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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 MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 16 11WC 45513 SABIEL, AMKALSOUM TYSON FRESH MEATS INC 03/15/11 LEADERS LAW CENTER LLC GANAN & SHAPIRO 17 12WC 05662 HANDEL, MARSHA K WAHL CLIPPER CORPORATION 07/02/11 FRANCIS J DISCIPIO LAW OFF HEYL ROYSTER VOELKER & ALLEN 13WC008031 -C 18 12WC 11097 GREENO, MICHAL W STERLING RAIL SERVICE 10/12/11 MERTES & MERTES PC BRADY, CONNOLLY & MASUDA, PC 19 12WC 18370 CASEY, LAWRENCE J COLONY BRANDS INC 11/01/11 THOMAS R LICHTEN WOLFE & JACOBSON, LTD 20 12WC 21707 TASSIKE, ABALA KOMA TYSON FRESH MEATS INC 07/13/11 LEADERS LAW CENTER LLC GANAN & SHAPIRO 21 12WC 22237 JEAN-CLAUDE, MULUMBA TYSON FOODS 06/14/12 CAPRON & AVGERINOS PC GANAN & SHAPIRO 22 12WC 22579 BEESON, MARK KINSETH HOTEL CORP 05/10/12 KATZ HUNTOON & FIEWEGER P HOLECEK & ASSOCIATES 23 12WC 23610 GORDON, JIM HOLM INDUSTRIES INC 04/19/12 LAW OFFICE DAVID HUNT WIEDNER & MCAULIFFE LTD 12WC023611 -C 24 12WC 27062 PUSKAR, JOHN M JENSEN CONSTRUCTION 05/18/12 STEPHENS FIDDES MCGILL ASS 25 12WC 27763 DEAN, ROBERT E EXPORT PACKAGING CO, INC 05/30/12 KATZ HUNTOON & FIEWEGER P RUSIN & MACIOROWSKI LTD 26 12WC 29912 BRODY, MATTHEW P AG FAB LLC W 10/19/11 JAMES M RIDGE & ASSOC PC ASSISTANT ATTORNEY GENERAL 12WC029913 -C 27 12WC 40583 JENNINGS, CHADWICK JOHN DEERE HARVESTER 01/24/12 BELCHER LAW OFFICE CALIFF & HARPER PC 28 13WC 03467 FLORES, JOSE XPAC 07/09/12 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 29 13WC 08393 ALI, PAMELA MCLAUGHLIN BODY CO 01/14/13 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 30 13WC 10626 CLASSEN, KEITH TYSON FOODS 01/24/13 FICHERA & MILLER GANAN & SHAPIRO 31 13WC 10656 HALEY, DANIEL EAST MOLINE FIRE DEPT 04/01/10 THOMAS W DUDA MCCARTHY, CALLAS & FEENEY PC 32 13WC 10811 HALEY, DANIEL EAST MOLINE FIRE DEPARTME 04/02/10 THOMAS W DUDA MCCARTHY, CALLAS & FEENEY PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 3 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 33 13WC 11241 KOTOKU, YAO JOHN DEERE HARVESTER 03/12/12 MARSZALEK AND MARSZALEK CALIFF & HARPER PC 34 13WC 11688 ADAMS, DANIEL ROCK ISLAND SCHOOL DIST 10/06/11 WINSTEIN KAVENSKY & WALLAC INMAN & FITZGIBBONS 35 13WC 13230 LEE, CHARLES D DOHRN TRANSFER COMPANY 10/11/11 RUUD SCOVIL & MARSH BETTY NEUMAN & MCMAHON 36 13WC 14499 HOLLANDER, VICKI M ARAMARK CORP 02/25/13 KATZ HUNTOON & FIEWEGER P STONE & JOHNSON CHARTERED 37 13WC 17314 SEGNERI, ALFRED UNITED ELECTRIC 01/24/12 TURNER & SACKETT LLC NYHAN BAMBRICK KINZIE & LOWR 38 13WC 18257 WARD, PHYLLIS CR ENGLAND DEDICATED 03/20/13 LEONARD LAW GROUP LLC THOMAS & PORTELA 39 13WC 18979 MANSARAY, WANDA A SAL FAMILY & COMMUNITY SV 11/01/12 KATZ HUNTOON & FIEWEGER P 40 13WC 19079 19B JONES, RHONDA SBM BUSINESS EQUIPMENT 12/21/12 WOLFE LAW PC HEYL ROYSTER VOELKER & ALLEN 41 13WC 27274 TOSSELL, BRUCE SOI DEPT OF NATURAL RESOU @ 12/03/10 HARVEY & STUCKEL ASSISTANT ATTORNEY GENERAL 42 13WC 28127 WEST, PAULA A WALMART DISTRIBUTING CENT 08/15/09 RIDGE & DOWNES LLC QUINTAIROS PRIETO WOOD & BOY 43 13WC 29165 SHELDON, DEBBIE JOHN DEERE 09/10/10 MARSZALEK AND MARSZALEK CALIFF & HARPER PC 44 13WC 30265 BARDONER, JENNIFER JOHN DEERE CYLINDER AND 12/15/12 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 13WC030266 -C 14WC021668 -C 15WC023198 -C 45 13WC 31416 MEYER, AMY E CITY OF STERLING/STERLING 07/27/13 MERTES & MERTES PC ANCEL GLINK DIAMOND BUSH & E 46 13WC 31503 COIL, RICK DOHRN TRANSFER CO 06/17/13 BLACK & JONES 47 13WC 31582 MEYER, AMY E CITY OF STERLING/STERLING 02/19/11 MERTES & MERTES PC ANCEL GLINK DIAMOND BUSH & E 48 13WC 33168 SHOWALTER, SCOTT JOHN DEERE HARVESTER WORK 05/02/12 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 13WC037262 -C 13WC037263 -C 49 13WC 35502 MARTINEZ, JERONIMO MCLAUGHLIN BODY COMPANY 07/13/13 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 4 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 50 13WC 38029 FETTERER, SAMANTHA TRIANGLE INN 12/27/12 HOPKINS & HUEBNER PC RUSIN & MACIOROWSKI LTD 51 13WC 39049 LANE, TIMOTHY ILLINOIS YOUTH CENTER KEW @ 04/11/13 RIDGE & DOWNES LLC ASSISTANT ATTORNEY GENERAL 52 14WC 05481 ALEXANDER, STEVE J MAZEL & CO 01/02/14 MERTES & MERTES PC BRADY, CONNOLLY & MASUDA, PC 53 14WC 10967 SPARROWGROVE, KENNETH J APPELL ENTERPRISES LLC DB 01/04/12 AMES LAW OFFICES THOMAS & PORTELA 54 14WC 16388 KERR, JOHN DO IT BEST 09/17/13 BLACK & JONES HOLECEK & ASSOCIATES 55 14WC 18134 DOMINGUEZ, NATASHA UNITY POINT TRINITY 03/14/14 WARNER & ZIMMERLE CALIFF & HARPER PC 56 14WC 18444 PASSNO, AMANDA TYSON FRESH MEATS INC 08/13/13 ELFENBAUM EVERS & AMARILIO BRYCE DOWNEY & LENKOV LLC 57 14WC 18819 THOMPSON, CAROL WAL-MART ASSOCIATES INC 02/07/14 KATZ HUNTOON & FIEWEGER P 58 14WC 18857 FITZSIMMONS, ROB HARTLAND CONTROLS 01/24/14 BLACK & JONES RUSIN & MACIOROWSKI LTD 59 14WC 19188 EWING, WILLIAM MCLAUGHLIN BODY COMPANY 02/28/14 RIDGE & DOWNES RUSIN & MACIOROWSKI LTD 60 14WC 20418 MEERDINK, KARIA SMITHFIELD FOODS, INC. 03/19/14 WINSTEIN KAVENSKY & WALLAC STEPHEN P. KELLY 61 14WC 21105 AVALOS, JOSE TYSON FRESH MEATS INC 01/15/14 ELFENBAUM EVERS & AMARILIO GANAN & SHAPIRO 62 14WC 22195 BOGGS, HERMAN E JR COUNTY WASTE SYSTEMS, INC 03/02/14 KATZ HUNTOON & FIEWEGER P 14WC022196 -C JAMES L WATTS DBA 14WC022197 -C 14WC022198 -C JAMES L WATTS DBA 63 14WC 23044 BLACK, JIMMY JOHN DEERE HARVESTER 06/05/13 ANKIN LAW OFFICE BOZEMAN NEIGHBOUR PATTON & N 14WC041179 -C 14WC041180 -C 64 14WC 29528 DERYCKE, TRINA M ST OF IL, IL YOUTH CENTER @ 04/30/14 CORNFIELD & FELDMAN ASSISTANT ATTORNEY GENERAL 65 14WC 30882 WHITSITT, TED AMEREN ILLINOIS POWER 07/13/14 SAUNDERS CONDON & KENNY HOLTKAMP LIESE ET AL 66 14WC 30905 MARCHAND, MARY JO GATES CORPORATION 03/02/14 SIMPSON PETERSON QUINTAIROS PRIETO WOOD & BOY

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 5 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 67 14WC 31835 RUSSELL, DONNA MANPOWER 08/12/14 BLACK & JONES GOLDBERG SEGALLA LLC 68 14WC 32336 FRAZEE, KAREN XPAC 01/13/14 CHRISTINE A KEYS PC RUSIN & MACIOROWSKI LTD 69 14WC 35241 BURKE, AUSTIN INPRO SEAL 08/13/14 WINSTEIN KAVENSKY & WALLAC COZZI & GOGGIN-WARD 70 14WC 35917 RAUSCH, CANDY L WALMART STORES INC 08/15/14 KATZ HUNTOON & FIEWEGER P 71 14WC 37856 MARCHAND, MARY JO GATES CORP 08/20/14 SIMPSON PETERSON QUINTAIROS PRIETO WOOD & BOY 72 14WC 38245 CARNS, LORETTA UNITED FACILITIES 10/12/14 RIDGE & DOWNES COZZI & GOGGIN-WARD 73 14WC 38383 ARNOLDUSSEN, JOHN OLD BLUE ILLINOIS, INC. 09/20/14 REHN LAW LLC HEYL ROYSTER VOELKER & ALLEN 74 14WC 38615 HILL, WILLIAM TRENT MCKEOWN CONSTRUCTIO 12/31/13 CAPRON & AVGERINOS PC HEYL ROYSTER VOELKER & ALLEN 75 14WC 40813 BROWNFIELD, MATT BOLDT MECHANICAL 11/13/14 WILLIAMS & SWEE RUSIN & MACIOROWSKI LTD 76 14WC 40921 MC KENNA, CHERISH R WALMART DISTRIBUTION CENT 08/22/14 MERTES & MERTES PC QUINTAIROS PRIETO WOOD & BOY 77 14WC 42454 MAXWELL, DIANE UNIVERSITY OF ILLINOIS 07/14/14 LAW OFFICE OF CHRIS DOSCOT GANAN & SHAPIRO 78 15WC 00369 MAY, DAVID E PEOPLELINK STAFFING SOLUT 06/18/14 MARSZALEK AND MARSZALEK LAW OFFICES FRANCESCA LARSEN 79 15WC 00926 REED, LISA ST OF IL DEPT OF ILLINOIS @ 11/18/14 RIDGE & DOWNES LLC ASSISTANT ATTORNEY GENERAL 80 15WC 01286 WILKINSON, APRIL ACHIEVEMENT UNLIMITED INC 08/26/14 REHN LAW LLC GANAN & SHAPIRO 81 15WC 02822 EDWARDS, RAYMOND JOHN DEERE HARVESTER 08/12/13 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 82 15WC 03286 KOUE-ADJA, AKOSSIWA TYSON FRESH MEATS 04/08/14 CROWLEY & PRILL GANAN & SHAPIRO 83 15WC 04733 MARTINEZ DE SANCEN, MONIC TYSON FRESH MEATS INC 01/10/14 ELFENBAUM EVERS & AMARILIO GANAN & SHAPIRO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 6 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 84 15WC 06301 JOHNSTON, BRUCE XPAC 02/03/15 DWORKIN AND MACIARIELLO RUSIN & MACIOROWSKI LTD 85 15WC 06818 EL-MAJDOUBI, AHMED XPAC 02/26/14 WARNER & ZIMMERLE RUSIN & MACIOROWSKI LTD 15WC038241 -C 86 15WC 07171 PESSMAN, TASHUA R IL DEPT OF HUMAN SERVICES @ 02/04/15 ASSISTANT ATTORNEY GENERAL 87 15WC 07624 TEMPLETON, HOLLYWOOD WALTER BRAUD, CHIEF JUDGE 03/21/12 KATZ HUNTOON & FIEWEGER P 88 15WC 08485 SEDAM, FRANNIE VALSPAR CORPORATION 11/24/14 HOPKINS & HUEBNER PC RUSIN & MACIOROWSKI LTD 15WC017842 -C THE VALSPAR CORPORATION 89 15WC 09160 PEREZ, ANTONIO D JR RELATED MANAGEMENT CO DBA 11/21/14 JOHN LESAGANICH RIPES NELSON BAGGOT KALOBRAT 15WC009325 -C 90 15WC 09733 DELOOSE, GERALD JOHN DEERE CYLINDER 04/17/14 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 91 15WC 10123 SEKAZ, MICHAEL QUICKWAY DISTRIBUTION SER 12/20/12 GLASS & KOREIN GRANT & FANNING 92 15WC 10335 MILLER, RICKY J. PRECISION LASER ALIGNMENT 11/26/12 HOPKINS & HUEBNER PC LAW OFFICE PATRICK JENNETTEN 93 15WC 10693 VEGA, MARIO FARMLAND FOODS INC 02/06/15 HOPKINS & HUEBNER PC 94 15WC 10889 BUSHMAN, DAVID A STERLING RAIL SERVICES LL 07/28/14 REESE & REESE RODDY LAW LTD 16WC036618 -C 95 15WC 11192 DENNIS, IONA J WAL-MART SUPERCENTER 01/23/15 REESE & REESE WIEDNER & MCAULIFFE LTD 96 15WC 12005 DAVIS, CINDY METROLINK 03/25/15 LEE, MARK N LAW OFFICE RUSIN & MACIOROWSKI LTD 97 15WC 13611 ZIMMER, JANE STATE OF ILLINOIS @ 12/30/14 COYLE STENGEL BAILEY ROBER ASSISTANT ATTORNEY GENERAL 98 15WC 13643 APPENZELLER, TIMOTHY UPM RAFLATAC 04/23/12 HORWITZ HORWITZ & ASSOC WOLFE & JACOBSON, LTD 99 15WC 14421 TRANSOU, JASON ILLINOIS YOUTH CTR - KEWA @ 02/20/15 RIDGE & DOWNES ASSISTANT ATTORNEY GENERAL 100 15WC 14663 PERSON, BRIAN R XENA INTERNATIONAL 10/25/14 GESMER LAW OFFICES, PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 7 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 101 15WC 16030 BARNES, TERRENCE ILLINOIS YOUTH 05/10/15 RIDGE & DOWNES KRISTINA D DION 102 15WC 16488 PEREZ, APOLONIA FARMLAND FOODS 08/06/14 VANDERGINST LAW PC STEPHEN P. KELLY 103 15WC 17117 WAGLER, BLAINE CON WAY FEIGHT 04/15/15 WINSTEIN KAVENSKY & WALLAC GAROFALO SCHREIBER STORM 104 15WC 17285 DINGMAN, DEBRA L MONMOUTH ROSEVILLE CUSD 2 05/21/12 STANSELL WHITMAN & BABER 105 15WC 18293 SMALL, GWENDOLYN HOPE CREEK CARE CENTER 06/11/14 GOLDSTEIN BENDER & ROMANOF BROOKS LAW FIRM 106 15WC 18409 SWANSON, KEN IFH GROUP 04/01/15 DWORKIN AND MACIARIELLO 107 15WC 18999 D'AGOSTIN, SPENCER MJ ELECTRIC LLC 03/13/15 HEDEEN, MICHAEL J PC RUSIN & MACIOROWSKI LTD 108 15WC 19925 GOLDEN, JEREMY BOSS ROOFING & SIDING EXP 03/17/15 109 15WC 20139 SANDIFER, DWIGHT USF HOLLAND INC 04/29/15 FRIEND LEVINSON & BERGAL MEACHUM & STARCK 110 15WC 20358 STILL, SHEILA JAMIESON COMMUNITY CENTER 11/05/14 DWORKIN AND MACIARIELLO NYHAN BAMBRICK KINZIE & LOWR 111 15WC 20379 WHEELER, MICHAEL DEERE HARVESTER 12/14/10 VANDERGINST LAW PC BOZEMAN NEIGHBOUR PATTON & N 112 15WC 21271 MOTZ, KRISTIN XPAC PACKAGING 04/15/15 SAUNDERS CONDON & KENNY RUSIN & MACIOROWSKI LTD 113 15WC 21374 WOOD, ADAM JOHN DEERE HARVESTER WORK 02/13/15 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 114 15WC 21433 CRAWFORD, MICHELLE A IOWA PHYSICIANS CLINIC 01/10/14 KATZ HUNTOON & FIEWEGER P BETTY NEUMAN & MCMAHON 115 15WC 22086 COOK, AMBER HEIRLOOM CAFE 05/23/15 PIGNATELLI & ASSOCIATES RUSIN & MACIOROWSKI LTD 116 15WC 22225 LARSON, HANNAH QUAD CITY SKYDIVING CENTE 06/29/14 WINSTEIN KAVENSKY & WALLAC AMES LAW OFFICES 117 15WC 22740 PUGA, JAIME TYSON FRESH MEATSINC 03/23/15 GANAN & SHAPIRO 118 15WC 25654 CHAVEZ, JUAN STERLING RAIL SERVICES 08/19/13 REESE & REESE RODDY LAW LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 8 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 119 15WC 26370 FOSTER, YAKISHA (GUARDIAN KFC 07/14/15 KEYS LAW OFFICES COZZI & GOGGIN-WARD 120 15WC 27525 ALI, PAMELA MCLAUGHLIN BODY CO 06/30/15 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 121 15WC 28416 ALLEN, ERIC ILLINOIS YOUTH CENTER KEW @ 08/23/15 RIDGE & DOWNES ASSISTANT ATTORNEY GENERAL 122 15WC 28524 ADAMS, ROBERT JOHN DEERE PARTS 01/01/15 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 16WC011812 -C 123 15WC 29173 WILKERSON, MARY CHRISTINE EYE SURGEONS ASSOC 10/01/14 WARNER & ZIMMERLE LAW OFFICES JOSEPH MARCINIAK 124 15WC 30056 KLINGAMAN, JEREMY DOHRN TRANSFER CO. 06/17/15 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 125 15WC 30203 DAVIS, TERRY L FARMLAND FOODS 10/15/14 REHN LAW LLC STEPHEN P. KELLY 126 15WC 30305 HARTMAN, JAMES K EXELON NUCLEAR SECURITY, 08/19/14 KATZ HUNTOON & FIEWEGER P HENNESSY & ROACH PC 127 15WC 31110 HARPER, FRANCISCO JETCO INC 06/16/13 O'CONNOR & NAKOS 128 15WC 33446 MC GEE, STACEY R ILLINOIS YOUTH CENTER KEW @ 08/29/15 RIDGE & DOWNES ASSISTANT ATTORNEY GENERAL 129 15WC 33822 DOMINGUEZ, JOEL TYSON FOODS, INC 11/09/12 HOPKINS & HUEBNER PC BRYCE DOWNEY & LENKOV LLC 130 15WC 34413 KOOPMAN, WENDY ROCK ISLAND SCHOOL DIST # 01/12/15 STENGEL BAILEY ROBERTSON BRYCE DOWNEY & LENKOV LLC 131 15WC 34580 MARISCAL, ANTONIO METO KOTE CORP 01/16/15 BROOKS LAW FIRM KNELL LAW LLC 132 15WC 34818 FLYNN, AMANDA XPAC 09/16/15 DWORKIN AND MACIARIELLO RUSIN & MACIOROWSKI LTD 133 15WC 34879 CERVANTES, JORGE MICRO INDUSTRIES 10/13/15 PIGNATELLI & ASSOCIATES HENNESSY & ROACH PC 134 15WC 35479 ADJANAKROU, MOUHAMED TYSON FOODS, INC. 09/15/14 LEADERS LAW CENTER LLC GANAN & SHAPIRO 135 15WC 35720 MASSAROLO, ANGELA WAL-MART STORES, INC 10/04/15 WINSTEIN KAVENSKY & WALLAC QUINTAIROS PRIETO WOOD & BOY 136 15WC 35806 MATHRE, RICHARD IL DEPT OF AGRICULTURE @ 03/17/15 LEE, MARK N LAW OFFICE

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 9 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 137 15WC 37670 BOLIO, WILLIAM JOHN DEERE SEEDING GROUP 10/12/15 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 138 15WC 38478 WARD, PATRICIA A DIDOUGH'S PRETZEL 01/31/15 MERTES & MERTES PC NYHAN BAMBRICK KINZIE & LOWR 139 15WC 38497 COVEMAKER, MICHAEL DEERE & COMPANY - JOHN DE 04/01/93 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 140 15WC 38600 ANDERSON, WES LEGGETT & PLATT 08/31/15 CAPRON & AVGERINOS PC RUSIN & MACIOROWSKI LTD 141 15WC 39841 SWARTS, DARREL W TYSON FRESH MEATS INC 09/15/15 KATZ HUNTOON & FIEWEGER P GANAN & SHAPIRO 142 15WC 39888 MEDHURST F/K/A MAGEE, KER ROSEWOOD ADMINISTRATIVE 04/19/15 REHN LAW LLC RUSIN & MACIOROWSKI LTD 16WC006417 -C 143 15WC 41321 MASON, SUE KONE 07/03/14 WINSTEIN KAVENSKY & WALLAC GAROFALO SCHREIBER STORM 17WC022207 -C 144 15WC 42090 MARTINEZ, JOSE JIM GIESE COMMERCIAL RFG 08/26/15 HOPKINS & HUEBNER PC KNELL & O'CONNOR 145 16WC 01419 VINAVICH, FARLEY HENRY CTY HOUSING AUTHORI 08/14/15 STRONG LAW OFFICE GILDEA & COGHLAN 146 16WC 01945 MUNTHER, PAULA JOHNSONS OIL INC 10/17/14 STRONG LAW OFFICE CAPUANI & SCHNEIDER 147 16WC 02081 HAJOSTEK, JERRILYN GATES CORPORATION 08/01/15 BROOKS LAW FIRM 148 16WC 02116 MARTH, MICHAEL COLONY BRANDS INC 12/10/15 HORWITZ HORWITZ & ASSOC WOLFE & JACOBSON, LTD 149 16WC 02309 HAAN, DARREN JOHN DEERE HARVESTER 01/17/13 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 150 16WC 02334 PASLEY, JOSHUA WALMART DISTRIBUTION CENT 12/01/15 RIDGE & DOWNES QUINTAIROS PRIETO WOOD & BOY 16WC002335 -C 151 16WC 04479 MAYES, DAVID REPUBLIC SERVICES INC 08/15/14 RIDGE & DOWNES GILDEA & COGHLAN 16WC004480 -C 16WC004481 -C 152 16WC 05097 WENDELL, JEFFREY TYSON FOODS INC 08/19/15 GOLDBERG WEISMAN & CAIRO L BRYCE DOWNEY & LENKOV LLC 153 16WC 05270 GUSTAFSON, LARRY JOHN DEERE SEEDING 09/08/14 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 10 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 154 16WC 05291 LEWIS, KEITH APPELL EQUIPMENT SALES & 12/19/15 LEFANTE LAW OFFICES COZZI & GOGGIN-WARD 155 16WC 05384 HERMEYER, KIRBY OSCAR J. BOLDT 02/03/14 MEYERS & FLOWERS RUSIN & MACIOROWSKI LTD 156 16WC 05744 LAMANTIA-MC FARLAND, KARE ALDI 03/06/14 WINSTEIN KAVENSKY & WALLAC BRADY, CONNOLLY & MASUDA, PC 16WC005745 -C 157 16WC 06426 DESHEPPER, LISA GALESBURG COTTAGE HOSPITA 08/15/15 GOLDBERG WEISMAN & CAIRO L 158 16WC 06598 HAHN, DAN DEERE & COMPANY INC/JOHN 01/28/16 SCHWEICKERT & GANASSIN LANE & WATERMAN 159 16WC 07043 JORDAN, SUSAN ARAMAK UNIFORM SERVICES 01/13/16 WINSTEIN KAVENSKY & WALLAC INMAN & FITZGIBBONS 160 16WC 07119 DURAN, ROSA ST OF IL DEPT OF CORRECTI @ 01/14/16 PIGNATELLI & ASSOCIATES KRISTINA D DION 161 16WC 07741 MEDRANO, JUAN RG CONSTRUCTION SERVICES 11/24/15 GOLDBERG WEISMAN & CAIRO L MACIOROWSKI SACKMANN & ULRIC 162 16WC 08101 MILLER, JAMES R ROCK ISLAND COUNTY 02/24/16 RIDGE & DOWNES BROOKS LAW FIRM 163 16WC 08257 AMOUZOU, AMIVI FARMLAND FOODS 12/23/15 WINSTEIN KAVENSKY & WALLAC STEPHEN P. KELLY 164 16WC 08373 HAAN, DARREN JOHN DEEREHARVESTER 08/03/15 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 165 16WC 08376 HAAN, DARREN JOHN DEERE HARVESTER 11/05/15 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 166 16WC 08557 LEAL, RALPH A ROCK RIVER CARTHAGE, INC 04/10/15 MERTES & MERTES PC RUSIN & MACIOROWSKI LTD 167 16WC 08564 WHITELY, BRAD J STERLING CHEVROLET 11/12/15 MERTES & MERTES PC INMAN & FITZGIBBONS 168 16WC 08649 WOLF, LANCE E. TERRY WOLF CONSTRUCTION 02/21/14 REESE & REESE NYHAN BAMBRICK KINZIE & LOWR 169 16WC 08915 HASTINGS, GAIL MCLAUGHLIN BODY 10/14/15 CAPRON & AVGERINOS PC RUSIN & MACIOROWSKI LTD 170 16WC 09408 MESSER, EARL LEON COOKS QUICK LUBE & AUTO R W 03/03/16 WOODRUFF & JOHNSON WARD MURRAY PACE & JOHNSON P 171 16WC 09665 DECRANE KAHA, SAMANTHA L. HYVEE, INC. 07/21/13 VANDERGINST LAW PC HOPKINS & HUEBNER PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 11 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 172 16WC 09811 HELLE, ROBYN KNOX COUNTY NURSING HOME 10/20/15 REHN & SKINNER LLC BUSH MOTTO CREEN KOURY 173 16WC 10654 RANKIN, REBECCA JOHN DEERE HARVESTER 01/08/13 MARSZALEK AND MARSZALEK CALIFF & HARPER PC 174 16WC 10657 ROCKWELL, SHELLEY JOHN DEERE HARVESTER 07/20/15 MARSZALEK AND MARSZALEK CALIFF & HARPER PC 175 16WC 10729 MILES, CASSANDRA M ROCK ISLAND COUNTY 12/31/14 VANDERGINST LAW PC BROOKS LAW FIRM 176 16WC 11353 CEDENO, RAMIRO JOHN DEERE HARVESTER 06/03/15 DWORKIN AND MACIARIELLO CALIFF & HARPER PC 177 16WC 11377 BENNETT, CHARLES MENARDS 07/12/15 SIMPSON PETERSON GANAN & SHAPIRO 178 16WC 11443 ABBOTT, SHARON DICK BLICK HOLDINGS, INC 11/06/15 STRONG LAW OFFICE LAW OFFICES JOSEPH MARCINIAK 179 16WC 12073 PUGA, JAIME TYSON FRESH MEATS, INC. 03/23/15 GANAN & SHAPIRO 180 16WC 12236 LIBERG, MATTHEW T RESCAR 02/01/16 THOMAS R LICHTEN 181 16WC 12322 FATAH, ABDI TYSON FRESH MEATS, INC 09/05/14 GANAN & SHAPIRO 182 16WC 12489 JENKINS, CORY MCLAUGHLIN BODY COMPANY 02/29/16 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 183 16WC 12868 EDWARDS, TERRY JOHN DEERE 11/25/15 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 184 16WC 12892 CASEY, THOMAS F III CF INDUSTRIES 02/20/14 KATZ HUNTOON & FIEWEGER P NYHAN BAMBRICK KINZIE & LOWR 16WC012893 -C 185 16WC 13384 ALLISON, CHRISTINA JOHN DEERE HARVESTER WORK 03/06/13 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 186 16WC 13871 WILSON, SHANNON ST OF IL DEPT OF HUMAN SE 11/16/15 RIDGE & DOWNES 187 16WC 13960 WEST, ANDREW W CITY OF ROCK ISLAND 11/04/15 THOMAS W DUDA BETTY NEUMAN & MCMAHON 188 16WC 14405 REID, AMANDA L. C.R. ENGLAND, INC. 12/17/15 MERTES & MERTES PC SPIEGEL & CAHILL, PC 189 16WC 14472 SHUMAN, ALLISON MIDLAND STATES BANK 12/08/15 BLACK & JONES COZZI & GOGGIN-WARD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 12 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 190 16WC 14612 KOVE-ADJA, AKOSSIWA TYSON FRESH MEATS INC 08/11/14 CROWLEY & PRILL GANAN & SHAPIRO 191 16WC 15922 HASSAN, HALIMA TYSON FOODS, INC. 05/02/12 WINSTEIN KAVENSKY & WALLAC BRYCE DOWNEY & LENKOV LLC 192 16WC 15947 DAVIS, JOSHUA ILLINOIS DEPT OF CORRECTI @ 04/02/16 REHN & SKINNER LLC KRISTINA D DION 193 16WC 16541 SEGAR, KARLA JOHN DEERE HARVESTER 09/09/15 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 194 16WC 16560 FAMUTIMI, IDA TYSON FOODS, INC 06/11/15 WINSTEIN KAVENSKY & WALLAC BRYCE DOWNEY & LENKOV LLC 195 16WC 16839 WADKINS, DANNY JR PPC PLASTIC PRODUCTS CO I 02/29/16 BROOKS LAW FIRM HENNESSY & ROACH 196 16WC 17063 THOMPSON, CINDY GENESIS MEDICQAL CENTER A 03/25/16 WINSTEIN KAVENSKY & WALLAC HOPKINS & HUEBNER PC 197 16WC 17759 VALDEZ, TEOFILO K&M EQUIPMENT, INC 01/24/11 BROOKS LAW FIRM GRANT & FANNING 198 16WC 17854 DEWITH, ENYO CITY OF ROCK ISLAND 06/23/13 THOMAS W DUDA 199 16WC 18905 DETMERS, PAUL FARMLAND FOODS 04/07/15 SIMPSON PETERSON STEPHEN P. KELLY 200 16WC 19401 PULFORD, ROBERT J CATHOLIC DIOCESE OF PEORI 10/11/15 KATZ HUNTOON & FIEWEGER P GANAN & SHAPIRO 201 16WC 19463 HERNANDEZ, ROSE UNITED TOWNSHIP HIGH SCHO 06/09/13 KATHERINE VARLAS TEEL RUSIN & MACIOROWSKI LTD 202 16WC 19639 DI KANDA, HENRY FARMLAND FOODS, INC 12/18/13 WOODRUFF & JOHNSON STEPHEN P. KELLY 203 16WC 20735 MCKENNA, TERRY A MALCOLM DRILLING CO INC 05/25/16 REESE & REESE COZZI & GOGGIN-WARD 204 16WC 20773 PATCH, JULIE F/N/A FOWLER REHN & SKINNER LLC 04/21/15 HARVEY & STUCKEL GANAN & SHAPIRO 205 16WC 20994 CLARK, KENNETH E WAL-MART DIST CENTER 11/07/15 MERTES & MERTES PC QUINTAIROS PRIETO WOOD & BOY 206 16WC 21362 JERVAY, PAULETTE WINNING WHEELS INC 05/10/16 PIGNATELLI & ASSOCIATES GANAN & SHAPIRO 207 16WC 21827 MONTIEL, ALEXANDER WAHL CLIPPER 03/01/16 BLACK & JONES HEYL ROYSTER VOELKER & ALLEN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 13 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 208 16WC 21881 FRANK, DALE JOHN DEERE HARVESTER 12/15/15 MARSZALEK AND MARSZALEK BOZEMAN NEIGHBOUR PATTON & N 209 16WC 22495 BECK, PAMELA WAHL CLIPPER CORPORATION 02/03/16 HORWITZ HORWITZ & ASSOC HEYL ROYSTER VOELKER & ALLEN 210 16WC 22871 HILL, MARK SCHULER MOTORS INC 01/07/15 MARKS INJURY LAW GAROFALO SCHREIBER STORM 211 16WC 23146 MINI, AARON CHICAGO BRIDGE & IRON CO 03/14/16 SCHWEICKERT & GANASSIN RIPES NELSON BAGGOT KALOBRAT 212 16WC 23757 JOHNSON, DANNY K SMITHFIELD FOODS INC 01/02/15 JOHN LESAGANICH 213 16WC 24195 PATEL, JIM DLZ CONSTRUCTION 07/22/16 SEIDMAN MARGULIS & FAIRMAN 214 16WC 24572 BUCKINGHAM, LISA WAL-MART DISTRIBUTION CEN 04/08/16 MARTIN V KUGIA QUINTAIROS PRIETO WOOD & BOY 215 16WC 24621 DRAPER, JAYME BUILDERS SALES & SERVICE 02/16/16 PATRICK JENNETTEN 216 16WC 25108 PICKREL, JAMES CARL NELSON & CO 12/31/14 STRONG LAW OFFICE GRANT & FANNING 15WC015243 -C 217 16WC 25134 ROBERTS, ZACHARY ANTON BAYER MILLWRIGHT 08/10/16 DWORKIN AND MACIARIELLO LOSS & PAVONE 218 16WC 25359 THARP, KENNETH I. JR. KENNY THARP MASONRY 11/06/15 BROOKS LAW FIRM BRADY CONNOLLY & MASUDA PC 219 16WC 25619 BEAL, JOSEPHINE GOOD SAMARITAN NURSING HO 04/23/16 CAPRON & AVGERINOS PC GAROFALO SCHREIBER STORM 220 16WC 26431 FASSIG, MATTHEW AREA MECHANICAL INC. 08/05/16 LEE, MARK N LAW OFFICE WIEDNER & MCAULIFFE LTD 221 16WC 27091 PITTINGTON, JACKIE DICK BLICK ART MATERIALS 05/05/16 RIDGE & DOWNES LAW OFFICES JOSEPH MARCINIAK 222 16WC 27760 STOLL, LESLIE ICW GROUP HOLDINGS, INC 04/01/15 CLARK FROST HOLTKAMP LIESE ET AL 223 16WC 28103 DAY, THADDEUS ELITE STAFFING 06/16/16 DWORKIN AND MACIARIELLO 224 16WC 28169 FERGUSON, ANGELA JOHN DEERE HARVESTER WORK 03/09/15 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 225 16WC 28192 STRAW, DAVID WILLIAM ADVANCED BUSINESS SYSTEMS 04/07/16 KEYS LAW OFFICES GANAN & SHAPIRO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 14 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 226 16WC 28658 WHITE, BRIAN J COCA COLA REFRESHMENTS, I 01/07/15 VANDERGINST LAW PC BRADY, CONNOLLY & MASUDA, PC 227 16WC 29061 NACHE, MICHAEL SR EBY-BROWN CO 05/08/15 BOSHARDY LAW OFFICE PC COZZI & GOGGIN-WARD 228 16WC 29087 PORSCHKE, CORRINA APERION CARE INC 06/25/16 VANDERGINST LAW PC 16WC029228 -C 229 16WC 29138 THOMPSON, TROY JOHN DEERE HARVESTER WORK 01/12/16 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 230 16WC 29142 KONEN, GARY R DABNEY TRUCKING, INC 04/05/16 THOMSON & WEINTRAUB NYHAN BAMBRICK KINZIE & LOWR 231 16WC 29155 TAFLINGER, BRAD JOHN DEERE 06/24/14 STEPHEN P. KELLY CALIFF & HARPER PC 232 16WC 29918 KAGEE, RANDY JOHN DEERE SEEDING GROUP 09/16/16 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 233 16WC 29981 HILL, JAMES VERN'S FARM SUPPLY 04/14/16 CRONAUER, CHARLES E RODDY LAW LTD 234 16WC 30122 NEULEIB, LADONNA JOHN DEERE 08/18/16 MARSZALEK AND MARSZALEK CALIFF & HARPER PC 235 16WC 30151 HUSSEIN, TAREQ JUMER'S CASINO & HOTEL 05/21/16 WARREN E DANZ, PC HOLECEK & ASSOCIATES 236 16WC 30171 STACH, STUART XPAC 09/09/16 HARVEY & STUCKEL RUSIN & MACIOROWSKI LTD 237 16WC 30317 ROBINSON, CARLOS TYSON FRESH MEATS 09/15/16 DWORKIN AND MACIARIELLO GANAN & SHAPIRO 238 16WC 30560 HAMM, LENDON J LKQ CORP D/B/A KEYSTONE 06/06/16 KATZ HUNTOON & FIEWEGER P BRYCE DOWNEY & LENKOV LLC 239 16WC 31305 CHARLET, ROBERT TYSON FOODS, INC 08/31/16 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 240 16WC 31566 MORRIS, PHILLIP DICK BLICK ART MATERIALS 05/13/16 JAY H JANSSEN LAW OFFICES JOSEPH MARCINIAK 241 16WC 31720 QAMHI, NAWAL TYSON FOODS INC 09/26/13 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 242 16WC 31920 JEFFERS, CHRISTOPHER D GREEN GABLES, INC 09/19/16 AMES LAW OFFICES BRADY, CONNOLLY & MASUDA, PC 243 16WC 32330 SEXTON, ANDREW JACK'S BRAKE & ALIGNMENT 03/18/16 CROWLEY & PRILL RODDY LAW LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 15 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 244 16WC 32422 BRANDT, MEREDITH EAST MOLINE SCHOOL 09/26/16 KATZ FRIEDMAN EAGLE ET AL 245 16WC 32751 CHAVEZ, LINDA XPAC 06/19/14 VANDERGINST LAW PC RUSIN & MACIOROWSKI LTD 16WC032754 -C 246 16WC 32911 CAMPEN, DEREK J CORPORATE SERVICES, INC 08/16/16 247 16WC 33408 BUCKINGHAM, LISA WALMART DISTRIBUTION CTR 04/08/16 MARTIN V KUGIA QUINTAIROS PRIETO WOOD & BOY 248 16WC 33855 PARKER, JOLENE GREAT DANE TRAILERS 07/07/16 STEPHENS FIDDES MCGILL ASS SPIEGEL & CAHILL, PC 249 16WC 34019 DEGBE, YAWA TYSON FRESH MEATS, INC 05/25/12 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 250 16WC 34488 ALFREDM EDELYN NAVIGATION INC 09/17/16 BRISKMAN BRISKMAN GREENBER 251 16WC 35763 ROSALES, LIZBETH GREAT DANE TRAILERS 12/09/15 SPIEGEL & CAHILL, PC 252 16WC 36206 FRANK, WALTER MEYER STEEL DRUM 03/15/16 BOWMAN & CORDAY QUINTAIROS PRIETO WOOD & BOY 253 16WC 37093 SMITH, CLARISSA WALMART DC 11/01/16 BLACK & JONES QUINTAIROS PRIETO WOOD & BOY 254 16WC 37247 PARKS, LARRY JOHN DEERE HARVESTER 01/16/14 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 255 16WC 37828 OLSON, JACKLYN K WEST CENTRAL CUSD #235 08/31/16 THOMAS E CADY MACIOROWSKI SACKMANN & ULRIC 256 16WC 38642 MORRISSEY, WAYNE ANTHONY EUCLID BEVERAGE LLC 01/05/16 REHN LAW LLC ROBERT L. SMITH 257 16WC 38812 CURTIS, NEIL ILLINOIS DEPARTMENT OF IL 12/12/16 DWORKIN AND MACIARIELLO 258 16WC 38881 JONES, ANDREA ROCK ISLAND SCHOOL DISTRI 04/07/16 DWORKIN AND MACIARIELLO HENNESSY & ROACH, PC 259 17WC 00725 BOERTLEIN, JOEL R OMNI SPECIALIZED, LLC 08/09/16 THOMAS E CADY NYHAN BAMBRICK KINZIE & LOWR 260 17WC 01386 EASLEY, KIMBERLY WINNIGN WHEELS INC 01/13/17 DWORKIN AND MACIARIELLO 261 17WC 01670 CASTANEDA-VALDEZ, ANGEL LA LEASING, INC DBA 09/23/16 THOMAS E CADY BETTY NEUMAN & MCMAHON

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 16 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 262 17WC 01684 CHAPMAN, JASON JOHN DEERE HARVESTER 01/30/14 WINSTEIN KAVENSKY & WALLAC 263 17WC 01930 VAN VOLTENBURG, DEANNA MILLER CONTAINER CORPORAT 11/30/16 WARNER & ZIMMERLE 264 17WC 02008 PETERSON, SHAWN STATE OF ILLINOIS - IDOT @ 10/28/14 JOHN LESAGANICH 265 17WC 02107 KLASSEN, CRAIG WEST ROCK 10/24/16 CROWLEY & PRILL SPIEGEL & CAHILL, PC 266 17WC 02379 CARDER, THOMAS A GATES CORPORATION 01/09/17 SIMPSON PETERSON 267 17WC 02963 LOHF, AMYRELIS TYSON FOODS, INC 06/06/16 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 268 17WC 03007 JOHNSON, JOHN JOHN DEERE HARVESTER 03/10/14 CAPRON & AVGERINOS PC CALIFF & HARPER PC 269 17WC 03053 ROYSE, JEFFREY JOHN DEERE HARVESTER WORK 01/19/16 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 270 17WC 03085 RUSSELL, TYLER MARTIN ENGINEERING 10/17/16 HORWITZ HORWITZ & ASSOC INMAN & FITZGIBBONS 271 17WC 03145 WILLIAMS, LONNY L BUILDERS SALES & SERVICE 07/21/15 ELFENBAUM EVERS & AMARILIO 272 17WC 03285 MILLER, RICKY J PRECISION LASER ALIGNMENT 12/01/15 HOPKINS & HUEBNER PC 273 17WC 03430 ADAMS, PATRICIA WALMART SUPERCENTER #2231 11/09/16 RIDGE & DOWNES QUINTAIROS PRIETO WOOD & BOY 274 17WC 03560 ASHBY, WILLIAM DANIEL PERFORMANCE FOOD GROUP 05/04/16 ELFENBAUM EVERS & AMARILIO 275 17WC 03615 MATTHEWS, TAQUANA JOHN DEERE HARVESTER 02/01/14 DONOVAN ROBERTSON CALIFF & HARPER PC 276 17WC 04475 MELTON, JAMES W WHITESIDE COUNTY 12/12/16 MERTES & MERTES PC HEYL ROYSTER VOELKER & ALLEN 277 17WC 04917 PAGE, JOHN F&W TRANSPORT 11/16/16 GALANTI LAW OFFICES 278 17WC 05308 SCHULTZ, JOHN MAMMOET USA NORTH 01/07/17 HORWITZ HORWITZ & ASSOC WIEDNER & MCAULIFFE LTD 17WC005307 -C 279 17WC 05609 EDWARDS, TERRY JOHN DEERE HARVESTER WORK 08/01/16 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 17 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 280 17WC 05748 FOX, JOSEPH EAST MOLINE CORRECTIONAL 11/15/16 PETER F FERRACUTI & ASSOCI ASSISTANT ATTORNEY GENERAL 281 17WC 05821 MANGIERI, LORI GATES CORP 08/25/16 DWORKIN AND MACIARIELLO 282 17WC 06032 SAMPSON, JIM O CGH MEDICAL CENTER 01/16/17 MERTES & MERTES PC 283 17WC 06099 STAHLER, JON KURT HAWKEYE BUILDING DISTRIBU 11/12/15 BUSH MOTTO CREEN KOURY INMAN & FITZGIBBONS 284 17WC 06525 MCDANEL, MICHAEL JOHN DEERE HARVESTER 02/02/17 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 285 17WC 06696 KPATCHA, AKLESSO TYSON FOODS, INC 11/27/15 STRONG LAW OFFICE GANAN & SHAPIRO 286 17WC 06707 HILL, PEGGY L THE SALVATION ARMY 07/26/16 THOMAS E CADY RODDY LAW LTD 287 17WC 06989 AKPLA, AMA TYSON FOODS INC 07/09/16 STRONG LAW OFFICE GANAN & SHAPIRO 288 17WC 07019 OGOUBI, AFI TYSON FRESH MEATS INC 02/28/17 LEADERS LAW CENTER LLC 289 17WC 07185 BENT, RHONDA FAIRFIELD INN & SUITES 02/10/17 GOLDFINE & BOWLES COZZI & GOGGIN-WARD 290 17WC 07392 COOK, MICHAEL WAYNE STOHL & SONS PLASTE 07/21/16 STENGEL BAILEY ROBERTSON RODDY LAW LTD 291 17WC 07433 DAVIDSON, PAMELA JOHN DEERE HARVESTER 02/07/16 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 292 17WC 07487 STEWART, ANGELA JOHN DEERE HARVESTER 06/01/16 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 293 17WC 07500 STEWART, ANGELA JOHN DEERE HARVESTER 05/02/14 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 294 17WC 07526 POLK, RUEBEN TYSON FRESH MEATS, INC. 10/03/16 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 295 17WC 07792 HATHAWAY, KIM WALMART 05/08/16 LAW OFFICE OF CHRIS DOSCOT GANAN & SHAPIRO 296 17WC 07835 HUSKEY, RANDAL ROCK ISLAND MILAN 03/23/16 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 297 17WC 08258 OMOKENGE, MOISE PUTSHU FARMLAND FOODS 12/28/16 LAW OFFICE DAVID HUNT

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 18 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 298 17WC 08973 ROOS, STEPHANIE FBG SERVICE CORPORATION 11/02/16 WINSTEIN KAVENSKY & WALLAC HOLECEK & ASSOCIATES 299 17WC 09091 BONNER, MARUISA GENESIS HEALTH SYSTEM 08/05/16 THOMAS E CADY HOPKINS & HUEBNER PC 300 17WC 09833 TUTTLE, KENNETH O'REILLY AUTO PARTS 11/29/16 CAPRON & AVGERINOS PC 301 17WC 10247 GALINDO-VAZQUEZ, BEATRIZ FARMLAND FOODS 03/01/17 LAW OFFICE DAVID HUNT 302 17WC 10458 CHEZEM, NICHOLAS WALMART DISTRIBUTION CENT 12/05/16 HAUSER LAW LLC QUINTAIROS PRIETO WOOD & BOY 303 17WC 10574 MAES, DEBRA CHS 11/01/16 WINSTEIN KAVENSKY & WALLAC BETTY NEUMAN & MCMAHON 304 17WC 10644 MORALES FLORES, VICTOR FE PERFORMANCE FOOD GROUPS 08/25/16 WOODRUFF & JOHNSON BRYCE DOWNEY & LENKOV LLC 305 17WC 11318 GLOVER, WILLIAM ESSG 03/18/17 LAW OFFICE DAVID HUNT WIEDNER & MCAULIFFE LTD 306 17WC 11375 FREDERICK, JENNIFER APERION CARE 03/08/17 DWORKIN AND MACIARIELLO 307 17WC 11688 KOVACS, JUSTIN QUAD CITY MALLAROS (ECHL) 02/17/17 FLOYD LAW FIRM INMAN & FITZGIBBONS 308 17WC 11776 EDWARDS, TERRY JOHN DEERE HARVESTER WORK 08/06/15 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 309 17WC 12101 THIESSEN, CARRY CHICAGO BRIDGE & IRON CO 04/04/17 HEALY SCANLON LAW FIRM RIPES NELSON BAGGOT KALOBRAT 310 17WC 12473 QAMHI, NAWAL TYSON FOODS INC 07/31/15 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 311 17WC 12551 SPROUSE, STEVEN H HIRSCHBACH MOTOR LINES, I 03/21/16 BETTY NEUMAN & MCMAHON 312 17WC 12744 MILLARD, ANNA M HOPE CREEK CARE CENTER 02/16/16 ELFENBAUM EVERS & AMARILIO BROOKS LAW FIRM 313 17WC 13062 NIMMERS, MARCQUES PFG-THOMAS PROESTLER COMP 03/15/17 RIDGE & DOWNES 314 17WC 13189 NAVARRO, HERIBERTO TYSON FOODS, INC 01/14/17 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 315 17WC 13676 SIMPSON, WAYNE FIRST STUDENT, INC 09/13/16 BLACK & JONES 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 MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 316 17WC 14700 GORANSON, MICHAEL JOHN DEERE HARVESTER 01/03/17 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 317 17WC 14834 DECLERCK, JON UPS FREIGHT 03/29/17 MARKS INJURY LAW COZZI & GOGGIN-WARD 318 17WC 14878 WEBER, JOSHUA CITY OF STERLING 04/09/17 FOOTE MIELKE CHAVEZ & O'NE 319 17WC 14953 PIERCE, JOSH JB EXCAVATING 07/20/15 GALANTI LAW OFFICES RODDY LAW LTD 320 17WC 14989 DOUMASHIE, AKU TYSON FOODS 05/30/14 WINSTEIN KAVENSKY & WALLAC BRYCE DOWNEY & LENKOV LLC 321 17WC 15047 KIVISTO, GRACE KCCDD 11/03/16 SIMPSON PETERSON 322 17WC 15172 TOPORAN, MUJO TYSON FOODS, INC 07/22/16 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 323 17WC 15504 PULLIAM, DERRICK BENNIGANS 02/10/17 WINSTEIN KAVENSKY & WALLAC COZZI & GOGGIN-WARD 324 17WC 15852 SCHMIDT, LEE MAINTENANCE AND MECHANICA 05/02/16 HOPKINS & HUEBNER PC CASSANO & ASSOCIATES 325 17WC 16080 BARNES, BRIAN L MAPES ASPHALT SVCS 05/03/16 WINSTEIN KAVENSKY & WALLAC COZZI & GOGGIN-WARD 17WC016081 -C 326 17WC 16095 MARTINEZ, GUILLERMINA TYSON FRESH MEATS, INC. 08/15/14 ANDREW BRIBRIESCO WIEDNER & MCAULIFFE LTD 327 17WC 16099 GETSON, PATTI VAN WESTERN ILLINOIS BROADCAS 08/08/15 VANDERGINST LAW PC HENNESSY & ROACH 328 17WC 16118 WILSON, LAURIE HEALTHCARE SERVICE GROUP 05/25/16 DWORKIN AND MACIARIELLO 329 17WC 16142 KOVACS, JUSTIN QUAD CITY MALLARDS 04/22/17 FLOYD LAW FIRM INMAN & FITZGIBBONS 330 17WC 16368 STEELE, MICHAEL VANOPDORP TRUCKING 10/31/16 BLACK & JONES JAMES M KELLY 17WC016369 -C 331 17WC 16474 FRANKS, KATHY L FIRST STUDENT 05/19/17 REESE & REESE 332 17WC 16632 SHELEY, BRYNN JOHN DEERE PDC 05/12/17 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 333 17WC 16966 MCMAHON, GARY P XPO LOGISTICS FREIGHT 04/08/16 HARVEY & STUCKEL RUSIN & MACIOROWSKI LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 20 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 334 17WC 17325 THOMPSON, TROY JOHN DEERE HARVESTER WORK 05/24/17 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 335 17WC 17642 HADDOCK, COY CASEYS GENERAL 06/11/17 DWORKIN AND MACIARIELLO 336 17WC 17739 SCHEMEL, GERHARD ILLINOIS QUAD CITY CIVIC 03/23/17 BLACK & JONES 337 17WC 18105 MEDINA, RAYMOND JOHN DEERE PARTS 03/09/16 HOPKINS & HUEBNER PC CALIFF & HARPER PC 338 17WC 18724 HASSELBACHER, MICHAEL KOPPERS 05/16/17 GOLDFINE & BOWLES RUSIN & MACIOROWSKI LTD 339 17WC 18979 GOOCH, CRYSTAL JOHNSON OIL 07/20/16 WARNER & ZIMMERLE 340 17WC 18995 CARDENAS, GUADALUPE VALLEY MEATS, LLC 02/21/17 ANDREW BRIBRIESCO HOLECEK & ASSOCIATES 17WC018994 -C 341 17WC 19200 RABE, FREDERICK BEST COB LLC 06/08/17 TAXMAN POLLOCK WIEDNER & MCAULIFFE LTD 342 17WC 19262 MOLER, JOHN BEACON ROOFING SUPPLY/ROO 02/03/16 LOGAN LAW 343 17WC 19286 NAJERA FIGUEROA, JAVIER BELLOTA AGRISOLUTIONS 01/22/17 LOGAN LAW 344 17WC 19370 TANNER, BRIAN HOSPICE SOURCE 04/06/17 DAVID W MARTAY 345 17WC 19511 VEAL, CELENA JOHN DEERE HARVESTER 06/09/17 HOPKINS & HUEBNER PC CALIFF & HARPER PC 346 17WC 20394 NAUGLE, SHARI KNOX COUNTY NURSING HOME 03/26/17 LEFANTE LAW OFFICES 347 17WC 20588 PEED, JASON TOM NELSON TRUCKING 06/02/17 WINSTEIN KAVENSKY & WALLAC 348 17WC 20713 MCGHEE, POWELL ROCK ISLAND/MILAN SCHOOL 09/15/16 MARSZALEK AND MARSZALEK 349 17WC 20799 RADOSEVICH, MARTHA ARAMARK 05/22/17 WINSTEIN KAVENSKY & WALLAC WIEDNER & MCAULIFFE LTD 350 17WC 20890 BROWN, ERIC B MOLINE POLICE DEPT 01/10/14 RIDGE & DOWNES CALIFF & HARPER PC 351 17WC 20925 STEWART, JACOB ROCK ISLAND COUNTY HEALTH 04/21/17 TAXMAN POLLOCK

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 21 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 352 17WC 21003 WAYLAND, JESSE W III ROCK ISLAND HIGH SCHOOL 06/27/15 WINSTEIN KAVENSKY & WALLAC 353 17WC 21256 CROWE, RUSSELL MCDERMAID ROOFING & INSUL 06/19/17 HORWITZ HORWITZ & ASSOC BRADY, CONNOLLY & MASUDA, PC 354 17WC 21613 HARRISON, WILLIAM C IL DEPT OF EMPLOYMENT SEC @ 06/05/17 HOPKINS & HUEBNER PC 355 17WC 21829 HAMERLINK, ADAM JOHN DEERE HARVESTOR WORK 06/28/17 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 356 17WC 21921 MUNOZ, CARMEN TYSON FRESH MEATS, INC. 02/24/14 ANDREW BRIBRIESCO GANAN & SHAPIRO 357 17WC 22297 FIGUEROA, JAVIER NAJERA BELLOTA AGRISOLUTIONS 08/01/16 LOGAN LAW LAW OFFICES JOSEPH MARCINIAK 358 17WC 22589 CHANDLER, MICHAEL EAST MOLINE SCHOOL 03/02/17 HOPKINS & HUEBNER PC 359 17WC 22966 CALHOUN, MARION STATE OF IL HENRY HILL @ 06/29/17 REHN & SKINNER LLC ASSISTANT ATTORNEY GENERAL 360 17WC 22995 YEAGER, DALE (DECEASED) THA MAY COMPANY # 01/09/81 RIDGE & DOWNES KNELL LAW LLC 361 17WC 23204 ADAMS, THOMAS STERLING STEEL COMPANY LL 07/16/17 STROW LAW LLC RUSIN & MACIOROWSKI LTD 362 17WC 23251 RICE, DEMETRIUS TYSON FOODS * 07/31/15 MEYERS & FLOWERS GANAN & SHAPIRO 363 17WC 23309 JONES, K.C. MIDWESTERN PET FOODS, INC 07/10/17 RIDGE & DOWNES 364 17WC 23445 HALSEY, BEVERLY JELLYSTONE PARK CAMPGROUN 05/18/17 LOREN S GOLDEN HENNESSY & ROACH 365 17WC 23965 OLTMANS, SHANE W WALMART DISTRIBUTION CENT 06/11/17 REESE & REESE QUINTAIROS PRIETO WOOD & BOY 366 17WC 24216 WOODRUFF, MARK JL BRADY COMPANY LLC 08/16/17 CAPRON & AVGERINOS PC 367 17WC 24289 DIRCK, KENT JOHN DEERE HARVESTER WORK 05/31/06 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 368 17WC 24550 SEAVEY, REBEKAH SELECT SPECIALTY HOSPITAL 11/30/16 STRONG LAW OFFICE COZZI & GOGGIN-WARD 369 17WC 24763 SWANSON, TINA JOHN DEERE HARVESTOR WORK 05/08/17 RIDGE & DOWNES BOZEMAN NEIGHBOUR PATTON & N

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 22 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 370 17WC 24989 IVES, DAKOTA W KROGER 04/25/17 MERTES & MERTES PC STONE & JOHNSON CHARTERED 371 17WC 25076 WILKINSON, TINA DURBY INDUSTIES 08/04/17 DWORKIN AND MACIARIELLO 372 17WC 25194 ONTIVEROS, HECTOR ANDERSON COMMERCIAL CONCR 05/22/17 LEE, MARK N LAW OFFICE BRADY, CONNOLLY & MASUDA, PC 373 17WC 25356 MANGO, BARBARA KEWANEE LIFE SKILLS @ 11/18/16 LAW OFFICE OF CHRIS DOSCOT 374 17WC 25638 GIBSON, ANGELA HY-VEE 02/02/17 WARREN E DANZ, PC HOPKINS & HUEBNER PC 375 17WC 26071 GONZALEZ, TONJA SMITHFIELD FARMLAND FOODS 12/15/16 LAW OFFICE OF CHRIS DOSCOT 376 17WC 26306 HAMILTON, JOSHUA KING FOOD SERVICES, INC 12/31/14 STRONG LAW OFFICE RUSIN & MACIOROWSKI LTD 15WC011936 -C 377 17WC 26613 MCSHANE, JEROME ELITE STAFFING 08/31/17 DWORKIN AND MACIARIELLO 378 17WC 26767 JOHNSON, JENNIFER ALDI 06/09/17 BLACK & JONES BRADY, CONNOLLY & MASUDA, PC 379 17WC 26890 BORUFF, JAMES JOHN DEERE 12/09/16 RIDGE & DOWNES 380 17WC 27051 JACKSON, TINA DERBY INDUSTRIES, LLC 08/04/17 REHN LAW LLC 381 17WC 27130 WITTEK, CYNTHIA TIMKEN DRIVES, LLC 05/05/17 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 382 17WC 27365 PLATT, DENNIS J OLD DOMINION FREIGHT LINE 08/03/17 THOMAS E CADY 383 17WC 27516 MASIAS, CHRISTOPHER ROCK ISLAND COUNTY 05/17/17 RIDGE & DOWNES BROOKS LAW FIRM 384 17WC 27639 IMLER, CHAD D TIMBERLYN LIGHTING MGMT I 04/27/17 SOPHER LAW FIRM 385 17WC 27829 SALAIS, PERRY ROCK ISLAND/MILAN SCHL DI 08/18/17 WINSTEIN KAVENSKY & WALLAC DAMON YOUNG 386 17WC 28092 MARKS, KELLY STERLING CHEVROLET 11/01/16 WOLFE LAW PC 387 17WC 28176 NEMETH, SCOTT A GALESBURG COTTAGE HOSPITA 05/25/17 MARKS INJURY LAW WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 23 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 388 17WC 28631 WALKER, KURT XPO LOGISTICS FREIGHT INC 08/18/17 CHRISTINE A KEYS PC RUSIN & MACIOROWSKI LTD 389 17WC 28831 BARNETT, RYAN ROCK ISLAND POLICE DEPT 09/21/17 RIDGE & DOWNES BETTY NEUMAN & MCMAHON 390 17WC 29400 ZIER, ANTHONY ROCK ISLAND POLICE DEPART 09/09/17 RIDGE & DOWNES BETTY NEUMAN & MCMAHON 391 17WC 29728 HELLE, ROBYN KNOX COUNTY NURSING HOME 08/07/17 REHN LAW LLC 392 17WC 30000 PEREZ-HERNANDEZ, ROSA FARMLAND FOODS 04/12/17 VANDERGINST LAW PC STEPHEN P. KELLY 393 17WC 30111 SEIDEL, CRAIG A STERLING STEEL CO., A DIV 05/04/15 REESE & REESE RUSIN & MACIOROWSKI LTD 394 17WC 30170 MILLER, TAMMY HNB OIL CORPORATION 03/25/16 SIMPSON PETERSON RIPES NELSON BAGGOT KALOBRAT 395 17WC 30328 HEMMINGER, MARVIN LEE MAZEL & COMPANY 07/15/17 PIGNATELLI & ASSOCIATES LAW OFFICE PAUL LARIMORE 396 17WC 30511 RUSSELL, ALVIN LEGGETT & PLATT DBA STERL 11/18/16 STROW LAW LLC 397 17WC 30533 DELACRUZ, TERRIE FARMLAND FOODS 04/07/15 REHN & SKINNER LLC 398 17WC 31076 LINDSAY (VOLOVITZ), JAMIE AUNT MARTHA'S HEALTH 02/20/17 STRONG LAW OFFICE BRADY, CONNOLLY & MASUDA, PC 399 17WC 31148 CORK, TERRY GREEN GABLES 08/08/17 DAVID W OLIVERO POWER & CRONIN LTD 400 17WC 31569 LYDY, ELIZABETH GATES CORPORATION 07/14/15 REHN LAW LLC 401 17WC 31660 JEWELL, RICHARD MOLINE PUBLIC WORKS 09/27/17 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 402 17WC 31695 CASTRO, ARIEL QUICK ONE DETASSELING 07/08/16 CAPRON & AVGERINOS PC 403 17WC 32273 NAERT, SHANE ADVANCED BUSINESS SYSTEMS 04/19/17 VANDERGINST LAW PC GANAN & SHAPIRO 404 17WC 32299 PARKER, JEREMY FRANKLIN MAINTENANCE 07/09/17 PIGNATELLI & ASSOCIATES 405 17WC 32435 PUENTE, MIGUEL CRUZ TYSON FRESH FOODS 06/30/15 HOPKINS & HUEBNER PC GANAN & SHAPIRO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 24 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 406 17WC 32472 VALDEZ, BERTHA SEDONA STAFFING 01/05/17 ANDREW BRIBRIESCO 407 17WC 32475 PEREZ, GRWUASLLY ARAMARK UNIFORM SERVICES 12/17/16 ANDREW BRIBRIESCO 408 17WC 32493 LEC, VEZAIP MENK USA 03/17/17 REESE & REESE 409 17WC 32641 FOSTER, STEVEN UNITED PARCEL SERVICE INC 08/17/17 WINSTEIN KAVENSKY & WALLAC 410 17WC 32658 PARVIN, THOMAS J KENDRA & RENE SOTELO DBA W 04/15/17 REESE & REESE 411 17WC 32825 COURTNEY, SAN D THE BEDDING GROUPO, INC 09/14/17 THOMAS E CADY 412 17WC 32981 WOODS, CAROLE KNOX COLLEGE 07/27/17 LAW OFFICE OF CHRIS DOSCOT 413 17WC 33150 BICAN, GEORGE ROYAL CLEANING 02/06/14 REHN LAW LLC 414 17WC 33367 ERICSON, JASON UNITED FACILITIES 11/07/17 RIDGE & DOWNES COZZI & GOGGIN-WARD 415 17WC 33654 DENTON, JAY KONRAD CUSTOM HOMES INC 09/20/17 NESSLER, FREDERIC LAW OFFI BRADY, CONNOLLY & MASUDA, PC 416 17WC 33856 PERDUE, CURT FIRST GLASS INC 02/22/16 REHN LAW LLC 417 17WC 34111 STEPHENS, GARY T ELITE STAFFING INC 10/20/17 ANESI OZMON RODIN NOVAK KO 418 17WC 34138 ATCHISON, MARY LYNN METROPOLITAN AIRPORT AUTH 08/08/17 LEONARD LAW GROUP LLC 419 17WC 34553 PETERSON, JEFF USF HOLLAND 08/02/17 WINSTEIN KAVENSKY & WALLAC HENNESSY & ROACH 420 17WC 34674 HOUGHTON, JOHN FIFTH WHEELS PLUS INC 02/01/17 STRONG LAW OFFICE 421 17WC 34709 PHEIFFER, BARRY AC MCCARTNEY 05/09/13 LAW OFFICE PATRICK JENNETT 422 17WC 34991 VARGAS, JOSE THE CROWN GROUP 05/15/17 CHEPOV & SCOTT LLC PERRY GENTILE 423 17WC 35044 CLARK, IVORY BHASED 10/22/15 VANDERGINST LAW PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 25 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 424 17WC 35101 NACHE, MICHAEL J SR. EBY-BROWN COMPANY, LLC 07/07/17 BOSHARDY LAW OFFICE PC NYHAN BAMBRICK KINZIE & LOWR 425 17WC 35297 BRASSART, BRADY QUAD CITY MALLARDS 04/22/17 FLOYD LAW FIRM 426 17WC 35442 VALLEJO, ISABEL M ARC OF THE QUAD CITIES 10/01/17 STENGEL BAILEY ROBERTSON 427 17WC 35897 HART, ANGELA FRIENDSHIP MANOR 10/27/16 VANDERGINST LAW PC RIPES NELSON BAGGOT KALOBRAT 428 17WC 35954 WRIGHT, DENISE DICK BLICK HOLDINGS, INC 08/30/17 JOHN LESAGANICH 429 17WC 36395 BORYS, MICHAEL JAY NATIONAL FREIGHT INCORPOR * 06/27/17 WARNER & ZIMMERLE MACIOROWSKI SACKMANN & ULRIC 430 17WC 36578 ZINKE, CHAD SENSIENT TECHNOLOGIES COR 09/22/17 SCHWEICKERT & GANASSIN GAROFALO SCHREIBER STORM 431 17WC 36647 SHAFFER, PENNY JOHN DEERE HARVESTER WORK 05/16/17 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 432 17WC 36872 SIVELS, BRANDY AVONLEA COTTAGE 09/08/17 DWORKIN AND MACIARIELLO 433 17WC 37065 LACY, DERIC RIVERSIDE STAFFING 11/15/17 WINSTEIN KAVENSKY & WALLAC 434 17WC 37075 IBLKOUNLE, DAOUDA TYSON FOODS INC * 07/28/15 HOPKINS & HUEBNER PC GANAN & SHAPIRO 435 17WC 37490 DUKE, DARA MARIGOLD NURSING HOME 07/27/17 LAW OFFICE DAVID HUNT 436 17WC 38031 BAHENA, VICENTE MICRO INDUSTRIES, INC 03/16/17 REESE & REESE 437 18WC 00438 DURAN, ANTHONY QUALITY LIQUID FEEDS INC * 02/13/17 GESMER LAW OFFICES, PC STEPHENS FIDDES MCGILL ASSOC 438 18WC 00718 ANDERSON, LARRY O'REILLY AUTO PARTS * 06/18/17 CHRISTINE A KEYS PC 439 18WC 01104 MORALES, EUGENIO NAPLETON WESTMONT PORSCHE * 01/02/18 GOLDBERG WEISMAN & CAIRO L LAW OFFICES FRANCESCA LARSEN 440 18WC 01226 WIGGINS, LEANNDRA WALMART * 07/30/17 WINSTEIN KAVENSKY & WALLAC QUINTAIROS PRIETO WOOD & BOY 441 18WC 01538 BELL, YVONNE HALLCON CORPORATION * 12/24/17 REHN LAW LLC KNELL & O'CONNOR

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 26 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 442 18WC 01555 HARRINGTON, RUSSELL ROCK ISLAND HOUSING AUTHO * 07/01/17 BLACK & JONES GILDEA & COGHLAN 443 18WC 01819 BROOKS, PAUL ELITE STAFFING * 09/08/17 DWORKIN AND MACIARIELLO 444 18WC 02071 WARNER, JOSHUA M GATES CORP * 01/05/18 HASSELBERG & ROCK 445 18WC 02126 MILLARD, DARWIN PERFORMANCE FOOD GROUP * 01/01/18 ELFENBAUM EVERS & AMARILIO 446 18WC 02398 ZUNIGA, ADAN CLEAN HARBORS INDUSTRIAL * 12/12/17 THE ROMAKER LAW FIRM RODDY LAW LTD 447 18WC 02508 WALSH, KRISTEN GENESIS MEDICAL CENTER * 01/13/15 HOPKINS & HUEBNER PC 448 18WC 02560 MUHAMMAD, TAWANA CHECKERS * 06/14/17 JOSEPH PIEROTTI 449 18WC 02656 TOSSI, PAULIN TYSON FOODS INC * 12/07/17 WINSTEIN KAVENSKY & WALLAC 450 18WC 02698 DUEX, JENNIFER ORION CCSD #223 * 04/07/16 BROOKS LAW FIRM KNELL LAW LLC 451 18WC 02880 WATERS, CRETA TYSON FRESH MEATS * 11/01/17 BLACK & JONES GANAN & SHAPIRO 452 18WC 03112 RANDALL, WILLIAM ALB FREIGHT TRANSPORTATIO W* 09/10/17 REHN LAW LLC 453 18WC 03123 WHITTINGTON, RODNEY JOHN DEERE HARVESTER * 11/15/16 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 454 18WC 03158 HARRELL, TANASHA JOHN DEERE HARVESTER * 02/29/16 WINSTEIN KAVENSKY & WALLAC 455 18WC 03239 SCHROCK, RICHARD CITY OF AMBOY * 04/12/17 KALEEL, DAVID M POWER & CRONIN LTD 456 18WC 03293 RICO-MORALES, EVA TYSON FRESH MEATS INC * 08/05/13 GANAN & SHAPIRO 457 18WC 03332 JENKINS, SHAWN E BUILDERS SALES & SERVICE * 01/04/18 THOMAS E CADY 458 18WC 03468 MBEMBA, JEAN PAUL EXPORT PACKAGING CO INC * 03/30/16 THOMAS E CADY RUSIN & MACIOROWSKI LTD 459 18WC 03617 DETMERS, PAUL FARMLAND FOODS * 11/30/16 SIMPSON PETERSON

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 27 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 460 18WC 03790 HUSSEIN, TAREQ JUMER'S CASINO & HOTEL * 05/21/16 WARREN E DANZ, PC 461 18WC 03806 DAVIS, JACOB JEWEL-OSCO * 01/23/18 WINSTEIN KAVENSKY & WALLAC 462 18WC 03944 JACKSON, MARK L ML JACKSON QUALITY PLUMBI * 08/10/16 BOZEMAN NEIGHBOUR PATTON & 463 18WC 04089 SLOAN, ADAM WALMART * 07/04/16 DWORKIN AND MACIARIELLO QUINTAIROS PRIETO WOOD & BOY 464 18WC 04292 HARPER, CLARA XPAC * 12/13/17 MEYERS & FLOWERS RUSIN & MACIOROWSKI LTD 465 18WC 04411 AKPO, SEBABOU TYSON FRESH MEATS, INC 09/18/17 GANAN & SHAPIRO 466 18WC 04534 BAH, ADAMA HOPE CREEK CARE CENTER * 03/21/17 RUBENS AND KRESS BROOKS LAW FIRM 467 18WC 04674 BRITT, TERRY XPAC * 01/16/18 DWORKIN AND MACIARIELLO 468 18WC 05025 GADJETOR, KOKOU TYSON FRESH MEATS * 01/08/16 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 469 18WC 05237 STOCKHAM, BRADLEY CENTURY LINK * 10/10/17 GOLDFINE & BOWLES 470 18WC 05330 MAUS, TAWNY LAMI INC * 01/07/17 CHRISTINE A KEYS PC 471 18WC 05413 VASQUEZ, GRICELDA WALMART DISTRIBUTION CENT * 12/09/17 REESE & REESE 472 18WC 05486 AUGUSTINE, THOMAS SCHWAN'S HOME SVC * 09/23/17 O'CONNOR & NAKOS GAROFALO SCHREIBER STORM 473 18WC 05535 HAJOSTEK, JERRILYN GATES CORPORATION * 12/08/17 BROOKS LAW FIRM 474 18WC 05598 DODSON, JEFF UNITYPOINT HEALTH - PROCT * 01/15/18 BLACK & JONES STEPHEN P. KELLY 475 18WC 05683 GUERRERO, RITA GREAT DANE TRAILERS * 02/22/16 SCHWEICKERT & GANASSIN 476 18WC 05777 COGDALL, CHRISTOPHER T R.H. BOELK TRUCK LINES IN * 01/15/18 MERTES & MERTES PC 477 18WC 05829 CUEVAS, DAVID HY-VEE INC * 11/04/17 REHN LAW LLC QUINN JOHNSTON HENDERSON ETA

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 28 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 478 18WC 06029 ALBERTSON, DANIEL STERLING RESTORATIONS * 09/28/17 PIGNATELLI & ASSOCIATES 479 18WC 06359 BANKS, ERIC CITY OF MOLINE * 09/05/17 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 480 18WC 06623 MASIAS, GREG CITY OF MOLINE * 03/20/17 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 481 18WC 06813 SWIFT, JUSTIN E KREIDER SERVICES * 02/10/18 REESE & REESE 482 18WC 06993 SHORT, SALLY WESTROCK * 02/22/18 STRONG LAW OFFICE 483 18WC 07307 BUNTON, RONALD JOHN DEERE PDC * 09/14/16 WINSTEIN KAVENSKY & WALLAC 484 18WC 07596 NICHOL-RUSSELL, TONYA DOLLAR GENERAL * 10/12/17 WINSTEIN KAVENSKY & WALLAC LEAHY EISENBERG & FRAENKEL 485 18WC 07700 FRAGA, RAYMUNDO TYSON FRESH MEATS, INC * 03/10/17 GANAN & SHAPIRO 486 18WC 08072 JOHNSON, KIMBERLY IN HOME SERVICES * 12/01/17 BLACK & JONES RODDY LAW LTD 487 18WC 08169 CHAVEZ, MICHAEL R CITY OF GENESEO * 01/02/17 POWER & CRONIN LTD 488 18WC 08361 VOLS, GREGORY JOHN DEERE HARVESTER * 07/25/17 WINSTEIN KAVENSKY & WALLAC 489 18WC 08404 DANIEL, SCOTT L NRE GLOBAL HOLDINGS, INC * 02/09/18 THOMAS E CADY 490 18WC 08493 SCHEUER, STEVE G5 TECH SOLUTIONS * 11/28/17 CHRIS DOSCOTCH 491 18WC 08827 BENNETT, PEGGY A MUSELMAN INVESTMENTS, LTD * 04/21/16 THOMAS E CADY 492 18WC 08850 NIYONGABO, FREDERIC TYSON FRESH MEATS * 02/01/18 ELFENBAUM EVERS & AMARILIO 493 18WC 08929 DEYO, DEBRA L MACLEAN-FOGG COMPONENT * 12/06/17 TUITE LAW 494 18WC 09283 LOGOSSOU, AMAH TYSON FRESH MEATS, INC * 08/20/16 GANAN & SHAPIRO 495 18WC 09346 KEMPEL, JEFFREY JOHN DEERE HARVESTER * 08/04/16 WINSTEIN KAVENSKY & WALLAC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 29 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 05/01/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 496 18WC 09514 ANDERSON, EMILY SEDONA STAFFING * 03/01/18 MARC J SHUMAN & ASSOCIATES