789 VASQUEZ BLANCO, EDITH SNAP ON INC AS A BORROWIN 11/19/13 JOHN J CASTANEDA GILDEA & COGHLAN 14WC042907 -C CRV ELECTRONICS/STAFFMARK 67 14WC 03970 SOSA, JULIO INDUCTION HEAT TREATMENT 04/12/13 SALK, STEVEN B & ASSOC LTD NYHAN BAMBRICK KINZIE & LOWR 14WC039308 -C 68 14WC 04259 COLE, KEVIN CRYSTAL LAKE SCHOOL DIST 07/30/13 HORWITZ HORWITZ & ASSOC NYHAN BAMBRICK KINZIE & LOWR 14WC004260 -C 69 14WC 07044 CEBALLOS, RODRIGO KNAACK 12/06/13 GOLDSTEIN BENDER & ROMANOF 70 14WC 07556 O'DONNELL, PATRICK RAGING BUFFALO SNOWBOARD 03/02/14 HEALY LAW FIRM BRYCE DOWNEY & LENKOV LLC 71 14WC 08209 MURE, ELIZABETH ZALES CORPORATION 12/22/13 ANKIN LAW OFFICE 72 14WC 08321 CORLELY, SHERI KING CUT CONCRETE CUTTERS 02/05/14 ALBERT R. PINO LAW OFFICE 73 14WC 08867 VANDERWIEL, ROBIN FOLLETT LIBRARY RESOURCES 02/18/14 HANNIGAN & BOTHA, LTD RIPES NELSON BAGGOT KALOBRAT 74 14WC 09124 VIERCK, DUANE SHARKEY TRANSPORTATION IN 01/21/14 FRANKS, GERKIN & MCKENNA P 75 14WC 09268 SIDDIQUI, MUSARRAT MEIJERS 09/21/13 DWORKIN AND MACIARIELLO NYHAN BAMBRICK KINZIE & LOWR 76 14WC 09847 DAVIS, CAROLYN CENTEGRA HEALTH SYSTEM 08/15/12 LINN, CAMPE & RIZZO LTD MACIOROWSKI SACKMANN & ULRIC 77 14WC 10746 WERNER, WANDA WALMART 01/05/14 HANNIGAN & BOTHA, LTD WIEDNER & MCAULIFFE LTD 78 14WC 11393 BEDELL, WAYNE CUSTOM ELECTRIC TECHNOLOG 11/22/13 DAVID W MARTAY LAW OFFICES JOSEPH MARCINIAK 79 14WC 11485 WIMMER, JAY COM ED 01/09/14 CULLEN HASKINS NICHOLSON RUSIN & MACIOROWSKI LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 6 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 80 14WC 12876 19B ISUNZA, TANIA CONSOLIDATED SCHOOL DIST 03/05/14 MARKS & ASSOCIATES POWER & CRONIN LTD 81 14WC 13231 VAZQUEZ, MIGUEL MILLENNIUM STONE INC 03/11/14 MC HARGUE, JAMES P LAW OFF RODDY LAW LTD 14WC013574 -C 82 14WC 13398 BROWN, KENNETH SHERMAN MECHANICAL 02/09/14 TARADASH LAW OFFICE 83 14WC 13741 RUDOLPH, ARTHUR M DEAN DAIRY HOLDINGS LLC 10/10/13 FRANKS, GERKIN & MCKENNA P BRADY CONNOLLY & MASUDA PC 84 14WC 14339 CRUZ, MARIA ELVIA MEDELA INC 10/21/13 BOTTO GILBERT LAW OFFICES JOSEPH MARCINIAK 85 14WC 14547 STAVROPOULOS, GEORGE TRANS JOINT AGREEMENT 12/18/13 HANNIGAN & BOTHA, LTD 86 14WC 15619 HIGUERA, ROSARIO COVIDIEN 02/02/12 BLACK & JONES POWER & CRONIN LTD 87 14WC 15824 LIST, JACK E DEAN DAIRY HOLDINGS LLC 04/02/14 FRANKS, GERKIN & MCKENNA P BRADY CONNOLLY & MASUDA PC 15WC023157 -C 88 14WC 16455 MERLA, MARGARET CPC FOX VALLEY CRYSTAL LA 11/18/13 LINN, CAMPE & RIZZO LTD MACIOROWSKI SACKMANN & ULRIC 89 14WC 18348 COLUCCI, GINO S CRYSTAL LAKE FIRE DEPT 05/02/14 BARRY A KETTER RUSIN MACIOROWSKI & FRIEDMAN 90 14WC 19408 PAULSEN, BRAD GENERAL EXTERIOR CONSTRUC 03/20/14 VOGG, MARK J LAW OFFICE BRADY CONNOLLY & MASUDA PC 91 14WC 20805 CUSTODIO, RANFERI BRILLIANCE HONDA 01/27/14 BOTTO GILBERT WIEDNER & MCAULIFFE LTD 92 14WC 22308 WALKER, SABRINA A FOLLETT LIBRARY RESOURCES 05/07/14 HANNIGAN & BOTHA, LTD RIPES NELSON BAGGOT KALOBRAT 14WC022309 -C 93 14WC 22655 TORRES, CARMEN COMMUNITY UNIT 11/19/13 SANDMAN LEVY & PETRICH NYHAN BAMBRICK KINZIE & LOWR 94 14WC 23420 BARNDT, DAWN M MCDONALD'S OF BULL VALLEY 03/21/14 MADSEN SUGDEN & GOTTEMOLLE BRYCE DOWNEY & LENKOV LLC 95 14WC 23730 CABALLERO, HERMELINDA COMFORT INN 07/05/14 BOTTO GILBERT THOMAS & PORTELA

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 96 14WC 23987 TRIPP, BRIAN AMERICAN BOTTING COMPANY 05/09/14 OLMSTEAD, GREGORY J LAW OF GAROFALO SCHREIBER STORM 97 14WC 24168 CASKEY, PATRICK K ALGONQUIN/LITH FIRE PROT 06/27/14 THOMAS W DUDA RUSIN & MACIOROWSKI LTD 15WC024361 -C 16WC036193 -C 98 14WC 24252 MARCUM, DANIEL J PARKING LOT SERVICES 06/27/14 BLACK & JONES 99 14WC 24535 EISNER, DAVID II JEWEL ALGONQUIN 12/29/13 MEYERS & FLOWERS BRADY CONNOLLY & MASUDA PC 100 14WC 25654 FLORY, CARL ROBERT YOUR CORNER NURSERY 04/15/14 GAINES & GAINES 101 14WC 26005 GRANATA, JASON T (DECEASE IDEAL MODULAR SOLUTIONS L 04/25/14 SOSTRIN AND SOSTRIN PC GILDEA & COGHLAN 102 14WC 26123 LYONS, ANDREA L DEPT OF CHILDREN & @ 05/31/14 MADSEN SUGDEN & GOTTEMOLLE ASSISTANT ATTY GENERAL 103 14WC 26277 HUFFY, LANCE GARRETTS & SONS 04/16/14 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 104 14WC 27750 JARVA, LISA CUNAT PAYROLL, INC 02/24/14 FRANKS, GERKIN & MCKENNA P THOMAS & PORTELA 14WC027751 -C 105 14WC 27777 FLORES, MARISELA CHICK-FIL-A 02/26/14 BOTTO GILBERT RUSIN MACIOROWSKI & FRIEDMAN 106 14WC 28078 GUTIERREZ, STEVE UNITED THERAPIES, LLC 10/10/13 HORWITZ HORWITZ & ASSOC 107 14WC 28249 HOPKINS, KRISTY S ALGONQUIN 07/28/13 THOMAS W DUDA RUSIN & MACIOROWSKI LTD 15WC000899 -C 108 14WC 29010 KANDA, DAVID EDSON GROUP, CORP W 03/26/14 MC HARGUE, JAMES P LAW OFF CHEPOV & SCOTT LLC 109 14WC 30203 WESTCOTT, ROCKY LAKEMOOR POLICE DEPT 02/25/12 GOLDBERG WEISMAN & CAIRO L RUSIN & MACIOROWSKI LTD 110 14WC 30706 ROJAS, DOLORES WORKING WORLD STAFFING SE 07/03/14 CULLEN HASKINS NICHOLSON BRADY CONNOLLY & MASUDA PC

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 111 14WC 31142 ABSOLON, NANCY G CARQUEST AUTO PARTS 05/24/14 LINN, CAMPE & RIZZO LTD GOLDBERG SEGALLA LLC 112 14WC 31365 MAKI, JEANNE HAMPSHIRE FIRE PROTECTION 03/20/12 CAMERON CLARK RUSIN & MACIOROWSKI LTD 14WC031366 -C 14WC031367 -C 113 14WC 31570 DOMINGUEZ, GILBERTO THE TEXAN BAR-B-QUE INC 09/03/14 STROM, NEAL B RUSIN & MACIOROWSKI LTD 114 14WC 34178 VAZQUEZ, ROBERT JEWEL 04/18/13 ALLEN, WILLIAM LAW OFFICES BRADY CONNOLLY & MASUDA PC 14WC034179 -C 115 14WC 34381 WESOLEK, K WENDY MCHENRY COUNTY 06/01/14 MADSEN SUGDEN & GOTTEMOLLE WIEDNER & MCAULIFFE LTD 116 14WC 34615 CHAIREZ, VERONICA LEICA BIOSYSTEMS RICHMOND 04/04/13 FIGLIOLI, DAVID GILDEA & COGHLAN 117 14WC 34673 LESTER, ANNA D HAPPY TAILS ANIMAL 09/09/14 BOTTO GILBERT ACCIDENT FUND HOLDINGS, INC 118 14WC 35061 HEIDT, LENNY CRYSTAL LAKE SD #47 04/17/14 SEIDMAN MARGULIS & FAIRMAN NYHAN BAMBRICK KINZIE & LOWR 119 14WC 35125 COTTONE, LAWRENCE MENARD'S 12/11/12 KOCH & ASSOCIATES CHILTON YAMBERT PORTER LLP 120 14WC 35385 HALVORSEN, DEBRA L FIFTH THIRD BANK 12/20/13 GREG TUITE & ASSOC COZZI & GOGGIN-WARD 121 14WC 36676 SATKIEWICA, KHALIA MCHENRY COUNTY SHERIFF 10/16/14 BRILL & FISHEL WIEDNER & MCAULIFFE LTD 122 14WC 37288 MANESS, DWIGHT MCHENRY COUNTY SHERIFF 10/16/14 BRILL & FISHEL WIEDNER & MCAULIFFE LTD 123 14WC 37422 PAGE, JAMES FEDERAL EXPRESS 07/22/14 LEO ALT HANSON LAW OFFICE 124 14WC 37638 ROMERO, CARLOS NEW WERNER HOLDING CO INC 04/03/13 MARTIN V KUGIA THOMAS & PORTELA 125 14WC 38286 COLEMAN, EGAN AKMG LLC 05/13/14 WOODRUFF & JOHNSON CRAIG & CRAIG 126 14WC 38555 OGLE, RICHARD CATALENT PHARMA SOLUTIONS 05/30/14 HANNIGAN & BOTHA, LTD LITCHFIELD CAVO 127 14WC 39084 GONZALEZ, JOSE LUIS METRO STAFFING 08/14/14 BOTTO GILBERT

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 128 14WC 39618 BUSCH, JAMES AMERICAN PALLET INDUSTRIE 07/30/14 GUMMERSON & RAUSCH LLC BRADY CONNOLLY & MASUDA PC 129 14WC 40084 ODDO, LARRY D CENTEGRA HEALTH SYSTEM 10/01/13 GUMMERSON & RAUSCH LLC MACIOROWSKI SACKMANN & ULRIC 130 14WC 40480 RAMOS, ANDRES SNAP-ON-TOOLS 09/05/14 WOLFE LAW PC GILDEA & COGHLAN 131 14WC 40907 KOTSY, AMANDA STATE OF ILLINOIS @ 07/26/13 STEVEN H MEVORAH & ASSOCIA ASSISTANT ATTORNEY GENERAL 132 14WC 41106 SANCHEZ-PEREZ, SANTIAGO IRFAN NASIR AND USMAN CHE 06/14/14 EPSTEIN, JACK R LAW OFFICE 133 14WC 41398 SEYLLER, DEBORAH SCHOOL DISTRICT 300 04/04/14 MEYERS & FLOWERS NYHAN BAMBRICK KINZIE & LOWR 134 14WC 42385 MYLES, MELVIN COVIDIAN 08/12/14 POWER & CRONIN LTD 135 14WC 42770 SNOW, BRANDON COPENHAVER CONSTRUCTION 10/30/14 136 15WC 00183 CANO, JAVIER RPS PRODUCTS INC 12/13/14 STROM, NEAL B RUSIN & MACIOROWSKI LTD 137 15WC 00245 ROBELET, VICTOR P CRYSTAL LAKE PD 08/19/14 JOHNSON, MICHAEL D & ASSOC RUSIN & MACIOROWSKI LTD 138 15WC 01072 ORTIZ-SEQUEIRA, JAIME PORK KING PACKING INC 11/29/14 PORRO NIERMANN & PETERSEN RODDY LAW LTD 139 15WC 01171 O'DONNELL, TOM BLACK HORSE CARRIERS 07/25/13 COYNE REINKE LAW COZZI & GOGGIN-WARD 140 15WC 01272 RODRIQUEZ, MARIA E MODERN ABRASIVE CORP. 05/12/14 TARADASH LAW OFFICE 141 15WC 02211 KEARNS, DACIA L WILLIAMS SONOMA 02/01/13 FRANKS, GERKIN & MCKENNA P BRADY CONNOLLY & MASUDA PC 142 15WC 02341 CASTANEDA, DANIEL JAN-AIR INC 11/12/14 BOTTO GILBERT GEHRIS 143 15WC 02577 MACLACHLAN, PEARL CONSOLIDATED SCHOOL DIST 10/28/14 WOODRUFF & JOHNSON NYHAN BAMBRICK KINZIE & LOWR 144 15WC 03793 ANGEL, RACHELLE WATLOW 04/26/13 NEWLAND & NEWLAND HENNESSY & ROACH PC 145 15WC 04372 ZUNIGA, RICK TREND GRAPHICS 01/05/15 DWORKIN AND MACIARIELLO MACIOROWSKI SACKMANN & ULRIC

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 146 15WC 05321 SALINAS. ADRIANA ACCURATE PERSONNEL SERVIC 01/16/15 JOHN S. ELIASIK MC ANDREWS & NORGLE LLC 147 15WC 05768 GONZALEZ, DEMETRIO KING PORK CO 02/10/15 ANKIN LAW OFFICE RODDY LAW LTD 148 15WC 06005 MURO, SANDRA METRO STAFF INC 03/06/14 JOHN P GOGGIN 149 15WC 06089 ALONSO, MARIA G WEBER 10/04/14 JONATHAN SCHLACK LAW OFFICES JOSEPH MARCINIAK 150 15WC 06186 SLOVE, DANIEL CITY OF CRYSTAL LAKE 09/14/11 BLACK & JONES POWER & CRONIN LTD 151 15WC 06448 ZEPEDA, SERAFIN PORK KING PACKING 06/26/14 BLACK & JONES 152 15WC 06489 LARSON, STACY SUPERIOR COATING 09/02/14 BLACK & JONES HOLTKAMP LIESE ET AL 153 15WC 06885 PUZZO, CHRISTOPHER CORPORATE SERVICES INC 01/23/15 GOLDBERG WEISMAN & CAIRO L GRANT & FANNING 154 15WC 08509 FRANZONE, DEBRA CENTEGRA HEALTH SYSTEMS 12/02/14 CONRAD, NORMAN MACIOROWSKI SACKMANN & ULRIC 155 15WC 08685 HRIBAL, SARAH ANDROID INDUSTRIALS/AL BE 10/15/13 BLACK & JONES WIEDNER & MCAULIFFE LTD 156 15WC 08818 MANCILLA, ANGEL E A SWEEN CO 02/13/15 SMOLER LAW OFFICE, PC 157 15WC 09066 ROJAS, LEODEGARIO AC HOME CONSTRUCTION 10/22/14 HANNIGAN & BOTHA, LTD HOLECEK & ASSOCIATES 158 15WC 09530 SMITH, ROSEANN COVIDIEN LP AKA MEDTRONIC 02/05/15 GOLDBERG WEISMAN & CAIRO L POWER & CRONIN LTD 159 15WC 09908 LIEBMANN, ADAM MJB MARKETING DBA 04/19/13 CLARK, JUSTEN & ZUCCHI, LT 160 15WC 10661 DEVITT, FRANKIE ELBURN FIRE DEPT 10/02/13 MEYERS & FLOWERS RUSIN & MACIOROWSKI LTD 161 15WC 11001 CARTWRIGHT, STACI IAC 10/07/14 BLACK & JONES 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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 162 15WC 11548 ALDANA, MARIA COVIDIEN, LTD. 03/23/15 MARKS & ASSOCIATES POWER & CRONIN LTD 163 15WC 11722 ORTIZ, EDGARDO ST OF IL, DOC PAROLE DEPT @ 03/23/15 BLOCK, KLUKAS & MANZELLA P ASSISTANT ATTORNEY GENERAL 15WC011762 -C 164 15WC 11764 WAGNER, DANIEL JOHN CRANE INC 10/16/12 MADSEN SUGDEN & GOTTEMOLLE GAROFALO SCHREIBER STORM 165 15WC 12200 NEESE, TIMOTHY M. CJ'S SEAMLESS GUTTERS, LL 03/16/15 GREG TUITE & ASSOC RUSIN & MACIOROWSKI LTD 166 15WC 12551 ROMAN, ANA MARIA ADDUS HOME CARE INC 12/31/14 LAW OFFICE OF JAMES URTIS HENNESSY & ROACH PC 167 15WC 12622 FROST, JACK JR GREAT LAKES FIRE & W 03/18/15 SOSTRIN AND SOSTRIN PC CAMPION CURRAN LAMB 168 15WC 12834 JONES, ANDREW SDR LOGISTICS INC 04/06/15 15WC013617 -C 169 15WC 12895 ROWE, MATHA NORTHERN ROSE HOME HEALTH 03/03/14 GOLDBERG WEISMAN & CAIRO L 170 15WC 13267 ELIZARRARAZ, EULALIO RYASCAPE, INC. 03/30/15 PARENTE & NOREM PC COZZI & GOGGIN-WARD 171 15WC 13651 DVORKA, DAVID ELECTRIC CONDUIT CONSTRUC 06/02/14 HORWITZ HORWITZ & ASSOC ACCIDENT FUND HOLDINGS 172 15WC 15480 GOMEZ, ADOLFO TOLENTINO TRUCKS 06/09/14 JONATHAN SCHLACK RUSIN & MACIOROWSKI LTD 173 15WC 15774 NIEZGODZKI, LAURA A EUROPEAN SERVICES AT HOME 11/10/14 GREG TUITE & ASSOC INMAN & FITZGIBBONS 174 15WC 15834 LAWYER, RONNIE IL DEPT OF NATURAL RESOUR @ 12/10/13 FRANKS, GERKIN & MCKENNA P ASSISTANT ATTORNEY GENERAL 175 15WC 15968 CRAMER, DEBORAH MEIJER MARKET 03/20/15 KREITER, BYCK & ASSOC LLP NYHAN BAMBRICK KINZIE & LOWR 176 15WC 16424 SCHMEICHEL, THOMAS SPITSON MASONRY INC 03/04/15 DUDLEY & LAKE LLC WIEDNER & MCAULIFFE LTD

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 177 15WC 18498 JEFFRIES, STEPHANIE A SRC OF ILLINOIS 04/11/15 KARNO, MARK L & ASSOC THOMAS & PORTELA 178 15WC 18546 WOODBURN, SHARON FABRIK INDUSTRIES 04/20/15 NEWLAND & NEWLAND GILDEA & COGHLAN 15WC024886 -C 179 15WC 19092 PEARSON, BRADLEY J UPS 11/10/14 LEONARD LAW GROUP LLC NYHAN BAMBRICK KINZIE & LOWR 180 15WC 19270 HARRIS, SAVANNAH PANERA BREAD 04/27/15 GESMER LAW OFFICES, PC COZZI & GOGGIN-WARD 181 15WC 19386 ROSAS, FRANCISCO RIGGSBY COMPANIES LLC 05/07/15 GOLDBERG WEISMAN & CAIRO L QUINTAIROS PRIETO WOOD & BOY 182 15WC 20112 FINKE, JOHN INTERSTATE INTERIORS INC 06/05/14 FRANKS, GERKIN & MCKENNA P COZZI & GOGGIN-WARD 183 15WC 20236 REYNOSO, FRANCISCA CLAUSSEN PICKLE COMPANY 04/14/14 GOLDBERG WEISMAN & CAIRO L RUSIN & MACIOROWSKI LTD 15WC028908 -C 184 15WC 20609 BRECEDA, JUAN KNAACK LLC/WERNER MANUFAC 07/31/14 THOMAS J STIBERTH LAW OFFI THOMAS & PORTELA 185 15WC 20883 GERMANN, JOANNE BURNT TOAST RESTAURANT 12/14/13 VRDOLYAK LAW GROUP LLC RUSIN & MACIOROWSKI LTD 186 15WC 20970 GARCIA, THANIA M. MCDONALDS 06/06/15 187 15WC 21490 TEJEDA, CIRILO SURE STAFF INC 01/15/15 GESMER LAW OFFICES, PC SURE-STAFF 188 15WC 21639 TIBBLE, JOSHUA CARE FREE WINDOWS 06/23/15 GESMER LAW OFFICES, PC 189 15WC 22112 LACHER, KRISTINE J NIPPERSINK SCHOOL DISTRIC 04/08/14 GOLDBERG WEISMAN & CAIRO L NYHAN BAMBRICK KINZIE & LOWR 190 15WC 22198 ESCOBAR, VERONICA CRV ELECTRONICS 12/12/14 BOTTO GILBERT LAW OFFICES JOSEPH MARCINIAK 191 15WC 22292 COLLET, SCOTT CENTEGRA HEALTH SYSTEM 03/28/15 DAVID W MARTAY MACIOROWSKI SACKMANN & ULRIC 192 15WC 22518 UPHAM, APRIL TOTAL SYSTEMS ROOFING, IN 12/03/14 RIDGE & DOWNES WOLF LAW LTD 193 15WC 22757 SOLANO, RAUL MARENGO TOOL AND DIE WORK 06/19/15 KATZ FRIEDMAN EAGLE ET AL ROBERT L. SMITH 194 15WC 23216 FIGUEORA, JESUS HEARTH AND HOME 06/04/15 BOTTO GILBERT

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 195 15WC 24415 RIVERA, PABLO PORK KING PACKING 12/06/14 SOSTRIN AND SOSTRIN PC 196 15WC 24891 MOST, COREY JIM OLSON COLLISON 06/03/15 CHRISTIAN & MANNO GANAN & SHAPIRO 197 15WC 25610 ALLEN, CHARLES AT & T SERVICES, INC. 07/15/15 STROM, NEAL B HENNESSY & ROACH PC 198 15WC 25910 VELLE, LUIS LIFE TIME FITNESS 04/21/15 KUMLIN & FROMM 199 15WC 26484 HORNE, CHRIS SPANLINK COMMUNICATIONS I 07/15/15 ZANCK COEN WRIGHT & SALADI NYHAN BAMBRICK KINZIE & LOWR 200 15WC 26679 YOUNGLOVE, JILL MC HENRY CO. ANIMAL CONTR 07/05/15 LEE, MARK N LAW OFFICE ELMAN & EHARDT LTD 201 15WC 26897 MELCHOR, FIDEL WEBER-STEPHEN PRODUCTS, L 10/23/14 JOHN S. ELIASIK LAW OFFICES JOSEPH MARCINIAK 202 15WC 27305 PETERS, KENNETH E CUNAT INC 05/07/15 HANNIGAN & BOTHA, LTD RUSIN & MACIOROWSKI LTD 203 15WC 27591 AUBERT, MARIA COILCRAFT, INC. 06/09/15 TARADASH LAW OFFICE 204 15WC 28495 LABUY-BROCKETT, DAWN SNAP ON PRODUCT CENTER 03/11/15 BLACK & JONES GILDEA & COGHLAN 205 15WC 29092 GONZALEZ, JOSE EXTENDED HOME LIVING SERV 09/11/14 SOSTRIN AND SOSTRIN PC THOMAS & PORTELA 15WC029093 -C 206 15WC 29613 SCHWANTZ, EDWARD PEPSICO 06/16/15 KUMLIN & FROMM 207 15WC 29832 BOYCE, MICHAEL J WEBER GRILL 04/06/15 ANESI OZMON RODIN NOVAK KO LAW OFFICES JOSEPH MARCINIAK 208 15WC 30315 WARNER, AMANDA ALEXANDER LEIGH CENTER 06/01/15 CLARK FROST 209 15WC 30451 MODESTO, JOSE J SWEDERSKI CONCRETE 09/09/15 ALBERT R. PINO LAW OFFICE NYHAN BAMBRICK KINZIE & LOWR 210 15WC 30760 VILLANUEVA, HORTENCIA KRAFT FOODS GROUP, INC 07/09/13 JOHN C SERKLAND 211 15WC 31439 DORADO, ROBERTO POTSIE;S INC. 09/15/15 NEMEROFF LAW OFFICES BRADY CONNOLLY & MASUDA PC 212 15WC 32157 FERRER, ALEXE EARTH PEST CONTROL CO. 08/26/15 RONALDSON & KUCHLER

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 213 15WC 32359 DIAZ, SALVADOR TRRS CORP D/B/A 01/05/15 THE ROMAKER LAW FIRM RODDY LAW LTD 214 15WC 32751 ROMERO, JESUS MARIANI ENTERPRISES INC. 03/26/15 GRANT & FANNING 215 15WC 32874 PERKINS, SHAUN MATRIX RESOURCES 08/20/15 HORWITZ HORWITZ & ASSOC HOLECEK & ASSOCIATES 216 15WC 33521 MISIK, LINDA NEW ALBERTON'S, INC. 08/06/15 TARADASH LAW OFFICE 217 15WC 33596 KEARNS, CINDY HUNTLEY COMMUNITY 06/01/15 FRANKS, GERKIN & MCKENNA P NYHAN BAMBRICK KINZIE & LOWR 218 15WC 33932 CARRAZCO, JOSE ARMSTRONG PAINTING, INC 10/17/14 LULAY LAW OFFICES GANAN & SHAPIRO 219 15WC 34820 LANE, BRIAN DYLAN'S PUB 02/10/15 DWORKIN AND MACIARIELLO 220 15WC 34979 MIRELES-ALVARADO, MARLENE FOLLETT LIBRARY RESOURCES 04/22/15 HANNIGAN & BOTHA, LTD RIPES NELSON BAGGOT KALOBRAT 221 15WC 35215 RANGEL, ANGELICA POLAR TECH INDUSTRIES INC 03/09/15 MC HARGUE, JAMES P LAW OFF LAW OFFICES JOSEPH MARCINIAK 15WC042522 -C 222 15WC 35455 WILSON, TIMOTHY L COMPLETE PERSONNEL LOGIST 08/22/15 ANESI OZMON RODIN NOVAK KO GILDEA & COGHLAN 223 15WC 37464 DIAZ, SALVADOR TRRS, CORP. DBA COMMERCIA 10/29/15 THE ROMAKER LAW FIRM RODDY LAW LTD 224 15WC 37620 SOLLITTO, NICHOLAS J MERLIN CORP 09/02/15 RANDALL A. WOLFF & ASSOC 225 15WC 38696 CONNORS, ROXANNE MEMORIAL MEDICAL CENTER 10/05/15 TARADASH LAW OFFICE MACIOROWSKI SACKMANN & ULRIC 226 15WC 38899 ZAREK, BRUCE J D5 IRONWORKS 11/16/15 ANTHONY ESPOSITO 227 15WC 39459 ZALEWSKI, HALINA SILGAN PLASTICS 01/19/14 FRANKS & RECKENBERG BRADY CONNOLLY & MASUDA PC 228 15WC 39726 HYLAND, SHARON M ALDI 12/29/14 BRILL & FISHEL MACIOROWSKI SACKMANN & ULRIC 229 15WC 41571 STUTESMAN, RICHARD BENOY MOTOR SALES, INC. 08/08/15 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 230 15WC 42140 THOMPSON, DEBBIE GEORGE R JUSTEN & SON FUN 05/23/14 TARADASH LAW OFFICE WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 15 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 231 16WC 00716 PHEMISTER, MATHEW EXPRESS EMPLOYMENT PROF. 12/10/15 DWORKIN AND MACIARIELLO MC ANDREWS & NORGLE LLC 232 16WC 01002 TRUJILLO, DIEGO TC INDUSTRIES 07/30/15 POLANSKY & CICHON CHTD HENNESSY & ROACH PC 233 16WC 01948 GARCIA, MARISOL GERON ACCURATE PERSONNEL 11/18/15 TARADASH LAW OFFICE RODDY LAW LTD 234 16WC 02000 NEVAREZ-GARCIA, TAMARA BAG MAKERS 10/01/15 BLACK & JONES KEEFE CAMPBELL & ASSOC LLC 16WC012545 -C 17WC002530 -C 17WC002531 -C 235 16WC 02406 SAGO, BERNARD MDC DISPOSAL 12/21/15 DOUGLAS RALLO PC 236 16WC 02559 IRACHETA, RITCHARD TRADESMEN INTERNATIONAL 10/09/14 SCOTT BARBER RODDY LAW LTD 237 16WC 02671 DIAZ, SALVADOR TRRS CORP DBA TIRE 01/16/15 THE ROMAKER LAW FIRM 238 16WC 03737 KELLER, MICHAEL MEMORIAL MEDICAL CENTER 12/21/15 TARADASH LAW OFFICE MACIOROWSKI SACKMANN & ULRIC 239 16WC 04207 PLUHM, FRANK CITY OF GENOA 11/20/14 RICHARD O. GREENFIELD POWER & CRONIN LTD 240 16WC 04251 KRUZEL, CANDANCE ALDI MCHENRY 06/07/15 HANNIGAN & BOTHA, LTD MACIOROWSKI SACKMANN & ULRIC 241 16WC 04605 SCHROEDER, KEVIN DOW CHEMICAL 09/03/15 RUBENS AND KRESS KNELL & O'CONNOR 16WC020544 -C 242 16WC 04806 BURKART, MARLA HUNTLEY COMMUNITY 06/03/15 ELFENBAUM EVERS & AMARILIO NYHAN BAMBRICK KINZIE & LOWR 243 16WC 05144 KRUCEK, ALICE FOLLETT CORPORATION 05/17/13 JAMES P. TUTAJ RIPES NELSON BAGGOT KALOBRAT 16WC005145 -C 16WC005146 -C 244 16WC 05589 GAZDA, JENNIFER DISTINCTION SALON & SPA 01/08/16 CULLEN HASKINS NICHOLSON LAW OFFICES JOSEPH MARCINIAK 245 16WC 05828 HERNANDEZ, ESTHER KRAFT FOODS 07/24/15 JOHN J CASTANEDA 246 16WC 06052 RAMIREZ, JOSE ELGILOY SPECIALTY METALS 03/15/13 RICHARD E ALEKSY POWER & CRONIN 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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 247 16WC 06116 KELLER, CHARLIE SEPTRAN INC 11/24/15 WOODRUFF & JOHNSON BRADY CONNOLLY & MASUDA PC 248 16WC 06159 BOUCHAREUNE, SOUVAHN DIRECT DIMENSION INC 10/21/15 TARADASH LAW OFFICE 249 16WC 06372 COSTAN, SUSAN A COMMUNITY HIGH SCHOOL DIS 02/03/16 LOCASCIO, MARK A LTD 250 16WC 07083 MARCUM, DANIEL PARKING LOT SERVICES MAIN 06/27/14 BLACK & JONES 251 16WC 08549 HURLEY, JESS EXPRESS EMPLOYMENT 06/16/15 ALBERT R. PINO LAW OFFICE MC ANDREWS & NORGLE LLC 252 16WC 08948 QURESHI, MOHAMMED STATE OF IL-IDOT 12/22/15 KROL BONGIORNO & GIVEN LTD ASSISTANT ATTY GENERAL 253 16WC 09401 CRUZ, ADELA TACO BELL #19788 02/26/16 CHEPOV & SCOTT LLC 254 16WC 09559 MANCHESTER, THOMAS S CITY OF HARVARD 08/11/14 MADSEN SUGDEN & GOTTEMOLLE RUSIN & MACIOROWSKI LTD 255 16WC 10690 GARCIA, JOSE RODARTE OLD WORLD STONE 02/08/16 DAVID J. BAWCUM WIEDNER & MCAULIFFE LTD 256 16WC 10865 BIENIARZ, KRZYSZTOF A-1 DAKUM, INC. 09/24/15 BELLAS & WACHOWSKI GAROFALO SCHREIBER STORM 257 16WC 11219 MARQUEZ, EMILIO ARNOLD MAGNETIC TECHNOLOG 08/07/15 GESMER LAW OFFICES, PC 258 16WC 11879 FINNEGAN, DANIEL P SIEMENS INDUSTRY, INC 02/02/16 VRDOLYAK LAW GROUP LLC HOLECEK & ASSOCIATES 259 16WC 11927 PEREZ, JOSE M KCG MANAGEMENT LLC 05/20/14 CULLEN HASKINS NICHOLSON 260 16WC 12130 WITTKAMP, LUCAS NORTHERN IL TILE & TERRAZ 01/04/16 GREGORIO & MARCO RODDY LAW LTD 16WC012131 -C 261 16WC 12195 HOKE, DALE R JEWEL OSCO 03/25/16 BOTTO GILBERT BRADY CONNOLLY & MASUDA PC 262 16WC 12264 FIGUEROA, ROSY MCDONALD'S 03/19/16 CHEPOV & SCOTT LLC BRYCE DOWNEY & LENKOV LLC 263 16WC 12642 CERDA, JUAN J SERV-ALL DIE AND TOOL COM 03/15/16 HART & DAVID LLP 264 16WC 12929 CYGNAR, JAMES VILLAGE OF CARY 03/18/16 RICHARD O. GREENFIELD

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 265 16WC 13046 LAMBERT, HEIDI ELGILOY SPECIALTY METALS 09/13/15 ELFENBAUM EVERS & AMARILIO POWER & CRONIN LTD 266 16WC 13279 ORTEGA, JOSE AEROTEK 03/29/16 GORDON LAW OFFICES LTD 267 16WC 13415 RUIZ, JOSEPH F ORKIN, LLC DBA 02/19/15 KOSIN LAW OFFICE LTD BRADY CONNOLLY & MASUDA PC 268 16WC 13515 HUBER, PHILLIP L WAL-MART 01/30/16 FRANKS & RECKENBERG GANAN & SHAPIRO 269 16WC 14111 STANKUS, MICHELLE WENDY'S 01/04/16 COLLISON LAW OFFICES KEEFE CAMPBELL & ASSOC LLC 270 16WC 14221 AVILES, MARIO HT LUMBER & CRATES 05/04/15 COSTA IVONE LLC 271 16WC 14319 TELLADO, ROSE WHOLE FOODS MARKET 02/15/16 BLACK & JONES BRYCE DOWNEY & LENKOV LLC 272 16WC 14474 ONGMAN, KEITH J HOME DEPOT 03/10/16 MADSEN SUGDEN & GOTTEMOLLE ADELSON TESTAN & BRUNDO 273 16WC 14626 HERNANDEZ, DAVID WASTE MANAGEMENT 01/26/16 TURNER & SACKETT LLC GAROFALO SCHREIBER STORM 274 16WC 14864 BOWLES, MICHAEL ASBACH & VANESLOW INC. 04/05/16 TARADASH LAW OFFICE WIEDNER & MCAULIFFE LTD 275 16WC 15550 ROMERO, IVAN BUSS FORD LINCOLN 10/27/14 NEWLAND & NEWLAND QUINTAIROS PRIETO WOOD & BOY 276 16WC 15647 TINAJERO, JORGE C/O PORK KING PACKING, INC. 03/10/16 DEPAOLO ZADEIKIS GORE 277 16WC 16083 MOYER, CORY LEVEL CONSTRUCTION INC. 01/27/16 LEE, MARK N LAW OFFICE COZZI & GOGGIN-WARD 278 16WC 16138 BENTHANS, MICHAEL FEDEX 04/19/16 MARTIN V KUGIA WIEDNER & MCAULIFFE LTD 16WC029387 -C 279 16WC 16257 MONTGOMERY, SCOTT ART VAN FURNITURE 03/23/16 BARRY STEWART SILVER 280 16WC 16335 GARLAND, JASON M WOODSTOCK HEATING CO. 04/27/16 FRANKS & RECKENBERG 281 16WC 16609 ACEVEDO, SUSANA KENNA META/EXTRUDE HOME 11/02/15 LAW OFFICE OF SCOTT B SHAP 282 16WC 16794 SHYMANIK, ELIZABETH LEICA BIOSYSTEMS RICHMOND 12/31/15 VOGG, MARK J LAW OFFICE GILDEA & COGHLAN

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 283 16WC 17011 MORALES, GLORIA NOVATION INDUSTRIES 04/08/16 CULLEN HASKINS NICHOLSON 284 16WC 17082 BRUE, HEATHER R. COSTCO WHOLESALE CORPORAT 06/23/15 TUITE LAW GANAN & SHAPIRO 285 16WC 17423 MARTINEZ, LUCIA LEICA BIOSYSTEMS, INC. 10/28/15 COLLISON LAW OFFICES GILDEA & COGHLAN 286 16WC 17613 BAUMAN, KIMBERLY MERCY HEALTH SYSTEMS 02/27/15 HANNIGAN & BOTHA, LTD HOLECEK & ASSOCIATES 287 16WC 17882 ACEVEDO, SUSANA KENNA METAL/EXTRUDE HOME 11/03/15 LAW OFFICE OF SCOTT B SHAP 288 16WC 17976 SCHROEDER, SHAUN CITY OF ELGIN 06/13/14 MURPHY & MURPHY FRED J BEER LAW OFFICES 289 16WC 18144 CONTOISE, ROBERT LENCO ELECTRONICS INC 04/14/16 GANAN & SHAPIRO 290 16WC 18314 GOODMAN, CHRISTOPHER XPO LOGISTICS DBA CON-WAY 06/07/16 KROL BONGIORNO & GIVEN LTD STATES ATTORNEY OF COOK COUN 291 16WC 18433 BOURGE, OSCAR DEAN FOODS 01/03/15 BLACK & JONES BRADY CONNOLLY & MASUDA PC 292 16WC 18521 WRIGHT, WANDA L MEIJERS 11/28/15 BRILL & FISHEL KOPKA, PINKUS & DOLIN, PC 293 16WC 18834 JUAREZ, OSBALDO HUNTLEY PARK DISTRICT 05/07/16 LAW OFFICES LEONARDO MORAL 294 16WC 19169 CHARO, ROBERT WEBER STEPHENS 03/24/16 NEWLAND & NEWLAND LAW OFFICES JOSEPH MARCINIAK 295 16WC 19660 ANDERSON, ANGIE PLAS-PRO, INC 12/03/15 ALBERT R. PINO LAW OFFICE LAW OFFICES JOSEPH MARCINIAK 296 16WC 19908 TROSSKOPF, EDWARD MEIJER 06/16/16 DWORKIN AND MACIARIELLO ALLEN & NEWMAN 297 16WC 19947 SELLNER, CAROL VILLAGE OF PALATINE 06/04/14 BLACK & JONES POWER & CRONIN LTD 298 16WC 20292 DECICCO, ALYSON HOME DEPOT 05/03/15 CLARK JUSTEN ZUCCHI ADELSON TESTAN & BRUNDO 299 16WC 21227 QUINTANA, DINORA WEBER-STEPHEN PRODUCTS, L 05/04/16 JOHN J CASTANEDA 300 16WC 21283 TRACY, LISA CITY OF CRYSTAL LAKE 09/10/15 BOWMAN & CORDAY

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 301 16WC 21550 OKRAY, CONNIE THE SPRINGS OF CRYSTAL LA 03/16/16 ATSAVES, LOUIS G LTD BRADY CONNOLLY & MASUDA PC 302 16WC 21574 REESE, JOHN PEP WAUCONDA 04/18/14 CAPRON & AVGERINOS PC LAW OFFICES JOSEPH MARCINIAK 303 16WC 21848 BRITO, JACQUELINE THREE OAKS ASSISTED LIVIN 05/03/16 ANKIN LAW OFFICE RUSIN & MACIOROWSKI LTD 304 16WC 22093 HOMOLA, NANCY CONSOLIDATED SCHOOL DIST 05/20/16 OWENS & LAUGHLIN LLC 305 16WC 22140 LUTSCH, KEVIN P. FIRST MERIT CORP. 03/18/15 FRANKS, GERKIN & MCKENNA P 306 16WC 22195 AMICK, PAULA MCHENRY COMMUNITY CONS 12/18/15 HANNIGAN & BOTHA, LTD 16WC022196 -C 307 16WC 22578 KAROLUS, JOSEPH E MCHENRY COUNTY GLASS & MI 06/27/16 JOHN E LUSAK 308 16WC 22668 GRANDT, TAMARA I WORKING WORLD, INC. 01/05/16 FRANKS & RECKENBERG BRADY CONNOLLY & MASUDA PC 309 16WC 22849 SEMENOW, CHRISTOPHER CHARTER DURA-BAR 08/05/15 BRAD J. BALKE, PC MACIOROWSKI SACKMANN & ULRIC 310 16WC 22856 RIVERA, CANDIDA LABOR NETWORK 05/26/15 GOLDBERG & DOHAN ROBERT L. SMITH 311 16WC 22927 MENZER, TIMOTHY ILLINOIS STATE TOLL HIGHW 01/12/16 COLLISON LAW OFFICES GANAN & SHAPIRO 312 16WC 23143 TEJEDA, CIRILO MINERALLAC 06/28/16 FRANKS, GERKIN & MCKENNA P 313 16WC 23584 KOZIEL, DOMINIK DIRECT SAT USA, LLC 07/05/16 TARADASH LAW OFFICE GRANT & FANNING 314 16WC 23603 LISAFIELD, JEFFREY CITY OF MCHENRY 06/23/15 HEALY SCANLON LAW FIRM 315 16WC 23687 VANCE, DENNIS E UNION SPECIAL, LLC 03/24/15 GESMER LAW OFFICES, PC RODDY LAW LTD 316 16WC 24402 COX, BRIAN CARMICHAEL CONSTRUCTION 07/08/16 MARKS & ASSOCIATES 317 16WC 24564 TORRES, JOSE ZARATE SERV-ALL 06/06/16 HANNIGAN & BOTHA, LTD MCANANY VANCLEVE & PHILLIPS 318 16WC 25543 LOPEZ, RODRIGO EXPRESS EMPLOYMENT 06/13/16 SANDMAN LEVY & PETRICH MC ANDREWS & NORGLE LLC

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 319 16WC 25650 JOHNSON, MARIA STRLCHECK CHIROPRACTIC CL 10/21/15 TARADASH LAW OFFICE 320 16WC 26339 HIVON, TERRENCE CENTEGRA HEALTH SYSTEM 03/23/15 CLARK FROST MACIOROWSKI SACKMANN & ULRIC 321 16WC 26368 RODRIGUEZ, TITO ELILOY SPECIALTY METALS 05/16/16 GESMER LAW OFFICES, PC 322 16WC 26489 ORTIZ, ESTEBAN PORK KING PACKING 08/13/16 SOSTRIN AND SOSTRIN PC RODDY LAW LTD 323 16WC 26635 MARTINEZ, CHRISTINA SURESTAFF 06/22/16 DWORKIN AND MACIARIELLO KEEFE CAMPBELL & ASSOC LLC 324 16WC 27040 FREDERICK, GRANT HERITAGE CRYSTAL CLEAN IN 11/03/14 LEONARD LAW GROUP LLC HENNESSY & ROACH PC 325 16WC 27803 FERNANDEZ, PEDRO SORIA SEBERT LANDSCAPING 04/07/16 SEIDMAN MARGULIS & FAIRMAN NYHAN BAMBRICK KINZIE & LOWR 326 16WC 27882 AVILLA, JOSE LUIS ERICK AVILLA & LUIS AVILA 01/20/16 SALGADO, DAVID L 327 16WC 28042 FLATHAU, NICHOLAS HEARTHSTONE COMMUNITIES 11/26/15 FRANKS, GERKIN & MCKENNA P NYHAN BAMBRICK KINZIE & LOWR 328 16WC 28129 CHAMBERLAIN, ROBERT W ABCO ELECTRICAL CONSTRUCT 07/23/16 TURNER & SACKETT LLC 329 16WC 28639 RAMIREZ, BERTHA INDUCTION HEAT TREATING 03/15/16 BOTTO GILBERT 330 16WC 28686 QUICK, PATRICK ELGILOY SPECIALTY METALS 04/07/16 BLACK & JONES POWER & CRONIN LTD 16WC028687 -C 331 16WC 28776 TORRES, ELMER BERRY PLSTICS 08/26/16 DWORKIN AND MACIARIELLO 332 16WC 29080 COLLINS, ANTHONY ALANTIC TRACK & TURNOUT C 12/28/15 GRAHAM J. JEEP 333 16WC 30025 LORUSSO, NICK ELECTRONIC FOR IMAGING 10/27/15 COLLISON LAW OFFICES 334 16WC 30118 RUIZ, VICTORINO PORT EDWARDS RESTAURANT 06/27/16 LAW OFFICE ROBERTO ACEVEDO LAW OFFICES JOSEPH MARCINIAK 335 16WC 30393 CEJA, FERNANDO M BERUMEN TREE SVC, INC 07/20/16 LULAY LAW OFFICES RUSIN & MACIOROWSKI LTD 336 16WC 31368 BARAN-TKACS, MARY C JEWEL FOOD STORE, INC 03/20/16 ANKIN LAW OFFICE 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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 337 16WC 31393 CAUDLE, KENNETH D HUNTLEY FIRE PROT DISTRIC 04/11/16 THOMAS W DUDA RUSIN & MACIOROWSKI LTD 338 16WC 31518 BAKER, SCOTT CUSTOM ALUMINUM PRODUCTS 06/21/16 TURNER & SACKETT LLC 339 16WC 31746 HOOD, HEATHER TRANSITIONS HOSPICE, LLC 09/05/16 FRANKS, GERKIN & MCKENNA P BRADY CONNOLLY & MASUDA PC 340 16WC 31970 SEIBEL, RICHARD F CHAS HERDRICH & SONS 07/05/16 FRANKS & RECKENBERG 341 16WC 32730 HERNANDEZ, ERIC TC INDUSTRIES INC 09/30/16 LAW OFFICES OF ANSELMO DUR 342 16WC 33003 PENA, MARY C TRUE VALUE 09/21/16 FRANKS, GERKIN & MCKENNA P 343 16WC 33411 KLEPARSKI, DALE THOMPSON LINEAR AKA DANAH 07/31/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 344 16WC 33854 SCHROEDER, ADRIAN COMMUNITY ACTION AGENCY 12/12/13 BAUM RUFFOLO & MARZAL LTD INMAN & FITZGIBBONS 345 16WC 34035 EVANS, DENISE CASEY'S GENERAL STORE 06/28/16 KATZ FRIEDMAN EAGLE ET AL 346 16WC 34386 BAUMANN, BRIAN SUSTAINABLE STAFFING INC 10/03/16 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 347 16WC 34463 UDESEN, JAMES MCHENRY COUNTY SHERIFF 09/15/16 THOMAS J STIBERTH LAW OFFI WIEDNER & MCAULIFFE LTD 348 16WC 34494 HUDSON, JESSICA CRYSTAL LAKE SCHOOL DIST 10/20/16 GOLDBERG WEISMAN & CAIRO L 349 16WC 34523 NAZARIO, MAIRA SURESTAFF, INC 09/18/16 AIOSSA LAW FIRM KEEFE CAMPBELL & ASSOC LLC 350 16WC 34729 ESPEJEL, MARGARITA PEKIN INSURANCE 06/28/16 DEPAOLO ZADEIKIS GORE WIEDNER & MCAULIFFE LTD 351 16WC 34917 LOCKE, TERENCE O'REILLY AUTO ENTERPRISES 11/04/16 ALBERT R. PINO LAW OFFICE HENNESSY & ROACH PC 352 16WC 35060 HARRIS, WENDY D FRESENIOUS KIDNEY CARE 10/25/16 FIGLIOLI, DAVID 353 16WC 35275 CASTANEDA, BLANCA BESTMETAL CORP 10/28/15 LINN, CAMPE & RIZZO LTD HOLECEK & ASSOCIATES 354 16WC 35613 MAYA-ESQUIVEL, SERGIO PROTECT-ALL INNOVATIVE 03/28/16 ALBERT R. PINO LAW OFFICE

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 355 16WC 36469 BROCK, DANIELLE ANGELO'S MARKET, INC. 08/21/16 CLARK FROST ROSARIO CIBELLA 356 16WC 36590 BERNAL, MARIA CUNAT PAYROL, INC 09/07/16 MC HARGUE, JAMES P LAW OFF HEYL ROYSTER VOELKER & ALLEN 357 16WC 36931 RAVEN, JEFFREY A SUPER MIX 02/10/16 HANNIGAN & BOTHA, LTD GANAN & SHAPIRO 358 16WC 37079 DAHL, ANDREA MARIE G2 REVOLUTION LLC 08/24/16 PETER D CORTI LAW GROUP PERRY GENTILE 359 16WC 37169 PETTIGREW, JAY UNICARRIERS AMERICAS CORP 11/15/16 BLACK & JONES 360 16WC 37511 LOPEZ, FELIPE HARVARD PRODUCTS 10/05/16 BOTTO GILBERT LAW OFFICES JOSEPH MARCINIAK 361 16WC 37703 RANDALL, ELIZABETH DONLEY'S WILD WEST TOWN 06/26/16 BLACK & JONES 362 16WC 38205 DOMINQUEZ, BALVINA WEBER-STEPHEN PRODUCTS LL 05/06/16 WHITESIDE & GOLDBERG LTD 363 16WC 38238 FARNER, RICHARD LAKE COUNTY FOREST PRESER 01/12/16 RIDGE & DOWNES 364 16WC 38361 COLLINS, CHRISTOPHER NILCO INC 06/29/16 FRANKS, GERKIN & MCKENNA P 365 16WC 38923 REYES, MARTHA WEBER STEPHEN PRODUCTS 12/14/16 HERRERA LAW CENTER 366 16WC 39218 JOHNSON, DRU SURESTAFF 10/24/16 BLACK & JONES SURE-STAFF 367 16WC 39288 HANRAHAN, JOANNE F CENTEGRA HEALTH SYSTEMS 05/16/16 FRANKS & RECKENBERG MACIOROWSKI SACKMANN & ULRIC 368 17WC 00021 THOMPSON, TERESA ARNOLD ENGINEERING 11/01/16 RIDGE & DOWNES 369 17WC 00520 REBECCA, JIM ARAMARK 12/29/16 GESMER LAW OFFICES, PC 370 17WC 00692 GARCIA, LUZ MARIA PACKAGING COODINATORS INC 08/18/16 WOODRUFF & JOHNSON 371 17WC 00898 ADAMS, DANIEL ILLINOIS STATE TOLL HWY A 10/26/16 WILLIAMS MCCARTHY LLP GANAN & SHAPIRO 372 17WC 00921 NEUKIRCH, ARMINDA ILLINOIS DEP OF REHABILIT @ 06/27/16 HANNIGAN & BOTHA, LTD

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 373 17WC 01088 CORTES, IGNACIO SALINAS SAGE PRODUCTS 11/05/16 BOTTO GILBERT 374 17WC 01626 MAHLER, ROBERT THORNE ELECTRIC, INC 11/03/16 GOLDBERG WEISMAN & CAIRO L 375 17WC 01792 DAVOLI, PETER MENARDS 10/01/15 BRAD J. BALKE, PC 376 17WC 02063 MILLER, MICHAEL W VILLAGE OF FOX RIVER GROV 11/02/16 FIGLIOLI, DAVID 377 17WC 02244 RODIO, MIKE GENERAL KINEMATICS 10/13/16 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 378 17WC 02602 DUFFEY, DENNIS KWCC, INC. 12/16/16 LAW OFFICES MICHAEL HELLMA 379 17WC 03034 CLIFFORD, MELISSA ALDI INC * 09/10/16 ARIANO HARDY NYULI JOHHSON MACIOROWSKI SACKMANN & ULRIC 380 17WC 03671 TRIPLETT, JASON DIRECT DRIVE EXPRESS * 01/16/17 HANNIGAN & BOTHA, LTD RUSIN & MACIOROWSKI LTD 381 17WC 03831 DEGRAAF, STEPHEN MARTAM CONSTRUCTION * 07/30/16 HORWITZ HORWITZ & ASSOC 382 17WC 03925 BABCOCK, KAREN BAG MAKERS, INC (BORROWIN * 01/11/17 LEONARD LAW GROUP LLC 383 17WC 04105 ARGUELLES, EDGAR CHARTER DURA-BAR * 05/16/16 DWORKIN AND MACIARIELLO 384 17WC 04238 BLAKE, ROSAFE FOLLETT SCHOOL SOLUTIONS * 11/05/16 FRANKS, GERKIN & MCKENNA P 385 17WC 04425 JULIAN, MICHAEL J ICON MODERN INC * 12/31/15 ANKIN LAW OFFICE LAW OFFICES JOSEPH MARCINIAK 386 17WC 04749 MARIN, ALVARO MAINES PAPER & FOOD SVCS, * 12/12/16 JONATHAN SCHLACK 387 17WC 04838 DEKEYSER, DANIEL ATLANTIC TRACK & TURNOUT * 11/04/16 TARADASH LAW OFFICE 388 17WC 05029 GARCIA, DANIEL TRUE VALUE * 07/25/16 GOLDSTEIN BENDER & ROMANOF 389 17WC 05195 GAZZANO, JILL A KOHLS DEPT STORES, INC * 12/03/15 DIAMOND & LESUEUR PC CHILTON YAMBERT PORTER LLP 390 17WC 05280 GOLLADAY, ANINA KOUNTRY PET RESORT * 12/23/16 COVEN LAW GROUP RUSIN & MACIOROWSKI LTD

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 391 17WC 05374 SALMERON, MARIA WEBER STEPHEN PRODUCTS LL * 07/17/14 ALBERT R. PINO LAW OFFICE 392 17WC 05613 SOTO, FEDERICO ILA TRUCK, INC * 01/11/17 SOSTRIN AND SOSTRIN PC ROSARIO CIBELLA 393 17WC 05633 MILLER, WILLIAM IL DEPT OF TRANSPORTATION * 09/07/16 GOLDBERG WEISMAN & CAIRO L 394 17WC 05751 MARTINEZ, REYNALDA KRAFT HEINZ CO * 12/14/16 PORRO NIERMANN & PETERSEN GAROFALO SCHREIBER STORM 395 17WC 06217 MEDINA, CHERYL MARENGO CAFE * 10/20/16 FRANKS, GERKIN & MCKENNA P 396 17WC 06248 RONEY, REGINA T JEWEL FOOD STORES, INC * 03/13/15 W RANDAL BAUDIN 397 17WC 06572 MAYO, VICTORIA SWIFT TRANSPORTATION * 02/01/17 ROGER D RUDICH LTD WIEDNER & MCAULIFFE LTD 398 17WC 06593 VEACH, KELSIE ALDI * 10/12/16 COLLISON LAW OFFICES MACIOROWSKI SACKMANN & ULRIC 399 17WC 06677 ELGANZOURI, MERVAT ARAMARK FOOD SERVICES * 09/26/16 WHITING LAW GROUP 400 17WC 06984 STRICKLAND, CHARLES CRYSTAL LAKE INN CORP C/O * 08/25/16 HETHERINGTON KARPEL BOBBER CHILTON YAMBERT PORTER LLP 401 17WC 07452 HANSEN, DENISE ALEXANDER KEIGH CTR FOR A * 11/28/16 KATZ FRIEDMAN EAGLE ET AL INMAN & FITZGIBBONS 402 17WC 07687 KHOSHABA, MARTA SEARS * 03/03/17 SEIDMAN MARGULIS & FAIRMAN 403 17WC 07847 SCHUETTE, MICHAEL GLO BOWL FUN CENTER LLC * 07/08/16 MADSEN SUGDEN & GOTTEMOLLE 404 17WC 08093 KRUSE, HERBERT WOODSTOCK HIGH SCHOOL * 01/23/15 MC HARGUE, JAMES P LAW OFF 405 17WC 08419 STRATMAN, PAIGE KOUNTRY PET RESORT * 12/12/16 TURNER & SACKETT LLC 406 17WC 08688 LIVINGSTON, MARIO WEBER STEPHEN PRODUCTS * 02/07/17 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 407 17WC 09371 HANSEN, DENISE ALEXANDER LEIGH CENTER * 01/19/17 KATZ FRIEDMAN EAGLE ET AL 408 17WC 09482 ROSS, DANETTE CENTEGRA HEALTH SYSTEM * 09/15/16 VOGG, MARK J LAW OFFICE

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 409 17WC 09761 JOHNSON, RYAN IHC CONSTRUCTION IL * 03/26/16 DAVID W MARTAY 410 17WC 09947 GARCIA, MARCO FYH BEARINGS * 03/03/17 WOLFE LAW PC WOLFE & JACOBSON, LTD 411 17WC 09974 TURNER, SHERI TRADER JOE'S COMPANY * 10/04/15 GAROFALO SCHREIBER STORM 412 17WC 10063 KING, JOEL DEE'S PLUMBING & CONSTRUC * 09/16/15 HEDEEN, MICHAEL J PC RODDY LAW LTD 413 17WC 10198 FRAIRE, JORGE AMERICA'S BATH COMPANY * 01/12/17 CARONE LAW OFFICES 414 17WC 10349 MARTINEZ, PAPHANY ALPHA SWISS INDUSTRIES, I * 12/06/16 BLACK & JONES GAROFALO SCHREIBER STORM 415 17WC 10523 ROTH, KATHLEEN CARY POLICE DEPT * 01/17/17 HEALY SCANLON LAW FIRM 416 17WC 10630 SANCHEZ, JULIA ALPHA SWISS INDUSTRIES * 01/26/17 BOTTO GILBERT 417 17WC 10763 GRAPENTHIEN, GERALD EAGLE EXPRESS LINES INC. * 03/28/17 BOWMAN & CORDAY WIEDNER & MCAULIFFE LTD 418 17WC 11140 BARE, BRIAN WILLARD AUTO REBUILDERS, * 10/14/16 WOLF LAW LTD 419 17WC 11158 KINDER, FREDRICK GUARDIAN ELECTR MANUFACTR * 09/21/15 MADSEN SUGDEN & GOTTEMOLLE GANAN & SHAPIRO 420 17WC 11237 SOTO, MARIA IRMA CARLSON BUILDING MAINTENA * 03/18/17 SALK, STEVEN B & ASSOC LTD 421 17WC 11417 RAMOS, MARIA MEDTRONIC * 06/15/16 WOODRUFF & JOHNSON POWER & CRONIN LTD 422 17WC 11598 EHARDT, JOSEPH SNO-BELT INDUSTRIES, INC * 11/09/15 CLARK FROST 423 17WC 11828 JUSTO, TOMAS BRAKE PARTS INC * 06/01/10 MACIOROWSKI SACKMANN & ULRIC 424 17WC 11972 RODRIGUEZ, ARMANDO WEBER-STEPHEN PRODUCTS CO * 04/03/17 SALK, STEVEN B & ASSOC LTD 425 17WC 12083 RIESING, ANNETTE THE HOME DEPOT * 11/23/16 MC ANDREWS & NORGLE LLC 426 17WC 12445 ORTIZ, EDGAR KNAACK LLC * 04/27/16 TARADASH LAW OFFICE

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 WOODSTOCK 52003 ON 06/07/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 427 17WC 12509 RIESING, ANNETTE L HOME DEPOT #1940 * 11/23/16 FRANKS & RECKENBERG 428 17WC 12962 THOUNSAVATH, PHOUGEUN BAG MAKERS INC * 07/11/16 LEONARD LAW GROUP LLC