ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 1 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 1 97WC 40184 RECTOR, CRAIG CHRYSLER CORPORATION 08/16/94 SMOLER LAW OFFICE, PC WILLIAMS & MCCARTHY 97WC040185 -C 2 99WC 40701 JAMES, DOUGLAS S INGERSOLL GMBH 01/23/98 GREG TUITE & ASSOC PICHA & SALISBURY 3 99WC 63640 BLEWETT, ARTHUR E WINNEBAGO COUNTY SHERIFF' 11/09/99 GESMER LAW OFFICES, PC WILLIAMS & MCCARTHY 4 03WC 35239 NELSON, MARTHA KABLE NEWS COMPANY INC 03/20/03 JAMES G AHLBERG WIEDNER & MCAULIFFE LTD 5 06WC 14328 SANTEE, DEBBIE AROUND THE CLOCK W 02/12/06 BLACK & JONES 6 06WC 22868 MEISE, SHARON B DAIMLER CHRYSLER AG N/K/A 05/01/06 KATZ FRIEDMAN EAGLE ET AL WILLIAMS & MCCARTHY 7 06WC 30632 BECHTEL, FRANK W JR ILLINOIS TOOK WORKS 02/02/06 BLACK & JONES HENNESSY & ROACH PC 8 06WC 40041 MEISE, SHARON B DAIMLER CHRYSLER AG N/K/A 09/05/06 KATZ FRIEDMAN EAGLE ET AL WILLIAMS & MCCARTHY 9 07WC 04561 MEISE, SHARON B DAIMLER CHRYSLER AG N/K/A 01/07/07 KATZ FRIEDMAN EAGLE ET AL WILLIAMS & MCCARTHY 10 07WC 11053 CASTELLANOS,DAWN THE WACKENHUT CORP. 05/26/06 GESMER LAW OFFICES, PC RUSIN MACIOROWSKI & FRIEDMAN 11 07WC 40316 ZIEGLER, SARAH K ROCK VALLEY COLLEGE 09/11/06 GREG TUITE & ASSOC RUSIN MACIOROWSKI & FRIEDMAN 12 07WC 46356 MALM, SHANE RUBLOFF EXCAVATION 12/18/06 BLACK & JONES HINSHAW & CULBERTSON 13 07WC 49283 CARLSON, LAURA J SWEDISH AMERICAN HOSPITAL 02/28/07 CONSIDINE LAW OFFICES WILLIAMS MCCARTHY LLP 14 08WC 18566 PARSONS, STEVE A THE KROGER CO 09/03/05 BLACK & JONES STONE & JOHNSON CHARTERED 15 08WC 23510 DICUS, ANGELIA SWEDISH AMERICAN HOSPITAL 12/01/07 FRANCINE B WHITE WILLIAMS MCCARTHY LLP

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 2 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 16 08WC 40465 GONZALEZ, RENEE L MARTY JOHNSON, IND & D/B/ W 08/28/08 GESMER LAW OFFICES, PC 17 08WC 45778 RENDLEMAN, RODNEY STATE OF ILL 06/23/08 LEE, MARK N LAW OFFICE ASSISTANT ATTORNEY GENERAL 10WC036694 -C 18 08WC 46038 19B TESSENDORF, DAN PACKARD EXCAVATING 05/15/08 FRANCINE B WHITE RUSIN MACIOROWSKI & FRIEDMAN 19 08WC 46411 RASNER, VICTORIA CHRYSLER LLC 10/07/08 BLACK & JONES WIEDNER & MCAULIFFE LTD 09WC014625 -C 13WC032564 -C 13WC032565 -C 20 09WC 05682 JONES, MATT GREEN GIANT 01/07/09 BLACK & JONES PAUL A COGHLAN & ASSOC 21 09WC 06025 MAYER, MARIA GRUPO ANTOLIN 10/20/08 KATZ FRIEDMAN EAGLE ET AL HEYL ROYSTER VOELKER & ALLEN 11WC030087 -C 14WC020993 -C 15WC039086 -C 22 09WC 09385 MARTINEZ, MONICA GENERAL MILLS 06/04/08 BLACK & JONES PAUL A COGHLAN & ASSOC 23 09WC 10896 MAIM, SHANE RUBLOFF EXCAVATING 04/28/08 BLACK & JONES HINSHAW & CULBERTSON 24 09WC 11810 DIAZ, IMILDA G DANAHER MOTION 12/04/07 BLACK & JONES GILDEA & COGHLAN 25 09WC 18478 FASULA, FRANK WINNEBAGO COUNTY 06/27/06 BLACK & JONES WILLIAMS MCCARTHY LLP 26 09WC 23881 TRONE, KAREN KOLB-LENA BRESSE BLEU INC 05/18/09 MOSS & MOSS PC RIPES NELSON BAGGOT KALOBRAT 09WC023882 -C 12WC003424 -C KOLB LENA BRESSE BLEU INC 27 09WC 36885 MATTHEWS, STEPHANIE T AMERICAN NATIONAL RED CRO 06/20/09 GREG TUITE & ASSOC RUSIN MACIOROWSKI & FRIEDMAN 28 09WC 38745 CRAWFORD-GREEN, SANDRA CHRYSLER LLC 04/20/09 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 10WC046308 -C 29 09WC 52102 MC KINNEY, DEB DCFS 01/18/09 BLACK & JONES MATTHEW LICAVOLI 30 10WC 08435 MRSIC, GORAN JOB NETWORK 02/02/10 BLACK & JONES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 3 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 31 10WC 10389 MCKINNEY, DEB DCFS 03/03/08 BLACK & JONES MATTHEW LICAVOLI 32 10WC 18616 DHARLINGUE, NOEL CHRYSLER LLC 01/15/10 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 33 10WC 21765 SEYMOUR, TERRY L IMAGE PRO'S 06/03/10 CACCIATORE, WILLIAM T HOLECEK & ASSOCIATES 34 10WC 28487 BUSH, TINA MARIE AROUND THE CLOCK 02/20/09 GOODE, MICHAEL C 35 10WC 29688 SAGER, DEBRA DIXON MEYERS TRANSPORTATI 07/13/10 LAW OFFICE ILONKA ULRICH DOWD & DOWD LTD 36 10WC 32830 BAUER, PATRICIA ARROW ELECTRONICS INC 06/17/10 LOSS & PAVONE SLAVIN & SLAVIN 37 10WC 35908 KUECHER, JUSTIN B JOHNSON CONTROLS INC 09/07/10 VITELL & SPITZ LTD RUSIN MACIOROWSKI & FRIEDMAN 38 10WC 42670 HERNANDEZ, FERNANDO SOURCE INTERLINKS CO INC 05/15/10 BLACK & JONES GAROFALO SCHREIBER STORM 10WC042671 -C 39 10WC 43135 GONZALEZ, GUADALUPE GUNITE 10/09/10 BLACK & JONES RUSIN MACIOROWSKI & FRIEDMAN 11WC009816 -C 11WC009817 -C 11WC009818 -C 40 10WC 45858 COLLINS, RHONDA CITY OF ROCKFORD 01/19/09 CONSIDINE LAW OFFICES HEYL ROYSTER VOELKER & ALLEN 10WC045860 -C 41 10WC 49373 MOORMAN, MARSHA WINNEBAGO COUNTY 06/01/10 O'CONNOR & NAKOS WILLIAMS MCCARTHY LLP 42 10WC 49463 STOUFFER, BRIAN T BRIAN CARLSON IND & D/B/A W 09/17/10 GESMER LAW OFFICES, PC PROROK LAW OFFICE 43 11WC 06821 LOVE, LORETTA BERGSTROM, INC 10/02/08 GESMER LAW OFFICES, PC 44 11WC 06989 PEDERSEN, MICHAELC ST ANTHONY HOSPITAL MEDIC 01/08/10 GREG TUITE & ASSOC HINSHAW & CULBERTSON 45 11WC 09621 TAYLOR, PAULA STATE OF ILLINOIS @ 05/20/08 DREW J FERRACUTI MATTHEW LICAVOLI

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 4 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 46 11WC 09881 DIAZ, NANCY TK GROUP INC 01/17/11 GESMER LAW OFFICES, PC LAW OFFICES JOSEPH MARCINIAK 47 11WC 10061 MCINTOSH, SCOTT R CHRYSLER LLC 01/21/11 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 11WC010062 -C 12WC004854 -C 48 11WC 22829 PRATHER, LARRY CHRYSLER LLC 04/13/11 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 49 11WC 23485 MEACHAM, TERRANCE A H DOUGLAS SINGER MENTAL H @ 03/02/09 ALEXANDER, PETER LTD. MATTHEW LICAVOLI 50 11WC 25258 RUSCHILL, LISA A CITY OF ROCKFORD 02/12/11 GESMER LAW OFFICES, PC HEYL ROYSTER VOELKER & ALLEN 11WC044633 -C 51 11WC 26816 SABINE, LISA ANDROID INDUSTRIES 05/16/11 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 52 11WC 35441 SOTO, MARION FIRST STUDENT 05/25/11 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 53 11WC 36227 WILLIAMS, BESSIE M CITY OF ROCKFORD 06/15/11 GESMER LAW OFFICES, PC HEYL ROYSTER VOELKER & ALLEN 11WC036228 -C 54 11WC 36490 RIGGS, DONNA CHRYSLER 05/09/11 KINNALLY FLAHERTY KRENTZ & WIEDNER & MCAULIFFE LTD 55 11WC 37207 O'BRIEN, RUTH STATE OF ILLINOIS @ 02/16/11 BLACK & JONES ASSISTANT ATTORNEY GENERAL 11WC042096 -C DEPT OF HUMAN SERVICES 12WC044097 -C ST OF IL DEPT OF DORS 12WC044098 -C 56 11WC 43639 ELLIOTT, PAUL JIMMY Z MASONRY 06/22/11 BOTTO GILBERT ROSARIO CIBELLA 12WC042996 -C 57 11WC 47418 RUSSELL, MICHAEL ILLINOIS CONSTRUCTORS COR 11/29/11 PORRO NIERMANN & PETERSEN SLAVIN & SLAVIN 13WC041166 -C 58 12WC 01477 DALGARD, JAMES 2M EQUIPMENT, INC. W 09/15/11 BLACK & JONES PUMILIA LAW LLC 59 12WC 02471 PRATHER, LYNNE CHRYSLER LLC 11/01/11 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 60 12WC 04448 BRUGMAN, DANIEL J PYRAMID PLASTICS 03/14/11 SHRIVER, O'NEAL & THOMPSON STONE & JOHNSON CHARTERED

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 5 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 61 12WC 15719 BUCALO-BUSS, ROSE P HAMILTON-SUNDSTRAND UTC 06/14/10 KATZ FRIEDMAN EAGLE ET AL 62 12WC 16684 HOLLAND, ELIZABETH M CHICAGO PUB. LIBRARY/CITY 09/19/11 PIGNATELLI & ASSOCIATES NYHAN BAMBRICK KINZIE & LOWR 63 12WC 17649 BELL, CAROL IL DEPT OF PUBLIC 04/07/11 BLACK & JONES ASSISTANT ATTORNEY GENERAL 64 12WC 17772 MCINTYRE, SHARON L LIFETOUCH SERVICES INC 04/13/12 GREG TUITE & ASSOC LEAHY EISENBERG & FRAENKEL 65 12WC 18747 WILLIAMS, JODI L ROCKFORD MASS TRANSIT DIS 04/17/12 WILLIAMS MCCARTHY LLP 15WC022321 -C 66 12WC 21076 SCHRADER, ELLEN LOUISE WINNEBAGO COUNTY 05/30/12 JOHN NELSON LAW OFF WILLIAMS MCCARTHY LLP 67 12WC 24494 MADERO, DANIEL PETERS ENGINEERING INC 01/16/12 DEUTSCHMAN, JEFFREY S RUSIN & MACIOROWSKI LTD 13WC022496 -C 68 12WC 24588 REX, CHARLES ARCHER DANIELS MIDLAND CO 06/11/12 PIGNATELLI & ASSOCIATES SCHOUEST BAMDAS SOSHEA 69 12WC 25354 GRAHAM, TAFFEY L ST OF IL DEPT OF 12/22/11 ASSISTANT ATTORNEY GENERAL 70 12WC 31241 BRADFORD, TRAVIS COCA COLA ENTERPRISES 11/20/11 BLACK & JONES WIEDNER & MCAULIFFE LTD 13WC015260 -C 13WC030695 -C 71 12WC 34339 MILLARD, CHRISTOPHER BYRON FIRE PROTECTION DIS 11/30/11 GOLDBERG WEISMAN & CAIRO L RUSIN MACIOROWSKI & FRIEDMAN 72 12WC 34469 WHITE, ROBIN CARDINAL GLASS COMPANY 08/10/12 NASH LAW OFFICE PC THOMAS & PORTELA 73 12WC 34541 WHITE, ROBIN CARDINAL GLASS CO 06/28/12 NASH LAW OFFICE PC THOMAS & PORTELA 74 12WC 35380 VILCHIS, MARIA CORPORATE SERVICES 08/30/12 LAWFIRST KNELL & O'CONNOR 75 12WC 36518 SAUNDERS, PAULETTE ROCKFORD BOARD OF EDUCATI 06/04/12 GREG TUITE & ASSOC WIEDNER & MCAULIFFE LTD 76 12WC 38584 WIGGINS, FELISHA E GRUPO ANTOLIN 08/28/12 KATZ FRIEDMAN EAGLE ET AL HEYL ROYSTER VOELKER & ALLEN 77 12WC 41446 WILLIAMS, ANGELA STATELINE STAFFING 01/13/11 LAWFIRST

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 6 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 78 12WC 43346 KELLER, CARLENE BURLINGTON COAT FACTORY 11/18/12 BLACK & JONES BRADY CONNOLLY & MASUDA PC 79 13WC 01670 FOGLE, DEBORAH (WIDOW) IDOT @# 12/28/12 BLACK & JONES ASSISTANT ATTORNEY GENERAL 80 13WC 03520 LAURES, LYNNE CHRYSLER LLC 11/01/12 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 13WC003521 -C 15WC033923 -C 81 13WC 05815 HAWTHORNE, MATTIE IL DHS REHAB DIVISION @ 05/07/10 LEE, MARK N LAW OFFICE ASSISTANT ATTY GENERAL 82 13WC 07053 SHERMAN, JESSICA RIVER BLUFF NURSING HOME 05/03/12 BLACK & JONES 83 13WC 08700 LOVE, LORETTA BERGSTROM INC 02/13/12 GESMER LAW OFFICES, PC 84 13WC 09075 BOTIC, FATA PBC LINEAR 03/27/07 BLACK & JONES COZZI & GOGGIN-WARD 85 13WC 09577 DEVLIEGER, RICHARD ROCKFORD POLICE DEPARTMEN 03/06/13 BLACK & JONES ODELSON & STERK 86 13WC 10011 DAUGHTRY, DAVID CHRYSLER LLC 02/11/13 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 15WC005974 -C 87 13WC 10531 CUEVAS, LUIS ROCKFORD BOLT & STEEL CO 12/13/12 BLACK & JONES LAW OFFICES FRANCESCA LARSEN 88 13WC 11530 JOHNSON, WARREN R JR ROCKFORD PUBLIC SCHOOL DI 01/08/13 JOHN J CASTANEDA WIEDNER & MCAULIFFE LTD 89 13WC 15261 JONES, DEAN NICOR GAS 11/05/10 BLACK & JONES MACIOROWSKI SACKMANN & ULRIC 90 13WC 15449 DEVEREUEAWAX, JAVELLE CHRYSLER LLC 12/18/12 ANESI OZMON RODIN NOVAK KO WIEDNER & MCAULIFFE LTD 13WC015450 -C 91 13WC 16926 BARTLETT, NEAL W CITY OF ROCKFORD 08/08/12 GESMER LAW OFFICES, PC HEYL ROYSTER VOELKER & ALLEN 92 13WC 17586 PAGAN, JOHNNY GRUPO ANTOLIN 01/01/13 BLACK & JONES HEYL ROYSTER VOELKER & ALLEN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 7 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 93 13WC 17589 DIAZ, IMILDA G DANAHER MOTION 11/13/08 BLACK & JONES GILDEA & COGHLAN 94 13WC 18276 DURAN, LUIS E CITY OF ROCKFORD 05/17/11 REESE & REESE HEYL ROYSTER VOELKER & ALLEN 13WC018279 -C 95 13WC 18569 TAYLOR, BONNIE NORTHWEST EXPRESS 12/21/12 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 96 13WC 19380 KIRCHNER, BONNIE L CHRYSLER LLC 09/08/10 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 13WC019381 -C 13WC019382 -C 97 13WC 21175 SHELBY, TODD MURPHYS PUB & GRILL 03/17/13 BLACK & JONES HENNESSY & ROACH PC 98 13WC 21196 DUNN, KAMI NORTHWEST EXPRESS INC 04/10/13 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 14WC025003 -C 99 13WC 21595 LEWIS, DENISE MONDELEZ INTERNATIONAL 12/12/12 BLACK & JONES WIEDNER & MCAULIFFE LTD 13WC021596 -C 100 13WC 23580 DELGADO, MIKE WINNEBAGO COUNTY SHERIFFS 12/12/12 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MC CARTHY LLP 101 13WC 24498 BARTZ, JEFF ROCKFORD BICKFORD HOUSE L 09/17/12 GREG TUITE & ASSOC LAW OFFICES JOSEPH MARCINIAK 14WC036707 -C BICKFORD SENIOR LIVING 102 13WC 26358 BARMORE, NICHOLE BELVIDERE ASSEMBLY PLANT 03/14/13 STROM, NEAL B WILLIAMS MCCARTHY LLP 103 13WC 26783 MAFFEI, CARMELLA SWEDISH AMERICAN HOSPITAL 07/15/12 BLACK & JONES 104 13WC 27992 PETERSON, NANCY WALGREENS 12/13/10 NASH LAW OFFICE PC GILDEA & COGHLAN 105 13WC 29560 MITCHELL, CAYLI LAWN CARE BY WALTER 06/13/13 BLACK & JONES GANAN & SHAPIRO 106 13WC 30468 DE PAZ, MIQUEL ANGEL J & M PLATING 06/01/13 BLACK & JONES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 8 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 107 13WC 30724 MOSHER-STOWERS, BETH RIVERBLUFF NURSING HOME 08/07/13 GESMER LAW OFFICES, PC WILLIAMS MCCARTHY LLP 108 13WC 30880 MOYER, JOE CHRYSLER LLC 08/21/13 KATZ FRIEDMAN EAGLE ET AL 13WC030881 -C 13WC030882 -C 109 13WC 30883 DEMOE, TINA CHRYSLER LLC 06/02/13 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 13WC030884 -C 15WC020241 -C 110 13WC 31124 LOPEZ, MARCELA ALPHA BAG GROUP 04/01/13 BRYCE DOWNEY & LENKOV LLC 111 13WC 31281 STRICKLAND, CHARLES MCDONALDS 07/02/13 BLACK & JONES BRYCE DOWNEY & LENKOV LLC 112 13WC 31503 COIL, RICK DOHRN TRANSFER CO 06/17/13 BLACK & JONES 113 13WC 32488 MOLITOR, RICK BEHR IRON & METAL INC 10/26/12 COZZI & GOGGIN-WARD 114 13WC 33236 DAVIS, TAISHA CHRYSLER CORP 06/26/13 BLACK & JONES WILLIAMS MC CARTHY LLP 115 13WC 35327 WOOLLUMS, TYWANNA MILLER WALMART 09/23/13 HAUSER LAW LLC QUINTAIROS PRIETO WOOD & BOY 116 13WC 36220 PAPKE, WILLIAM ROCK VALLEY COLLEGE 09/13/13 BLACK & JONES 117 13WC 36539 DAVIS, JAMES CHRYSLER CORP 04/23/13 BLACK & JONES WIEDNER & MCAULIFFE LTD 15WC017649 -C 118 13WC 36817 CENTENO, ROSA JOB NETWORK 06/05/13 BLACK & JONES ADELSON TESTAN & BRUNDO 119 13WC 37156 ROGERS, ANTHONY JR CHRYSLER LLC 10/26/13 KATZ FRIEDMAN EAGLE ET AL 120 13WC 37303 MEADOWS, MARK MOTIVE POWER RESOURCES 09/16/13 SOSTRIN AND SOSTRIN PC 121 13WC 39618 WILSON, GENITA T CHRYSLER GROUP LLC 11/02/13 GREG TUITE & ASSOC WILLIAMS MCCARTHY LLP 122 13WC 40316 BARMORE, NICHOLE BELVIDERE ASSEMBLY PLANT 11/26/13 STROM, NEAL B WILLIAMS MCCARTHY LLP 123 13WC 40378 POWELL, SARA YMCA OF ROCK RIVER VALLEY 02/21/12 BLACK & JONES WILLIAMS MCCARTHY LLP

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 9 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 124 13WC 40381 ALEXANDER, DIANE ROCKFORD SPRING CO 04/20/13 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 125 13WC 42228 MARTIN, MARY ANN MENARDS 08/30/12 BLACK & JONES 126 13WC 42592 LOVE, LORETTA BERGSTROM INC 10/24/13 GESMER LAW OFFICES, PC 127 13WC 44280 OAKLEY, STEVEN CHRYSLER LLC 08/08/12 KATZ FRIEDMAN EAGLE ET AL 128 14WC 00333 GRAWEY, WILLIAM S. FIRST STUDENT MANAGEMENT, 08/21/13 GREG TUITE & ASSOC BRADY CONNOLLY & MASUDA PC 129 14WC 00472 GOODSON, TRUMAN IMPERIAL PUNCH 03/10/13 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 130 14WC 03074 CAMACHO, ANA PACKAGING COORDINATOR INC 12/26/13 GOLDSTEIN BENDER & ROMANOF LAW OFFICES OF EDWARD J. KOZ 131 14WC 03161 BANGASSER, SUSAN COBALT MEDPLANS 06/26/13 GESMER LAW OFFICES, PC GRANT & FANNING 132 14WC 03274 HOLMES, KEVIN GKN ROCKFORD INC 12/20/13 KATZ FRIEDMAN EAGLE ET AL RIPES NELSON BAGGOT KALOBRAT 133 14WC 03421 PINESCHI, SELINA SCHNUCKS 06/09/13 BLACK & JONES HENNESSY & ROACH PC 134 14WC 03844 ROJAS, MARIA BERGSTROM INC 03/20/13 BLACK & JONES WOLFE & JACOBSON, LTD 135 14WC 04625 LANGSHOLT, PAUL CHRYSLER LLC 01/08/14 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 136 14WC 05975 JUBY, SAMANTHA ASHA SALON & SPA 12/18/13 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 137 14WC 06396 LOVING, JEFFERY D THERMO FISHER SCIENTIFIC 08/10/10 REESE & REESE KEEFE CAMPBELL & ASSOC LLC 138 14WC 06552 MCLESTER, LARRY E CHRYSLER CORPORATION 12/20/13 GREG TUITE & ASSOC WILLIAMS MCCARTHY LLP 139 14WC 06678 ALLEN, MEGAN STATELINE STAFFING 07/31/13 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 140 14WC 06769 RINALDO, AMANADA M WINNEBAGO COUNTY 08/01/13 GESMER LAW OFFICES, PC WILLIAMS MCCARTHY LLP 141 14WC 07200 RICHARDSON, MARIA BERGSTROM 12/21/12 BLACK & JONES WOLFE & JACOBSON, LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 10 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 142 14WC 08027 HALL, TIM DASCO PRO 09/27/13 BLACK & JONES GANAN & SHAPIRO 143 14WC 08766 ROCHA, MARIA BREMNER FOOD GROUP 03/03/14 KATZ FRIEDMAN EAGLE ET AL RUSIN MACIOROWSKI & FRIEDMAN 14WC008767 -C 14WC008768 -C 144 14WC 10017 KAHL, SHERRIE FREEPORT MEMORIAL HOSPITA 01/15/14 GESMER LAW OFFICES, PC GAROFALO SCHREIBER STORM 145 14WC 10881 MURPHY, DONNA CHRYSLER LLC 03/14/12 WOODRUFF & JOHNSON WIEDNER & MCAULIFFE LTD 146 14WC 10980 VILLAFUERTE, GUSTAVO PHILLIPS W 09/07/12 BLACK & JONES ASSISTANT ATTORNEY GENERAL 147 14WC 11207 SYVERSON, DAVE II CB&I D/B/A 03/04/14 PETER F FERRACUTI & ASSOCI RIPES NELSON BAGGOT KALOBRAT 148 14WC 11716 STEPHENS, LORI ROCKFORD DENTAL CARE 02/07/14 BLACK & JONES RUSIN MACIOROWSKI & FRIEDMAN 149 14WC 12131 DELGADO, CARLOS PROFESSIONAL HANDLING & 09/16/13 ANKIN LAW OFFICE RIPES NELSON BAGGOT KALOBRAT 14WC012132 -C 150 14WC 12239 PINEDO, LUZ MARYS MARKET 03/31/10 LAWFIRST BRADY CONNOLLY & MASUDA PC 151 14WC 12716 HARTZELL, GREGORY C MONDELEZ GLOBAL LLC 01/28/14 GREG TUITE & ASSOC WIEDNER & MCAULIFFE LTD 152 14WC 12906 RIZZO, BRENDA CHRYSLER CORP 08/10/13 SKLARE LAW GROUP WIEDNER & MCAULIFFE LTD 153 14WC 13159 RODRIQUEZ, EMILIO CHRYSLER LLC 02/04/14 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 154 14WC 13389 BOSS, DUSTIN JAMCO PRODUCTS, INC. 03/18/14 GESMER LAW OFFICES, PC HEYL ROYSTER VOELKER & ALLEN 155 14WC 13847 DAILY, LEIGH RENEE ALL STATE INSURANCE COMPA 08/01/13 FRANCINE B WHITE & ASSOC L HENNESSY & ROACH PC 156 14WC 14733 WESLEY, FELICIA DANFOSS DRIVES 07/15/12 BLACK & JONES COZZI & GOGGIN-WARD 157 14WC 14807 TALBOTT, JOSEPH M AMB BUFFET INC 05/02/11 SMITH AMUNDSEN LLC 158 14WC 16763 DERR, MELISSA CHRYSLER LLC 01/24/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 11 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 159 14WC 16770 HIEB, DEANA OSF PRIMARY CARE 01/15/14 BLACK & JONES GAROFALO SCHREIBER STORM 160 14WC 16857 BOHMS, JOSEPH E MACLEAN-FOGG 02/06/13 PIGNATELLI & ASSOCIATES 161 14WC 16967 FERNANDES, JESUS TH FOODS, INC 01/01/12 BLACK & JONES HOLECEK & ASSOCIATES 162 14WC 18372 POLK, SYLVANIA BON-TONE DISTRIBUTION CEN 11/01/13 CAPRON & AVGERINOS PC WIEDNER & MCAULIFFE LTD 163 14WC 18842 VOPATEK, JAY GOODWILL INDUSTRIES 05/05/14 BLACK & JONES HENNESSY & ROACH PC 164 14WC 18863 MARTIN, RONNIE R THE BON TON STORES INC 02/19/14 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 165 14WC 19551 OSEGUEDA, ASCENCION CARNICERIAS JIMENEZ INC 06/21/12 SEIDMAN MARGULIS & FAIRMAN 166 14WC 20341 FRISELLA,TODD & CIACCIO,S VENTRA BELVIDERE LLC # 06/10/14 KATZ FRIEDMAN EAGLE ET AL BRUCE WARREN 167 14WC 20761 SNIDER, STEVEN G4S SECURE SOLUTIONS 03/25/14 KATZ FRIEDMAN EAGLE ET AL BRYCE DOWNEY & LENKOV LLC 168 14WC 21694 COWAN, BOBBY INGERSOLL CUTTING TOOL 12/20/13 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 169 14WC 22190 MANDERA, ANNA FCA US LLC 03/28/14 BLACK & JONES WIEDNER & MCAULIFFE LTD 170 14WC 22521 SMITH, GLORIA RIVER BLUFF NURSING HOME 05/30/14 BLACK & JONES WILLIAMS MCCARTHY LLP 171 14WC 22841 MANNING, GERALD CHRYSLER LLC 06/30/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 172 14WC 23219 COOPER, WILLA INGERSOLL CUTTING TOOL 08/01/13 BLACK & JONES COZZI & GOGGIN-WARD 173 14WC 23837 STONE, MICHELE A IAC BELVIDERE CROSSLINK A 06/15/14 KATZ FRIEDMAN EAGLE ET AL GANAN & SHAPIRO 174 14WC 24464 OGLESBY, JEANETTE CHRYSLER ASSEMBLY PLANT 06/02/14 SAUNDERS CONDON & KENNY WIEDNER & MCAULIFFE LTD 16WC000201 -C

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 12 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 175 14WC 24504 COLEMAN, WANDA MERCY HEALTH SYSTEM 06/28/12 BLACK & JONES COZZI & GOGGIN-WARD 176 14WC 25004 AMADOR, LUZ ELENA ALDEN ALMA NELSON 05/31/12 BLACK & JONES KEEFE CAMPBELL & ASSOC LLC 14WC025005 -C 177 14WC 25928 CARRILLO, GERMAN PREFERRED ROOFING & SIDIN 07/16/14 LAW OFFICE EDWARD RUEDA 178 14WC 26193 CARON, GLYNN TRILLIUM INC 04/28/14 DWORKIN AND MACIARIELLO SPIEGEL & CAHILL, PC 179 14WC 26392 ROBINSON-WHEELER, DEBORAH ILLINOIS DEPT OF HUMAN SV @ 06/19/14 NEWLAND & NEWLAND ASSISTANT ATTORNEY GENERAL 180 14WC 26448 CRUZ-MORALES, NELSON CHRYSLER LLC 04/02/14 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 181 14WC 26766 CRASE, GEORGE ORANGEVILLE COMMUNITY 11/29/13 JOHN S. ELIASIK GAROFALO SCHREIBER STORM 182 14WC 26861 GODINEZ, JORGE A SYNCREON 03/21/14 ANESI OZMON RODIN NOVAK KO HOLECEK & ASSOCIATES 14WC026862 -C 183 14WC 27073 ALLEN, TROY JR LIEBOVICH STEEL 09/05/12 GESMER LAW OFFICES, PC POULOS & DIBENEDETTO LAW 184 14WC 27554 NOBLE, TANYA CHRYSLER LLC 06/10/14 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 185 14WC 27758 DAVIS, SHATIQUA ACCURIDE 06/16/14 GESMER LAW OFFICES, PC RUSIN & MACIOROWSKI LTD 186 14WC 27889 DOTSON, JANICE M ESA MANAGEMENT LLC D/B/A 07/22/14 GREG TUITE & ASSOC RUSIN & MACIOROWSKI LTD 187 14WC 27964 HARRIS, FIKISWA CHRYSLER LLC 06/19/14 BLACK & JONES 188 14WC 28189 MCDONALD, S BRENDA BERGSTROM INC 05/26/14 GREG TUITE & ASSOC WOLFE & JACOBSON, LTD 189 14WC 29356 WRIGHT-KELLEY, JANEL BON TON 07/10/14 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 13 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 190 14WC 29373 FERNANDEZ, MARTHA QUALITY SUITES 03/07/14 GESMER LAW OFFICES, PC RUSIN & MACIOROWSKI LTD 191 14WC 29670 FERGUSON, PAHLLON ADLI, INC. 11/02/13 DWORKIN AND MACIARIELLO MACIOROWSKI SACKMANN & ULRIC 14WC029671 -C ALDI, INC. 192 14WC 30414 LARIOS, JOSE TITAN GROUP 07/01/14 BLACK & JONES SMITH AMUNDSEN LLC 193 14WC 30439 WILLIAMS, JOHN ROCHELLE FOODS INC 05/20/14 BLACK & JONES PAUL A COGHLAN & ASSOC 14WC030440 -C 194 14WC 31310 HERAS, PABLO SEBERT LANDSCAPING 08/14/14 BLACK & JONES WIEDNER & MCAULIFFE LTD 195 14WC 31313 ALMENDARES, MARYSOL PACKAGING COORDINATORS IN 08/01/14 BLACK & JONES 196 14WC 31769 NICHOLS, ANGELIA FREEPORT REHABILITATION & 12/10/13 CLARK FROST GANAN & SHAPIRO 197 14WC 31834 RODRIGUEZ, ROBERT ROCK RIVER TEMP SERVICES 01/07/14 BLACK & JONES RUSIN & MACIOROWSKI LTD 198 14WC 32337 SHERMAN, JOYCE ASTA CARE 07/13/14 GESMER LAW OFFICES, PC RIPES NELSON BAGGOT KALOBRAT 199 14WC 33365 STEPHENS, THERESA LANDSTAR SYSTEM HOLDINGS 05/08/14 CLARK, JUSTEN & ZUCCHI, LT COZZI & GOGGIN-WARD 200 14WC 33586 GRIERT, LAWRENCE D RMTD 03/11/14 GESMER LAW OFFICES, PC WILLIAMS MCCARTHY LLP 14WC033587 -C 14WC038772 -C ROCKFORD MASS TRANSIT 15WC017235 -C 16WC022881 -C ROCKFORD MASS TRANSIT 201 14WC 33779 DECEGLIE, FAUSTO LITGEN CONCRETE CUTTING & 09/02/14 O'CONNOR & NAKOS QUINTAIROS PRIETO WOOD & BOY 202 14WC 34374 NIHAN, JANE BENSON STONE 05/06/14 GESMER LAW OFFICES, PC 203 14WC 34460 KINLEY, DELBERT C & D INTEGRATED 01/01/14 KATZ FRIEDMAN EAGLE ET AL HEYL ROYSTER VOELKER & ALLEN 14WC034461 -C G & D INTEGRATED 204 14WC 34650 SANDOVAL, CAIN C QUANTUM PERSONNEL 04/04/14 FABIANO LAW OFFICES 205 14WC 35242 MARQUEZ, TONYA EMERY AIR INC 07/06/13 BLACK & JONES COZZI & GOGGIN-WARD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 14 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 206 14WC 35492 SCHIRO, JOSEPH AT&T 08/18/14 FRANCINE B WHITE INMAN & FITZGIBBONS 207 14WC 35775 GUERRERO, ADRIAN QUALITY CELLULAR INC 08/28/14 BARRICK SWITZER LONG ET AL RUSIN & MACIOROWSKI LTD 208 14WC 36057 HECK, JIM UW PROVISION 09/09/14 GESMER LAW OFFICES, PC RODDY LAW LTD 209 14WC 36670 REGNIER, MICHELE ROCKFORD BOARD OF EDUCATI 11/07/13 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 210 14WC 37555 MATHERLY, KATHRYN ANDROID INDUSTRIES 09/25/14 WOODRUFF & JOHNSON WIEDNER & MCAULIFFE LTD 211 14WC 38348 PETERSON, RICHARD G COMCAST CABLEVISION 11/01/14 REESE & REESE POWER & CRONIN LTD 212 14WC 38751 KEATING, RAYMOND GREASE MONKEY MIDWEST 12/30/13 RATHBUN CSEVENYAK & KOZOL HOLECEK & ASSOCIATES 213 14WC 39369 GALLAGHER, DENNIS CHRYSLER LLC 04/12/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 214 14WC 39425 JORDON, PAMELA DELTA POWER 06/17/14 GESMER LAW OFFICES, PC HOLECEK & ASSOCIATES 215 14WC 39509 WILSON, JEREMY BEHR IRON & METAL 08/21/14 BLACK & JONES COZZI & GOGGIN-WARD 216 14WC 39603 MELENDEZ, BARBARA ALPINE BANCORPORATION * 12/07/11 HOLECEK & ASSOCIATES 217 14WC 39751 PETERSON, KATHLEEN SWEDISH AMERICAN 02/19/14 BLACK & JONES WILLIAMS MCCARTHY LLP 218 14WC 40881 STIVERS, SHELLY ST OF IL DEPT OF TOLLWAY 01/17/14 WOODRUFF & JOHNSON NYHAN BAMBRICK KINZIE & LOWR 219 14WC 40916 KURI, SOCORRO ARAMARK UNIFORM SERVICES 09/10/14 BLACK & JONES WIEDNER & MCAULIFFE LTD 220 14WC 41661 MASTRANGELI, KATHLEEN HARLEM SCHOOL 09/09/13 GESMER LAW OFFICES, PC NYHAN BAMBRICK KINZIE & LOWR 221 14WC 42101 MALDONADO, RAYMOD JOSE HUGE GOMEZ DBA W 10/24/14 BLACK & JONES RUSIN & MACIOROWSKI LTD 222 14WC 42742 SANDER, JAMES ALPHA BAKING CO. 11/18/14 HANNIGAN & BOTHA, LTD MACIOROWSKI SACKMANN & ULRIC 223 14WC 43200 MURILLO, HECTOR TAYLOR FREEZER 08/28/12 BURNES, EDWARD M MACIOROWSKI SACKMANN & ULRIC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 15 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 224 14WC 43250 KEY, DOUGLAS SPEEDY COURIER SERVICE IN 12/04/14 GESMER LAW OFFICES, PC RUSIN & MACIOROWSKI LTD 225 15WC 00134 BOYNTON, BRENDA SIEMENS ENERGY 09/19/14 GOLDBERG WEISMAN & CAIRO L KOPKA, PINKUS & DOLIN, PC 226 15WC 00338 FOSTER, CINDY J CHRYSLER CORP 10/07/14 STROM, NEAL B WILLIAMS MCCARTHY LLP 227 15WC 00606 MABIE, KEVIN CHRYSLER LLC 08/28/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 228 15WC 00690 JACOBS, SUSAN ROCKFORD TOOL CRAFT INC 09/17/14 BLACK & JONES ROBERT L. SMITH 15WC035882 -C 229 15WC 01095 YOUNG, ALEXIS OLIVE GARDEN ITALIAN KITC 11/02/14 BLACK & JONES COZZI & GOGGIN-WARD 230 15WC 01524 KIDD, JOHNNY SIEMENS WATER TECHNOLOGIE 01/16/12 HORWITZ HORWITZ & ASSOC KOPKA, PINKUS & DOLIN, PC 231 15WC 01930 LEWIS, TERRI ALTRA INDUSTRIAL MOTION I 08/12/14 KATZ FRIEDMAN EAGLE ET AL WOLFE & JACOBSON, LTD 232 15WC 02389 PITT, JUAMUAL GKN ROCKFORD 11/15/14 BLACK & JONES RIPES NELSON BAGGOT KALOBRAT 233 15WC 02619 SANDELL, CHAD TITAN TIRE CO 06/01/12 WOLFE LAW PC GRANT & FANNING 234 15WC 03134 HINTZ, MICHAEL TITAN TIRE 10/30/13 235 15WC 03254 RAMOS, EDUARDO GALVAN'S CONCRETE WORKS I 01/12/15 BLACK & JONES 236 15WC 03257 KEHOE, ELAISOIN EURIST SERVICES 08/16/14 MARSZALEK AND MARSZALEK HOLECEK & ASSOCIATES 237 15WC 03706 WINDHAM, JUSTIN K. CITY OF ROCKFORD 09/06/12 THOMAS W DUDA HEYL ROYSTER VOELKER & ALLEN 238 15WC 04227 ARZATE, EMILY ROCKFORD MEMORIAL HOSPITA 11/06/14 BLACK & JONES WIEDNER & MCAULIFFE LTD 239 15WC 05294 NIESMAN, DEBRA LEE GATEHOUSE MEDIA ILLINOIS 01/13/15 RICHARD O. GREENFIELD WIEDNER & MCAULIFFE LTD 240 15WC 05600 MC GEE, ELMER MONDELEZ INTERNATIONAL 01/01/13 BLACK & JONES WIEDNER & MCAULIFFE LTD 241 15WC 05931 ABUDAYYEH, JACK PACCAR PARTS DIVISION 08/01/14 BLACK & JONES BRADY CONNOLLY & MASUDA PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 16 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 242 15WC 06171 ARRINGTON-KLECZEWSKI, WEN CHRYSLER CORPORATION - 10/02/14 LOUIS A PLZAK & ASSOCIATES WIEDNER & MCAULIFFE LTD 243 15WC 06193 MIELKE, LOUIS H SYNCREON AMERICA INC 11/08/12 PAUL W GRAUER & ASSOC WIEDNER & MCAULIFFE LTD 15WC032564 -C 244 15WC 06487 SHUMAN, JODY WOOD EQUIPMENT 01/01/13 BLACK & JONES COZZI & GOGGIN-WARD 245 15WC 06796 GWALTNEY, MICHELLE J C PENNEY 11/07/14 BLACK & JONES ADELSON TESTAN & BRUNDO 246 15WC 07075 MURPHY, DONNA CHRYSLER LLC 05/31/12 WOODRUFF & JOHNSON WIEDNER & MCAULIFFE LTD 247 15WC 07507 MARTIN, LAWRENCE C IDOT 02/01/14 FRANKS, GERKIN & MCKENNA P ASSISTANT ATTORNEY GENERAL 16WC003693 -C ILLINOIS DEPT OF TRANSPORT 16WC003695 -C 248 15WC 07709 BUSSAN, PHIL TITAN TIRE CO 03/09/12 WOLFE LAW PC 249 15WC 07926 POHLMAN, STACY FIRST STUDENT 03/05/14 GESMER LAW OFFICES, PC BRADY CONNOLLY & MASUDA PC 250 15WC 08684 RUNKLE, JUDSON BERNER FOODS INC 01/07/14 BLACK & JONES EDWARD JANUSZKIEWICZ 251 15WC 08925 ROBERTSON, DANNY G SCHNIEDER NATIONAL 01/30/15 CANTOR & BURGER HENNESSY & ROACH PC 252 15WC 08948 JONES, CHRISTY WOODWARD GOVERNOR 07/28/14 GESMER LAW OFFICES, PC HINSHAW & CULBERTSON 253 15WC 09364 LEON, MARICELA GOLDEN CORRAL 02/28/15 TUITE LAW BRADY CONNOLLY & MASUDA PC 254 15WC 09791 HUFF, ROSS TRANSMETRO D/B/A ON THE R 01/09/15 BLACK & JONES 255 15WC 09968 MELTON, VICTORIA TS EMPLOYMENT, INC. 03/09/13 FRANCINE B WHITE SPIEGEL & CAHILL, PC 15WC009969 -C 15WC009970 -C 256 15WC 10001 HERBST, CINDY HAMILTON-SUNDSTRAND 02/19/15 KATZ FRIEDMAN EAGLE ET AL MACIOROWSKI SACKMANN & ULRIC 257 15WC 10170 CHRISTIANSEN, WANDA J UNITED TECHNOLOGIES CORP 02/23/15 FRANCINE B WHITE MACIOROWSKI SACKMANN & ULRIC 258 15WC 10923 LAFASTO, KAREN A ROCKFORD HEALTH SYSTEM 02/13/14 GREG TUITE & ASSOC WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 17 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 259 15WC 11006 BAKER, ESTIL WEISTERHUIS TRUCKING 06/14/14 BLACK & JONES GANAN & SHAPIRO 260 15WC 11285 HAGEN, MARTIN K CHRYSLER LLC 12/18/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 261 15WC 11509 LOUDERMILK, KEVIN SOURCE INTERLINK COMPANIE 10/23/13 CONSIDINE LAW OFFICES 262 15WC 11528 RAGAN, JAMES WOODWARD INC 10/29/13 PAUL MARZANO HINSHAW & CULBERTSON 263 15WC 11757 SUTHERLAND, JOE SOUTH BELOIT FIRE DEPARTM 01/01/15 BLACK & JONES RUSIN & MACIOROWSKI LTD 264 15WC 11954 HERNANDEZ, RICARDO AGENCY STAFFING/PEOPLE LI 04/02/15 LAW OFFICE OF SCOTT B SHAP WOLF LAW LTD 265 15WC 12115 BOWMAN, SYLVIA WALGREENS 12/05/14 CLARK FROST GILDEA & COGHLAN 266 15WC 12333 SICKELS, VICKY FIRST GROUP AMERICA 01/26/15 BLACK & JONES BRADY CONNOLLY & MASUDA PC 15WC033865 -C 16WC003716 -C 267 15WC 12961 ROJAS, MARIA BERGSTROM INC 08/24/14 BLACK & JONES 268 15WC 13831 BENNETT, DAVID S BRIAN MCWILLIAMS INDIV W 01/21/15 BLACK & JONES CHESTER R CHOSTNER, JR 269 15WC 13861 STEPHENS, THERESA LANDSTAR TRANSPORTATION 04/17/14 GESMER LAW OFFICES, PC 270 15WC 14449 BILLINGSLEA, TOMMIE ROCK RIVER ACADEMY 12/30/14 BLACK & JONES MC ANDREWS & NORGLE LLC 15WC041064 -C 271 15WC 14664 JACOBSON, THOMAS A PRECISION DRIVE & CONTROL 04/09/13 PIGNATELLI & ASSOCIATES 272 15WC 14824 GEEN, COLETTE T ROCKFORD BOARD OF EDUCATI 08/26/14 GREG TUITE & ASSOC WIEDNER & MCAULIFFE LTD 273 15WC 15843 KIRCHNER, PAMELA EAST DUBUQUE POLICE DEPAR 04/11/15 REESE & REESE RUSIN & MACIOROWSKI LTD 274 15WC 15881 PHILLIPS, JILL TERESA ILLINOIS TOLLWAY 05/04/15 BARRY A KETTER NYHAN BAMBRICK KINZIE & LOWR 275 15WC 16108 PONCE-TORRES, MARGARITO CHRYSLER LLC 04/15/15 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 18 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 276 15WC 16244 GRADMAN, RICHARD PORTER INSTALLATON 11/21/14 DWORKIN AND MACIARIELLO RODDY LAW LTD 277 15WC 16435 KENNINGTON, DANIEL R DISTINCTIVE ROOFING INC 04/20/15 GREG TUITE & ASSOC KEEFE CAMPBELL & ASSOC LLC 278 15WC 16458 HAYES, JAMES SWEDISHAMERICAN HOSPITAL 07/07/13 GESMER LAW OFFICES, PC WILLIAMS MCCARTHY LLP 279 15WC 16968 SCALZITTI, MARY FCA US LLC 02/01/14 GESMER LAW OFFICES, PC WILLIAMS MCCARTHY LLP 280 15WC 17127 PETERSON, RICHARD G COMCAST CABLEVISION 05/16/15 REESE & REESE POWER & CRONIN LTD 281 15WC 17542 PRESTON, CARRIE DAIMLER-CHRYSLER CORPORAT 04/20/15 GOLDBERG WEISMAN & CAIRO L WIEDNER & MCAULIFFE LTD 282 15WC 17711 MENDEZ, JOSE MANUEL PARK PLACE 05/28/15 VELLA & LUND BRADY CONNOLLY & MASUDA PC 283 15WC 17736 CURRY, DEMICHA M. CHRYSLER 05/07/14 ANESI OZMON RODIN NOVAK KO WIEDNER & MCAULIFFE LTD 16WC001820 -C 284 15WC 17886 SCHLOSSER, RICHARD DOLLAR GENERAL 11/27/08 RIDGE & DOWNES LLC WIEDNER & MCAULIFFE LTD 285 15WC 17953 ALLEN, GREGORY STATE OF IL @ 03/02/15 BLACK & JONES ASSISTANT ATTORNEY GENERAL 286 15WC 18272 MORLAND, LINDA C BERGSTROM INC 09/15/14 GREG TUITE & ASSOC WOLFE & JACOBSON, LTD 287 15WC 18307 YOUNG, STACY ROCKFORD P S DIST 205 09/29/12 BLACK & JONES WIEDNER & MCAULIFFE LTD 288 15WC 18310 FLETCHER, JAMES WINNEBAGO COUNTY HWY DEPT 10/07/13 BLACK & JONES WILLIAMS MCCARTHY LLP 289 15WC 18483 STEVENS, CHARLES SHERWIN WILLIAMS 05/28/15 GESMER LAW OFFICES, PC GAROFALO SCHREIBER STORM 290 15WC 18772 DOLE, MELINDA J MORMAN C SLEEZER 12/16/13 ALEXANDER, PETER LTD. 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 ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 291 15WC 18806 HOFFMAN, KIMBERLY S ROCKFORD MEMEORIAL HOSPIT 04/02/15 GREG TUITE & ASSOC WIEDNER & MCAULIFFE LTD 292 15WC 19108 LEDESMA, LARRY BELVIDERE YMCA 05/01/15 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 16WC007440 -C YMCA 293 15WC 19156 TURCATO, PETER A. ILLINOIS STATE TOLL @ 02/22/15 GESMER LAW OFFICES, PC GANAN & SHAPIRO 294 15WC 19182 GRANDSTRAND, PHILIP M. GO EXCAVATING, INC. 05/20/14 HAUSER LAW LLC CHILTON YAMBERT PORTER LLP 295 15WC 19272 STONE, JOHN H. USF HOLLAND INC. 02/22/15 BLACK & JONES HENNESSY & ROACH PC 16WC032571 -C 296 15WC 19274 BRUCE, JEROME GUNITE CORPORATION 02/18/15 GREG TUITE & ASSOC RUSIN & MACIOROWSKI LTD 297 15WC 19371 NEAL, JAMES JR COUNTY OF WINNEBAGO 08/05/14 GREG TUITE & ASSOC WILLIAMS MCCARTHY LLP 298 15WC 19759 MONTANEZ, LUCY I. LOWE'S HOME CENTERS, INC. 04/25/14 REESE & REESE KEEFE CAMPBELL & ASSOC LLC 299 15WC 19944 TOWNSEND, ANTHONY T CHRYSLER CORP 01/10/15 GREG TUITE & ASSOC WIEDNER & MCAULIFFE LTD 300 15WC 20519 GUSTAFSON, JULIE CHRYSLER 03/10/14 BLACK & JONES WILLIAMS MCCARTHY LLP 301 15WC 20856 TRAN, BANG ROCKFORD PROCESS CONTROL 05/17/15 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 302 15WC 20984 ADAMS, TERESA FCA US LLC 04/07/13 BLACK & JONES WIEDNER & MCAULIFFE LTD 15WC020985 -C 16WC005233 -C FAC US LLC 303 15WC 21025 GOROSTIETA, DAWN ROCKFORD PRODUCTS LLC 07/02/14 BLACK & JONES GILDEA & COGHLAN 304 15WC 21399 DISMUKE, BOBBY JR BARNES INTERNATIONAL INC 06/23/15 BLACK & JONES 305 15WC 21636 LOVE-COCKRELL, REGENIA ROCKFORD BRD OF ED DIST # 02/07/14 FRANCINE B WHITE WIEDNER & MCAULIFFE LTD 306 15WC 21961 TERRELL, ALAN R LEADING EDGE HYDRAULICS 05/15/15 GESMER LAW OFFICES, PC HOLECEK & ASSOCIATES 307 15WC 22075 BENTLEY, PATRICIA GENERAL MILLS 11/25/14 CLARK JUSTEN ZUCCHI PAUL A COGHLAN & ASSOC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 20 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 308 15WC 22322 WILLIAMS, JODI L ROCKFORD MASS 05/05/14 HEDEEN, MICHAEL J PC WILLIAMS MCCARTHY LLP 309 15WC 22588 PEARSON, KELLY CHRYSLER CORP 06/26/15 BLACK & JONES WILLIAMS MCCARTHY LLP 310 15WC 22617 OWENS, STEPHANIE COUNTY OF WINNEBAGO, RIVE 05/27/15 GESMER LAW OFFICES, PC WILLIAMS MCCARTHY LLP 311 15WC 22649 MIMIER, ANNA K PRESENCE LIFE CONNECTIONS 10/13/13 GREG TUITE & ASSOC NYHAN BAMBRICK KINZIE & LOWR 312 15WC 23014 LANE, RICKY L UNITED PARCEL SERVICE 06/12/15 GREG TUITE & ASSOC NYHAN BAMBRICK KINZIE & LOWR 313 15WC 23200 MCBRADY, MARK A CHRYSLER 06/26/15 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 314 15WC 23332 SANCHEZ, JAMES M AUTO RELEASING, INC 04/23/15 GREG TUITE & ASSOC KNAPP, OHL & GREEN 315 15WC 23522 CUEVAS, LUIS ROCKFORD BOLT & STEEL 07/31/12 GESMER LAW OFFICES, PC LAW OFFICES FRANCESCA LARSEN 316 15WC 23660 HUTSELL, ED CHRYSLER LLC 06/11/15 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 15WC029499 -C 15WC029500 -C 317 15WC 23850 BLACK, KEVIN L CATCHING FLUID POWER 07/29/14 CACCIATORE, WILLIAM T 318 15WC 23894 ANDERSON, JILL ST. ANTHONY'S MEDICAL CEN 07/12/15 KROL BONGIORNO & GIVEN LTD HINSHAW & CULBERTSON 319 15WC 24513 KING, WILLIAM MECHANICAL INC 06/29/15 CLARK JUSTEN ZUCCHI HEYL ROYSTER VOELKER & ALLEN 320 15WC 24743 LAWRENCE, JOHN CHRYSLER 04/15/15 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 321 15WC 25029 WILLIAMSON, CYNTHIA STATE OF IL DHS 07/07/15 BLACK & JONES ASSISTANT ATTORNEY GENERAL 322 15WC 25222 BILLINGSLEY, BARBRA CHRYSLER LLC 10/15/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 323 15WC 25721 WALSTON, HENRY ELNGLEWOOD ELECTRIC 03/03/14 ROSS TYRRELL COZZI & GOGGIN-WARD 324 15WC 26024 HAYNES, DUNSEY GUNITE CORP/ACCURIDE 08/16/12 BRADY & JENSEN RUSIN & MACIOROWSKI LTD 325 15WC 26371 SAYGO, LATRICA GUNITE CORPORATION 07/16/15 DWORKIN AND MACIARIELLO RUSIN & MACIOROWSKI LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 21 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 326 15WC 26557 REDNER, TERESA ANDROID INDUSTRIES 04/20/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 327 15WC 27217 KEHOE, ELAISOIN ALPHASTAFF/ SERVICOM, LLC 05/08/15 MARSZALEK AND MARSZALEK 328 15WC 27346 WAEFFLER, KIM BLUECROSS BLUESHIELD OF I 06/16/15 GESMER LAW OFFICES, PC HENNESSY & ROACH PC 329 15WC 27798 HUFF, ROSE TRANSMETRO DBA ON THE ROC W 01/09/15 BLACK & JONES 330 15WC 28389 MARTINEZ, HERMINIA ROCKNEL FASTENERS 08/07/15 BLACK & JONES INMAN & FITZGIBBONS 331 15WC 28716 MORRISON, TINA M CIMINOS PIZZA RESTAURANT 04/17/15 REESE & REESE 332 15WC 28948 OLSON, JONATHAN QPS EMPLOYMENT GROUP 11/15/14 DWORKIN AND MACIARIELLO WOLFE & JACOBSON, LTD 333 15WC 28978 LAMB, SUMALI EBERSPAECHER 08/26/15 BLACK & JONES THOMAS & PORTELA 334 15WC 29198 NAVA, RAQUEL VENTRA BELVIDERE LLC 04/01/15 GREG TUITE & ASSOC BRUCE WARREN 335 15WC 29470 ARTEAGA, CLAUDIO MODERN SUSPENSION SYSTEMS 02/14/14 GESMER LAW OFFICES, PC HENNESSY & ROACH PC 336 15WC 29826 NIEPRAWSKI, AARON ELGIN SUPER AUTO 08/14/15 HORWITZ HORWITZ & ASSOC RIPES NELSON BAGGOT KALOBRAT 337 15WC 30147 KUHSE, ANDREW A. BURKE TUBBS FUNERAL HOMES 02/12/14 HAUSER LAW LLC RIPES NELSON BAGGOT KALOBRAT 338 15WC 30184 SILVA, DONACIANO WELDMENTS INC 09/06/13 BLACK & JONES ROBERT L. SMITH 339 15WC 30235 HAYNES, SARAH IPSD 204 02/09/15 BLACK & JONES BRADY CONNOLLY & MASUDA PC 340 15WC 30350 THOMPSON, FAITH MCDONALD'S 08/06/15 CLARK FROST BRYCE DOWNEY & LENKOV LLC 341 15WC 30802 ZUNIGA, FRANCISCA CHRYSLER CORP 11/06/14 BLACK & JONES WIEDNER & MCAULIFFE LTD 342 15WC 31528 FIERRO, ANTONIO COMTRAK LOGISTIC, INC 09/25/13 HORWITZ HORWITZ & ASSOC SCOPELITIS GARVIN LIGHT 343 15WC 32121 WASHINGTON, JESSE CITY OF ROCKFORD 05/30/15 THOMAS L NASH PC HEYL ROYSTER VOELKER & ALLEN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 22 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 344 15WC 32625 SAMUELS, MARCUS CHRYSLER LLC 03/13/15 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 345 15WC 32988 SEAGO, DERRICK AEROTEK 07/17/15 MARKS & ASSOCIATES LITCHFIELD CAVO 346 15WC 33130 PEREZ-TESTA, ELADIO DELI ITALIA 08/30/15 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 347 15WC 33181 PAPKE, WILLIAM ROCK VALLEY COLLEGE 09/18/15 BLACK & JONES POWER & CRONIN LTD 348 15WC 33439 HAYNES, DUNSY GUNITE CORP/ACCURIDE 10/31/12 BRADY & JENSEN RUSIN & MACIOROWSKI LTD 349 15WC 33513 TROST, SUZANN MCCURDY TOOL 04/14/15 BLACK & JONES HOLECEK & ASSOCIATES 350 15WC 33809 VANDERVORT, KENDRA M. MEIJER STORES LP 09/30/15 GREG TUITE & ASSOC KOPKA, PINKUS & DOLIN, PC 351 15WC 33926 SHABATURA, PAULA IAC BELVIDERE CROSSLINK A 08/05/15 KATZ FRIEDMAN EAGLE ET AL 352 15WC 34392 METZGER, ANNETTE SNAK KING 07/14/15 GESMER LAW OFFICES, PC 353 15WC 34555 BARRICKLOW, JOHN ALPHA BAKING COMPANY 02/01/15 BLACK & JONES MACIOROWSKI SACKMANN & ULRIC 354 15WC 34801 GRAVES, JAQUELINE TDS AUTOMOTIVE 09/28/15 DWORKIN AND MACIARIELLO SMITH AMUNDSEN LLC 355 15WC 34848 SUMPTER, PATRICIA V CHRYSLER CORP 08/17/15 GREG TUITE & ASSOC WIEDNER & MCAULIFFE LTD 356 15WC 34869 ESTES, CHARLES ROCKFORD SCHOOL DISTRICT 10/14/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 357 15WC 35104 VALENCIA, JOSE ANTONIO STATELINE FOUNDRIES 04/28/15 BLACK & JONES RODDY LAW LTD 358 15WC 35196 KENNEDY, RICHARD CITY OF ROCKFORD 08/05/15 FOOTE MIELKE CHAVEZ & O'NE ODELSON & STERK LTD 359 15WC 35422 WILLIAMS, JENNY VAN MATRE HEALTH S REHAB 09/29/15 GESMER LAW OFFICES, PC SPIEGEL & CAHILL, PC 360 15WC 35429 SWEDLUND, KIM CHRYSLER, LLC 10/13/15 BARRICK SWITZER LONG ET AL WIEDNER & MCAULIFFE LTD 361 15WC 35878 WILLIAMS, LAKEISHA CHRYSLER CORP 01/01/15 BLACK & JONES WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 23 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 362 15WC 35881 PETERS, MARY MCDONALDS 03/16/15 BLACK & JONES GAROFALO SCHREIBER STORM 363 15WC 36593 LIEBER, STACEY HEALTHPORT 10/30/15 BLACK & JONES THOMAS & PORTELA 364 15WC 36732 RODRIQUEZ, JOSE ORTIZ BRISENO LAWN CARE & 06/19/15 STEWART C ORZOFF LAW OFFICES JOSEPH MARCINIAK 365 15WC 36935 PALMER, LAWRENCE MANEVAL CONSTRUCTION INC. 10/29/15 CORBOY & DEMETRIO PC 366 15WC 37196 RUIZ, MARTIN SYSCO FOOD SERVICE 06/25/15 GOLDBERG WEISMAN & CAIRO L HENNESSY & ROACH PC 15WC037197 -C 367 15WC 37675 SEDOLS, RHONDA ROCKFORD BELL CREDIT UNIO 01/26/15 PARENTE & NOREM PC 368 15WC 37802 LEDDY, NICK ROCKFORD ICE HOGS 11/25/12 GORDON LAW OFFICES LTD HENNESSY & ROACH PC 369 15WC 38127 MORSE, JAMIE TDS AUTOMOTIVE HOLDINGS, 10/26/15 ANESI OZMON RODIN NOVAK KO 370 15WC 38237 CORTES, BERNARDINO A. THE BON TON STORES INC. 10/08/15 GESMER LAW OFFICES, PC BRADY CONNOLLY & MASUDA PC 371 15WC 38479 LEBER, JONATHAN F CARRIER COMMERCIAL 02/01/13 GREG TUITE & ASSOC 372 15WC 38565 ROWELL, DANNY VAN MATRE HEALTH SOUTH 09/18/14 GOLDBERG WEISMAN & CAIRO L SPIEGEL & CAHILL, PC 15WC038566 -C 373 15WC 38654 SANCHEZ, JEFF ABEL'S LANDSCAPING 11/06/15 GESMER LAW OFFICES, PC 374 15WC 38888 ROBINSON, WILLIE TITAN TIRE CORP 08/26/15 JAMES J BURKE LAW OFFICE GRANT & FANNING 375 15WC 38973 GRAVES, MARILYN IAC BELVIDERE CROSSLINK A 10/12/15 WOODRUFF & JOHNSON 376 15WC 39242 SUTHERLAND, ELMER D AND D CONSTRUCTION 07/05/15 BLACK & JONES 16WC021961 -C D&D CONSTRUCTION EQUIP REP 377 15WC 39895 GUETSCHOW, RACHEL L RIVER BLUFF NURSING HOME 11/27/15 REESE & REESE WILLIAMS MCCARTHY LLP 378 15WC 39917 KLOEPPING, MARK WOODS EQUIPMENT CO 09/01/15 PIGNATELLI & ASSOCIATES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 24 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 379 15WC 39975 GARIBAY, MARTHA ANDROID INDUSTRIES 08/10/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 380 15WC 41075 FERONE, MARCY CHRYSLER LLC 01/09/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 381 15WC 41570 ANDERSON, ASHLEY APAC CUSTOMER SERVICE 10/30/15 BLACK & JONES QUINTAIROS PRIETO WOOD & BOY 382 15WC 41636 FARIAS, ROBERTO CORPORATE DEVELOPMENT INC 05/11/15 COSTA IVONE LLC 383 15WC 41707 MICHALSEN, JULIE CITY OF ROCKFORD 03/01/15 GESMER LAW OFFICES, PC HEYL ROYSTER VOELKER & ALLEN 384 15WC 42196 ALLEN, LORENZO PEARL VALLEY FARM EGGS 11/29/15 MARKS & ASSOCIATES 385 15WC 42249 BOOSE, CHRISTOPHER TRANSPORT AMERICA 11/24/15 BLACK & JONES KEEFE CAMPBELL & ASSOC LLC 386 15WC 42252 ZIERLER, SHELLY MEIJER 07/01/15 BLACK & JONES KNELL & O'CONNOR 387 15WC 42333 HERREN, PAUL V. SEDEXO 04/14/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 388 15WC 42348 DIAZ, JAVIER EVER READY PIN & MFG, INC 06/30/13 FRANKS, GERKIN & MCKENNA P 389 16WC 00481 ZILZ, JACK TERRACON CONSULTANTS, INC 07/27/15 THE FITZ LAW GROUP STEPHEN H LARSON LAW OFFICE 16WC012455 -C 16WC012456 -C 16WC012457 -C 390 16WC 00766 KEEHLER, BRITNEY OREGON LIVING AND REHAB C 01/20/15 BLACK & JONES GALLIANI DOELL & COZZI LTD 391 16WC 00769 GIVENS, STEVIE COMMONWEALTH EDISON 08/01/15 BLACK & JONES CHILTON YAMBERT PORTER LLP 392 16WC 00954 PETERS, MARY NEIMAN FOODS COUNTRY 10/20/15 BLACK & JONES SCHOLZ LOOS PALMER ET AL 393 16WC 01290 WALTER, JOHN FCA US LLC 04/07/15 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 394 16WC 01532 BARBER, SCOTT ROCK RIVER WATER 05/07/15 GESMER LAW OFFICES, PC WILLIAMS MCCARTHY LLP 395 16WC 01880 ST CLAIR, DAVID FN SMITH CORPORATION 10/16/13 DWORKIN AND MACIARIELLO MCANANY VANCLEVE & PHILLIPS

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 25 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 396 16WC 01913 HRIBAL, SARAH ANDROID INDUSTRIES 02/03/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 397 16WC 02312 ROLAND, THOMAS C ROCK RIVER 11/26/14 REESE & REESE WILLIAMS MCCARTHY LLP 398 16WC 02524 DUCKETT, ROSHAWNDA D SECRETARY OF STATE @ 01/14/16 WILLIAMS, ROBERT B LAW OFF ASSISTANT ATTORNEY GENERAL 399 16WC 03014 CAREY, WALLACE FCA US LLC 11/18/14 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 400 16WC 03171 LINDSEY, WILLIAM CHRYSLER CORP 07/20/13 HORWITZ HORWITZ & ASSOC WIEDNER & MCAULIFFE LTD 16WC003172 -C 401 16WC 03497 HOLMQUIST, AMY STAFF ON SITE 12/30/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 402 16WC 03573 JOHNS, STEPHEN ROCKFORD ICE HOGS 11/26/14 GORDON LAW OFFICES LTD HENNESSY & ROACH PC 16WC003574 -C 16WC003575 -C 16WC024879 -C 403 16WC 03669 VARGAS, VICTORIA METRO STAFFING 03/09/15 MARSZALEK AND MARSZALEK NYHAN BAMBRICK KINZIE & LOWR 404 16WC 03733 ASANOSKI, ALI ROCKFORD MASS TRANSIT DIS 11/21/15 FRANKS, GERKIN & MCKENNA P 405 16WC 03749 SELLERS, JERRETT REINHART FOOD SERVICES 04/17/15 HEDEEN, MICHAEL J PC BRADY CONNOLLY & MASUDA PC 406 16WC 03959 EVANS, TROY FCA US LLC 05/15/15 WOODRUFF & JOHNSON WIEDNER & MCAULIFFE LTD 407 16WC 04067 STEWART, ROBERT W VALSPAR CORPORATION 10/02/15 TUITE LAW RUSIN & MACIOROWSKI LTD 408 16WC 04139 GEYLER, LINDA HARLEM CONSOLIDATED SCHOO 09/02/15 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 409 16WC 04278 BIGHAM, CRYSTAL A WARNER-LINEAR 03/17/14 CACCIATORE, WILLIAM T WOLFE & JACOBSON, LTD 410 16WC 05061 SHIFFLETTE, RAY GOREMAN & CO 12/31/15 DWORKIN AND MACIARIELLO COZZI & GOGGIN-WARD 411 16WC 05236 MORRIS, KIM ROCKFORD TOOL CRAFT 10/26/15 BLACK & JONES ROBERT L. SMITH 412 16WC 05486 BRITTIAN, DANELLE JOB SMART 02/04/16 GESMER LAW OFFICES, PC HOLECEK & ASSOCIATES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 26 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 413 16WC 05553 LOGAN, DERRICK L WEST SIDE TRANSPORT INC 12/28/15 FRANCINE B WHITE HOLECEK & ASSOCIATES 414 16WC 05583 KISSICK, BRIAN FCA US LLC 01/01/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 415 16WC 05586 WEDEKIND, TROY FED EX FREIGHT 10/05/15 BLACK & JONES QUINTAIROS PRIETO WOOD & BOY 416 16WC 05910 BIGGS, HAROLD GKN OF ROCKFORD 10/15/15 GESMER LAW OFFICES, PC RIPES NELSON BAGGOT KALOBRAT 417 16WC 06616 RODRIGUEZ, ANAMARIA SODEXO 07/28/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 418 16WC 06721 SHAW, CLAUDIA ALLIANCE HEALTHCARE SERVI 02/03/16 GESMER LAW OFFICES, PC 419 16WC 06939 FERONE, MARCY FCA US LLC 01/23/13 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 420 16WC 07015 JAMISON, CLEAVEN J JR TITAN TIRE 06/15/15 CULLEN HASKINS NICHOLSON 421 16WC 07154 KING, TIFFIANY MILESTONE, INC 07/02/15 GESMER LAW OFFICES, PC 422 16WC 07180 ANDERSON, KENNETH FCA US LLC 02/17/16 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 423 16WC 07325 BIGGERS, DANIEL W BIGGERS AUTO CARE 08/26/15 REESE & REESE BRYCE DOWNEY & LENKOV LLC 424 16WC 07441 THOMPSON, ROSIE SNAK KING 02/01/16 BLACK & JONES COZZI & GOGGIN-WARD 425 16WC 07444 MANNING, GERALD FCA US LLC 11/17/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 426 16WC 07447 MANNING, GERALD FCA US LLC 06/01/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 427 16WC 07470 JORDAN, TIARA DASCO PRO 12/30/15 BLACK & JONES 428 16WC 07475 TROLLIET, BRAD DENT WIZARD 01/15/14 GESMER LAW OFFICES, PC 429 16WC 08104 SHAW, CYNTHIA WALMART 03/10/15 CAPRON & AVGERINOS PC QUINTAIROS PRIETO WOOD & BOY 430 16WC 08280 STONE, MICHELE INT'L AUTOMOTIVE COMPONEN 12/08/15 NASH LAW OFFICE PC GANAN & SHAPIRO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 27 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 431 16WC 08429 CRUZ, EDVIN CASSENS TRANSPORT COMPANY 02/08/16 RIDGE & DOWNES KNAPP, OHL & GREEN 432 16WC 08536 HATFIELD, BRETT W R & D THIEL, INC 01/19/16 TUITE LAW WIEDNER & MCAULIFFE LTD 433 16WC 08591 HENDERSON, WILLIE GKN ROCKFORD, INC 11/17/15 KATZ FRIEDMAN EAGLE ET AL RIPES NELSON BAGGOT KALOBRAT 434 16WC 08788 HEILIG, STACY WYNDHAM VACATION OWNERSHI 11/16/15 GESMER LAW OFFICES, PC COZZI & GOGGIN-WARD 435 16WC 09156 SANTELIZ, RICARDO CAMCRAFT INC. 11/23/15 CUSHING LAW OFFICES BRADY CONNOLLY & MASUDA PC 436 16WC 09276 KUBAN, RACHAEL H SWEDISH AMERICAN HEALTH S 02/19/16 GESMER LAW OFFICES, PC WILLIAMS MCCARTHY LLP 437 16WC 09339 LEGO, LESLIE FCA US LLC 04/23/15 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 438 16WC 09470 LEONARD, BOBBY E PROGRESSIVE STEEL TREATIN 01/27/16 TUITE LAW GANAN & SHAPIRO 439 16WC 09571 MENESES, ALFONSO ALLYN MASONRY, INC 06/19/15 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 440 16WC 09575 NAYONIS, MICHAEL WOODWARD GOVERNOR CO 03/21/12 BLACK & JONES HINSHAW & CULBERTSON 441 16WC 09606 GIDEON, CYNTHIA A RENO ENTERPRISES LLC 06/22/15 TUITE LAW LAW OFFICES JOSEPH MARCINIAK 442 16WC 09623 ALANIS, AIDA HEALTHCARE PLUS 01/18/16 BLACK & JONES HOLTKAMP LIESE ET AL 443 16WC 09631 COOK, ROME STEPHENSON NURSING CENTER 08/11/15 BLACK & JONES 16WC009632 -C 16WC009633 -C 16WC009634 -C 16WC009635 -C 16WC009636 -C 444 16WC 09650 MILLS, BRADLEY JAMES ROCKFORD ICEHOGS 04/12/14 FLOYD LAW FIRM 445 16WC 09921 MARTENS, HEIDI A CITY OF ROCKFORD, 04/10/15 TUITE LAW HEYL ROYSTER VOELKER & ALLEN 446 16WC 09981 SULLIVAN, BEVERLY PRESENCE COR MARIAE CENTE 01/16/16 GESMER LAW OFFICES, PC KEEFE CAMPBELL & ASSOC LLC 447 16WC 10161 JOHNSON, ERIC HOOGLAND FOODS D/B/A 05/07/15 MILLON & PESKIN LTD RUSIN & MACIOROWSKI LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 28 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 448 16WC 10472 VELASQUEZ, ROSALBA EVOLUTION STAFFING 06/17/15 LAW OFFICE OF JAMES H MILL SCOPELITIS GARVIN LIGHT 449 16WC 11056 RAINS, SALLY FEDEX 10/02/15 BLACK & JONES SCOPELITIS GARVIN LIGHT 450 16WC 11103 WOJEWODZKI, ANTHONY H JC MILLING CO INC. 01/18/16 ALEXANDER, PETER LTD. 451 16WC 11139 LIBBE, MARGARET A INFORMATION CONTROLS, INC 01/11/16 FRANCINE B WHITE LAW OFFICES OF EDWARD J. KOZ 452 16WC 11348 MALDONALDO, ASWALDO CHEMTOOL INC 11/13/11 DWORKIN AND MACIARIELLO LAW OFFICES JOSEPH MARCINIAK 453 16WC 11384 ZAHURONES, STEVEN C FCA USA INC 01/05/16 GESMER LAW OFFICES, PC WILLIAMS MCCARTHY LLP 454 16WC 11388 BERUMEN, TERESA ANDROID BELVIDERE LL 01/19/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 455 16WC 11398 ALCALA, JOSE NORTHWEST PALLET SUPPLY C 02/25/14 BLACK & JONES HEYL ROYSTER VOELKER & ALLEN 16WC017695 -C 456 16WC 11558 GIPSON, SCOTT ROY GIPSON, SCOTT ROY 06/05/15 REESE & REESE RUSIN & MACIOROWSKI LTD 457 16WC 11573 EARLY, SHAWN C. WASTE CONNECTIONS, INC. 12/23/15 TUITE LAW 458 16WC 11583 MARGRETZ, HEATHER L SKANDIA, INC. 03/18/16 TUITE LAW 459 16WC 11596 CASTEEL, MICKEY WOODWARD, INC 11/07/14 TUITE LAW HINSHAW & CULBERTSON 460 16WC 11688 STORAGE, CHRIS FCA US 11/07/13 HORWITZ HORWITZ & ASSOC WIEDNER & MCAULIFFE LTD 461 16WC 11897 JEFFREYS, BRIAN C CHRYSLER CORP 05/01/14 VELLA & LUND WIEDNER & MCAULIFFE LTD 462 16WC 11984 WISDOM, DENNIS SCHNUCKS 12/22/15 BROWN & BROWN 463 16WC 11992 GRANA, ANTONIO LAGUNA LOWE'S DISTRIBUTION CENTE 09/01/15 EPSTEIN, JACK R LAW OFFICE KEEFE CAMPBELL & ASSOC LLC 464 16WC 12525 MACLIN, IVA FCA US LLC 08/20/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 465 16WC 12872 KANE, CARMELLA ROCKFORD MEMORIAL HOSPITA 03/14/16 PATRICOSKI, MARK G

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 29 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 466 16WC 13145 MAURO, PHILLIP ALL LIFE'S SOLUTIONS 04/13/16 DWORKIN AND MACIARIELLO ROBERT L. SMITH 467 16WC 13174 MILVERT, DUSTIN PREMIER CONCRETE 07/08/15 BRYCE DOWNEY & LENKOV LLC 468 16WC 13237 KELLEMS, MELANIE SCHNUCKS 10/22/15 NASH LAW OFFICE PC LEMP & MURPHY 469 16WC 13299 PHILLIPS, MICHAEL W AUTO RELEASING INC 12/10/15 TUITE LAW KNAPP, OHL & GREEN 470 16WC 13448 RODRIGUEZ, MARY A ROSECRANCE HEALTH NETWORK 02/01/14 THE ROMAKER LAW FIRM POWER & CRONIN LTD 471 16WC 13575 TOBIN, BRIAN PREMIUM TRANSP. STAFFING 03/01/15 BLACK & JONES GRANT & FANNING 472 16WC 13839 ARRIOLA, INGRID VENTRA BELVIDERE 03/03/16 GESMER LAW OFFICES, PC BRUCE WARREN 473 16WC 14079 MEIBORG, TREVOR PRAIRIE FARMS DAIRY, INC. 05/01/13 BLACK & JONES HENNESSY & ROACH PC 16WC014080 -C 474 16WC 14087 AMES, AMBER FCA US LLC 08/15/13 BLACK & JONES WIEDNER & MCAULIFFE LTD 16WC014088 -C 475 16WC 14206 CORROS, POLICAR HEALTHCARE PLUS CORPORATI 03/31/16 STEPHEN G PINTO LTD HEYL ROYSTER VOELKER & ALLEN 476 16WC 14465 SWEENEY, DARRELL DEAN FOODS COMPANY 05/15/15 CLARK JUSTEN ZUCCHI BRADY CONNOLLY & MASUDA PC 477 16WC 14564 RIVAS, EDWIN HARRIS SILVER & SONS INC 03/17/16 LAW OFFICES ROBERT WARSASK 478 16WC 14769 ARVIGO, JAMES WINNEBAGO COUNTY JUVENILE 04/28/16 BLACK & JONES 479 16WC 14865 BURCHFIELD, MICHAEL H. FARM & FLEET OF ROCKFORD 02/08/16 CACCIATORE, WILLIAM T NYHAN BAMBRICK KINZIE & LOWR 480 16WC 15209 SCHULDT, TONJA DICKEY STAFFING SOLUTIONS 04/19/16 DWORKIN AND MACIARIELLO 481 16WC 15397 TALLARD, MICHAEL TANNER INDUSTRIES, INC. 12/04/15 FRANKS, GERKIN & MCKENNA P HENNESSY & ROACH PC 482 16WC 15422 ERICKSON, LEIF STRUCTURAL PRESERVATION 04/01/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 483 16WC 15425 FRISCH, JENNIFER ROCKFORD TOOLCRAFT 01/23/15 BLACK & JONES ROBERT L. SMITH

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 30 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 484 16WC 15443 CASIQUE, MOISES MID-STATES CONCRETE 09/22/15 GESMER LAW OFFICES, PC GAROFALO SCHREIBER STORM 485 16WC 15544 LAMAN, NANCY WOODWARD 07/01/15 GESMER LAW OFFICES, PC HINSHAW & CULBERTSON 486 16WC 15721 BALDAWI, AHMED AL VALSPAR CORP 10/01/15 GOLDSTEIN BENDER & ROMANOF RUSIN & MACIOROWSKI LTD 487 16WC 16121 BURG, BRAD ECHELON STAFFING SOLUTION 02/22/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 488 16WC 16160 HEILIG, STACY WYNDHAM VACATION OWNERSHI 05/02/16 GESMER LAW OFFICES, PC COZZI & GOGGIN-WARD 489 16WC 16345 SMITH, VANTANISHA J FCA US LLC 04/25/16 TUITE LAW WIEDNER & MCAULIFFE LTD 490 16WC 16361 SPRAGGINS, JOHN W STAFF ON SITE 04/12/16 TUITE LAW WIEDNER & MCAULIFFE LTD 491 16WC 16623 PROSIO, EUGENE AMERICAN ALUMINUM EXTRUSI 09/20/15 GESMER LAW OFFICES, PC RIPES NELSON BAGGOT KALOBRAT 492 16WC 16779 MERCER, TOMMY GCA SERVICES GROUP 03/11/16 GESMER LAW OFFICES, PC POWER & CRONIN LTD 493 16WC 16899 STEVENS, RICHELE LEE ALDI 04/22/16 BLACK & JONES MACIOROWSKI SACKMANN & ULRIC 494 16WC 16917 MONTES, FIDELA SURE-STAFF, INC. 06/30/15 RUBIN MACHADO ROSENBLUM KEEFE CAMPBELL & ASSOC LLC 495 16WC 16939 HENDRIKSEN, DOUGLAS BYRON POLICE DEPARTMENT 05/12/16 RIDGE & DOWNES INMAN & FITZGIBBONS 496 16WC 17076 CARR, RANDALL P. TRANE CO. 12/13/13 FRANCINE B WHITE HOLECEK & ASSOCIATES 497 16WC 17399 GARDNER, ANGELA CIRCLES OF LEARNING 05/09/16 BLACK & JONES NOBLE & ASSOCIATES PC 498 16WC 17470 HOUPT, JOHN LEMFCO, INC. 01/05/15 HOLECEK & ASSOCIATES 499 16WC 17518 HENBEST, BRETT CENEX HARVEST STATES 04/22/16 GESMER LAW OFFICES, PC 500 16WC 17527 CHRISTIANSEN, WANDA J UNITED TECHNOLOGIES CORP/ 09/14/15 FRANCINE B WHITE 501 16WC 17554 MONTENEGRO, RAUL WHITE & RED TRUCKING, INC 11/23/15 ANKIN LAW OFFICE

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 31 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 502 16WC 17687 MCCORMICK, JOHN HOPPERSTAD KERRY 07/30/15 CLARK FROST BRADY, CONNOLLY & MASUDA, PC 503 16WC 17698 ESTRADA, FLOR MORGAN BUILDING MAINT, IN 03/18/16 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 504 16WC 17798 MAURO, PHILLIP R HARBOR AMERICA EAST INC 04/05/16 TUITE LAW ROBERT L. SMITH 505 16WC 18008 GREINER, MICHAEL OAKLEY SUB ASSEMBLY 05/23/16 MARTIN V KUGIA PERRY GENTILE 506 16WC 18019 CLARK, LISA ROCK VALLEY COLLEGE 05/18/16 NASH LAW OFFICE PC POWER & CRONIN LTD 507 16WC 18202 PERRY, MICHAEL LUMBER LIQUIDATORS 02/01/16 BLACK & JONES GAROFALO SCHREIBER STORM 16WC018203 -C 508 16WC 18518 NUTTER, SHAWN QUALITY METAL FINISHING C 06/07/16 GESMER LAW OFFICES, PC HENNESSY & ROACH PC 509 16WC 18861 PINEDA, MARIA DEL CARMEN QPS EMPLOYMENT GRP 05/09/16 GESMER LAW OFFICES, PC WOLFE & JACOBSON, LTD 510 16WC 19031 WELLS, LISA YOUTH SERVICES BUREAU 01/01/16 BLACK & JONES RUSIN & MACIOROWSKI LTD 511 16WC 19576 BARBER, JOANNE E TRIM-DIM FILTER CORPORATI 05/29/16 WARREN W MARK INMAN & FITZGIBBONS 512 16WC 19684 FREEMAN, JANINA ROCK RIVER HEALTH CARE 03/26/16 BLACK & JONES KEEFE CAMPBELL & ASSOC LLC 513 16WC 19820 KELLY, MERCEDEZ ALDEN PARK STRATHMOOR 03/07/16 LEE, MARK N LAW OFFICE 514 16WC 19901 LOCKLIN, MICHELLE SCHMIDT JANITORIAL 04/09/15 CLARK FROST 515 16WC 19948 THOMPSON, STEPHANIE WOODWRD GOVERNOR COMPANY 03/07/16 BLACK & JONES HINSHAW & CULBERTSON 516 16WC 19984 HINKLE, MARVIN E REGAL CUTTING TOOLS, INC 08/15/14 ANESI OZMON RODIN NOVAK KO HOLECEK & ASSOCIATES 517 16WC 20016 SMITH, ERICH JOBSMART EMPLOYMENT SERVI 05/17/16 BLACK & JONES HOLECEK & ASSOCIATES 518 16WC 20019 BUFFINGTON, JEREMY GENERAL AUTO PARTS 03/15/16 BLACK & JONES BRADY CONNOLLY & MASUDA PC 519 16WC 20023 PLOMOS, CATHERINE CORCORAN, DAVID DR. 02/02/16 BLACK & JONES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 32 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 520 16WC 20113 DAVIS, MINNIE N FURST STAFFING SERVICES, 04/16/16 TUITE LAW 521 16WC 20394 HUDDLESTONE, DON G SPG INTERNATIONAL, LLC 10/27/14 TUITE LAW 522 16WC 20451 CARRENO, LUIS J&M PLATING 01/28/16 BLACK & JONES HOLECEK & ASSOCIATES 523 16WC 20454 HARRIS, BRIANT MONDELEZ INT'L 06/09/16 BLACK & JONES 524 16WC 20460 MARTINEZ-VALDEZ, MAYRA JONES NATURAL CHEWS 01/23/16 BLACK & JONES PERRY GENTILE 16WC020461 -C 525 16WC 20463 SANDOVAL, NOEMI GCA SERVICES 03/10/14 BLACK & JONES 526 16WC 20466 PEKAS, BRIAN FIELD FASTENER 04/25/16 BLACK & JONES 527 16WC 20560 FRESCAS, ALEJANDRO ANDROID INDUSTRIES 03/21/16 KATZ FRIEDMAN EAGLE ET AL SMITH AMUNDSEN LLC 528 16WC 20638 FITZGERALD, JOSHUA SECURITAS SECURITY SERVIC 06/14/16 BLACK & JONES 529 16WC 20641 DAVIS, ROBERT PETERSON MEADOWS RET COM 05/08/16 BLACK & JONES 530 16WC 20727 HUERTA, JOSE EVERGREEN IRRIGATION 07/06/15 GESMER LAW OFFICES, PC CAPUANI & SCHNEIDER 531 16WC 20804 MILLER, ANTHONY HUGHES RESOURCES 05/13/16 DAVID W MARTAY SLAVIN & SLAVIN 532 16WC 21107 WHELCHEL, RANDY FCA US LLC 05/08/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 533 16WC 21800 TAYLOR, JOHN NORTHWEST MECHANICAL INC 06/28/16 SCHWEICKERT & GANASSIN RUSIN & MACIOROWSKI LTD 534 16WC 21830 WATSON, AMBER GUNITE CORP 05/17/16 BLACK & JONES RUSIN & MACIOROWSKI LTD 535 16WC 21844 BOLAR, TERRY BIMBO BAKERIES USA INC 05/03/16 FRANCINE B WHITE 536 16WC 21964 GREEN, JENNIFER ROCKFORD HEALTH SYSTEM 08/04/14 CLARK FROST WIEDNER & MCAULIFFE LTD 537 16WC 22148 BOLIN, ELIZABETH JANE DEAN DAIRY HOLDINGS, LLC 05/01/16 BARRICK SWITZER LONG ET AL BRADY CONNOLLY & MASUDA PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 33 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 538 16WC 22247 ROFFERS, GREGORY (ESTATE HAGEMANN TRUCKING # 07/14/15 GESMER LAW OFFICES, PC JAMES M KELLY 539 16WC 22428 STARKS, PHOSHAWNDA M FCA US LLC 08/12/15 ANKIN LAW OFFICE WIEDNER & MCAULIFFE LTD 540 16WC 22459 RUSSO, DENISE ANDRIA CANNOVA'S ITALIAN CAFE 07/09/15 LAWFIRST 541 16WC 22587 WALTON, LEWIS FCA US LLC 03/15/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 542 16WC 22590 KUZIORA, TOMASZ FCA US LLC 04/11/16 WOODRUFF & JOHNSON WIEDNER & MCAULIFFE LTD 543 16WC 22607 COKE, KEVIN NATIONAL TECHNICAL SYSTEM 08/09/13 CAPRON & AVGERINOS PC 544 16WC 22705 ROMERO, GARDY CHIPOTLE MEXICAN GRILL 05/01/15 MEYERS & FLOWERS 545 16WC 22974 GRIERT, LAWRENCE ROCKFORD MASS TRANSIT 06/09/16 GESMER LAW OFFICES, PC RUSIN & MACIOROWSKI LTD 16WC023002 -C 546 16WC 23000 BARBER, ELMADONA MONDELEZ INTERNATIONAL 01/16/16 FRANCINE B WHITE 547 16WC 23091 LARSON, ROBBY SYNCREON 05/17/16 GESMER LAW OFFICES, PC HOLECEK & ASSOCIATES 548 16WC 23338 MANDUJANO, HUGO WOODS EQUIPMENT COMPANY 06/25/15 TUITE LAW COZZI & GOGGIN-WARD 549 16WC 23352 STAFFORD, ADAM J ILLINOIS TOOL WORKS INC 06/21/16 TUITE LAW HENNESSY & ROACH PC 550 16WC 23594 MCNALLY, ANGELA K. ROCKFORD PUBLIC SCHOOL 05/19/15 TUITE LAW WIEDNER & MCAULIFFE LTD 551 16WC 23615 WALLS, DARLENE TOP DIE CASTING COMPANY 10/01/15 MEYERS & FLOWERS HOLECEK & ASSOCIATES 552 16WC 23637 MIATKE, VIRGINIA CHECK INTO CASH 06/23/14 BLACK & JONES RUSIN & MACIOROWSKI LTD 553 16WC 23686 FINSNESS, KENNETH ANDROID INDUSTRIES 02/13/16 ALEXANDER, PETER LTD. 554 16WC 23963 JUERGENS, MARK HUGHES RESOURCES 01/26/16 DWORKIN AND MACIARIELLO SLAVIN & SLAVIN 555 16WC 24014 DONALDSON, MARK ROCKTON SCHOOL DIST #140 02/11/14 GESMER LAW OFFICES, PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 34 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 556 16WC 24068 ROBINSON, SHEILA LIFESCAPE COMMUNITY SERVI 06/21/16 BLACK & JONES GAROFALO SCHREIBER STORM 557 16WC 24337 HORTON, LEON BERNER FOOD AND BEVERAGEL 04/02/16 ANKIN LAW OFFICE 558 16WC 24372 LEISHER, GEORGE M AMERICAN EXTRUSION CORPOR 06/27/16 GOLDBERG WEISMAN & CAIRO L 559 16WC 24376 RAINWATER, ALAN UTC AEROSPACE SYSTEMS 03/03/16 KATZ FRIEDMAN EAGLE ET AL MACIOROWSKI SACKMANN & ULRIC 560 16WC 24604 MAPLES, JOSEPH FCA US LLC 06/22/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 561 16WC 24751 LUJAN, BRIGIDA SURE STAFF 07/28/16 LAW OFFICE OF SCOTT B SHAP KEEFE CAMPBELL & ASSOC LLC 562 16WC 24809 NAVARRETE-ROJAS, FERNANDO MIDWEST WIRE WORKS 03/17/16 BOTTO GILBERT 563 16WC 24956 CARROLL, STEVEN LIEBOVICH STEEL & ALUMINU 11/19/15 GESMER LAW OFFICES, PC POULOS & DIBENEDETTO LAW 564 16WC 25051 RIVAS, JULIO DEDICATED LOGISTICS 07/12/16 REESE & REESE LEAHY EISENBERG & FRAENKEL 565 16WC 25205 SINGMOUANGTHONG, SOUKPRAS ROCKFORD SANITARY SYSTEMS 01/29/15 FRANCINE B WHITE RODDY LAW LTD 16WC025206 -C 566 16WC 25262 JOHNSON, KRISTY SWEDISH AMERICAN HOSPITAL 06/01/15 BLACK & JONES WILLIAMS MCCARTHY LLP 567 16WC 25842 SERVANT, JAMIE CON AGRA FOODS, INC 06/10/16 BLACK & JONES 568 16WC 25851 SEITER, RYAN L KAYLABOB INC 03/24/16 TUITE LAW NYHAN BAMBRICK KINZIE & LOWR 569 16WC 25894 OSBORN, DEBRA J. TARGET 05/08/15 ALEXANDER, PETER LTD. 570 16WC 26143 GUZMAN, ANGELA GRUPO ANTOLIN 07/26/15 KATZ FRIEDMAN EAGLE ET AL HEYL ROYSTER VOELKER & ALLEN 571 16WC 26180 PAGAKIS, CHRISTINA WEST CARROLL DISTRICT #31 02/24/16 DWORKIN AND MACIARIELLO GAROFALO SCHREIBER STORM 572 16WC 26228 CACIC, MEIREMA INGERSOLL CUTTING TOOLS 06/01/16 BLACK & JONES HOLECEK & ASSOCIATES 573 16WC 26350 MUSGROVE, JEFFERY W. ACCURIDE CORPORATION 08/01/16 MERTES & MERTES PC RUSIN & MACIOROWSKI LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 35 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 574 16WC 26353 KINDS, SCHARLATTA BMO HARRIS BANK CENTER 04/26/16 BLACK & JONES RUSIN & MACIOROWSKI LTD 575 16WC 26387 HUNDLEY, DAVID J. TAYLOR COMPANY 04/30/14 REESE & REESE MACIOROWSKI SACKMANN & ULRIC 576 16WC 26404 BROWN, JEANETTA A SNAK KING 11/28/15 HAUSER LAW LLC 577 16WC 26578 GENTRY, STEVEN A MTE HYDRAULICS, INC 03/14/16 TUITE LAW 578 16WC 26640 MC LESTER, LARRY CHRYSLER CORPORATION 05/07/16 THOMAS J STIBERTH LAW OFFI 579 16WC 26735 NEAL, JOANNE ROCKFORD MEMORIAL HOSPITA 08/08/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 16WC026736 -C 580 16WC 26738 HACKENBURG, BRIAN NATIONAL FREIGHT INDUSTRI 07/30/15 BLACK & JONES 581 16WC 26776 LOWE, ROBERT ROCKFORD HOUSING AUTHORIT 08/11/16 RIDGE & DOWNES GILDEA & COGHLAN 582 16WC 27057 CRAYTON, NADINE PETERSON CLEANING INC 04/11/16 WOODRUFF & JOHNSON 583 16WC 27181 HURTADO, MARIO ROCKFORD BOLT & STEEL 03/17/15 RUBIN MACHADO ROSENBLUM 584 16WC 27448 JEFFERSON, MARGARET D ROCKNEL FASTENER, INC 06/02/16 BLACK & JONES HENNESSY & ROACH PC 585 16WC 27457 ORNELAS FLORES, GABRIEL JAMCO PRODUCTS 06/15/16 BLACK & JONES HEYL ROYSTER VOELKER & ALLEN 16WC027458 -C 586 16WC 27461 WEDEKIND, TROY FED EX FREIGHT 02/09/15 BLACK & JONES QUINTAIROS PRIETO WOOD & BOY 587 16WC 27549 CLARK, EMMANUEL OKALEY SUB ASSEMBLY 04/14/16 MARTIN V KUGIA PERRY GENTILE 588 16WC 27610 MILLER, MATTHEW AMERICAN EXTRUSION CORP 08/16/16 GOLDBERG WEISMAN & CAIRO L 589 16WC 27880 HARGRAVES, JEFF ALPINE BANK 09/03/13 GESMER LAW OFFICES, PC 590 16WC 28036 HILTON, DENNIS L. GENERAL MILLS, INC. DBA G 07/18/16 TUITE LAW PAUL A COGHLAN & ASSOC 591 16WC 28190 DIAZ, JUAN QPS EMPOYMENT GROUP 08/19/16 BLACK & JONES WOLFE & JACOBSON, LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 36 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 592 16WC 28195 STACY, KYLE BONNELL INDUSTRIES 06/16/16 BLACK & JONES HOLECEK & ASSOCIATES 593 16WC 28199 GOMEZ, ANA MATRANGA INDUSTRIES INC 08/01/16 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 594 16WC 28314 RADVILLE, LYNNE C PEGASUS SPECIAL RIDGERS I 03/15/16 REESE & REESE QUINTAIROS PRIETO WOOD & BOY 595 16WC 28387 ANDERSON, MICHAEL D ADP TOTALSOURCE/ 01/12/16 WIEDNER & MCAULIFFE LTD 596 16WC 28583 MC INERNEY, MICHAEL UPLAND HUNT CLUB, INC 11/20/15 SREENAN & CAIN PC HENNESSY & ROACH PC 597 16WC 28595 GOOD, PAUL FCA US LLC 07/02/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 598 16WC 28694 PETERS, DAVID K CITY OF ROCKFORD DEPT OF 08/24/16 REESE & REESE HEYL ROYSTER VOELKER & ALLEN 599 16WC 28767 VOSS, PAMELA MOSTLY CATS VETERINARY CL 09/07/16 GESMER LAW OFFICES, PC 600 16WC 28887 ARNETT, ROBERT P UNITED PARCEL SERVICE 06/08/16 TUITE LAW COZZI & GOGGIN-WARD 601 16WC 29159 BARRENGER, TRACY WOODWARD 06/24/15 GESMER LAW OFFICES, PC HINSHAW & CULBERTSON 602 16WC 29269 NEAL, MAQUINC FCA US LLC D/B/A 03/11/16 SPENCER LAW OFFICES WIEDNER & MCAULIFFE LTD 603 16WC 29577 CHAPMAN, JERAMEY STAFF ON SITE 09/22/16 DWORKIN AND MACIARIELLO 604 16WC 29824 CARR, JONATHAN CHRIS HOPPER DBA HOPPER D W 09/06/16 BLACK & JONES 605 16WC 30036 TROSPER, DIANE FCA US LLC 05/01/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 606 16WC 30104 JOHNSON, NATHAN QED DRYER SALES 08/13/15 DWORKIN AND MACIARIELLO GAROFALO SCHREIBER STORM 607 16WC 30135 BONNER, DAWN LOWE'S DISTRIBUTION CTR 07/01/15 BLACK & JONES KEEFE CAMPBELL & ASSOC LLC 608 16WC 30256 BUFORD, LASHAUNDA TREEHOUSE FOODS 09/23/16 DWORKIN AND MACIARIELLO KEEFE CAMPBELL & ASSOC LLC 609 16WC 30322 METEL, ZBIGNIEW AMERICAN ALUMINUM EXTRUSI 03/28/16 BELLAS & WACHOWSKI

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 37 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 610 16WC 30515 DAYTON, BOBBIE FCA US LLC 06/30/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 611 16WC 30527 HANSEN, GLENN D STATE OF IL-CMS 12/30/14 FRANKS, GERKIN & MCKENNA P HELEN LOZANO 612 16WC 30721 LARSON, STUART L JOHNSTONE SUPPLY OF ROCKF 09/14/16 GESMER LAW OFFICES, PC RUSIN & MACIOROWSKI LTD 613 16WC 30816 GREINER, MICHAEL OAKLEY SUB ASSEMBLY 09/21/16 MARTIN V KUGIA 614 16WC 30883 MILLER SR., TONY AUSTIN WESTRAN 07/08/16 KATZ FRIEDMAN EAGLE ET AL WOLFE & JACOBSON, LTD 615 16WC 31018 JONES, FRED WINNEBAGO COUNTY SHERIFF 08/11/16 GESMER LAW OFFICES, PC WILLIAMS MCCARTHY LLP 616 16WC 31048 REYES, SUZANNE HOWARD JOHNSON 07/30/16 BLACK & JONES QUINTAIROS PRIETO WOOD & BOY 617 16WC 31075 JOHNSON, RALPH NYLINT CORP 10/11/14 GORI, JULIAN & ASSOC 618 16WC 31163 HUNGNESS, JASON LORI'S LITTLE CRITTERS * 08/27/16 BLACK & JONES 619 16WC 31183 HIGGS, MICHAEL GKN ROCKFORD INC 08/29/16 KATZ FRIEDMAN EAGLE ET AL RIPES NELSON BAGGOT KALOBRAT 620 16WC 31319 SOMERS, JEFFREY LOUIE'S TRENCHING SERVICE 09/23/16 GOLDBERG WEISMAN & CAIRO L PERRY GENTILE 621 16WC 31330 MANIGAULT, HEYARD II FCA US LLC 07/05/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 622 16WC 31459 JACKSON, KEVIN ANDROID INDUSTRIES 08/26/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 623 16WC 31494 HAWKINS, SHIRLEY THE VILLA AT PA PETERSON 06/27/16 GESMER LAW OFFICES, PC LAW OFFICES FRANCESCA LARSEN 624 16WC 31532 CALMESE, YUPELLE SNAK KING 02/10/16 WOLFE LAW PC 625 16WC 31590 LAMKIN, JOHN MILTRAN, INC 06/23/16 SCHWEICKERT & GANASSIN INMAN & FITZGIBBONS 626 16WC 31638 BEESON, MICHAEL L APET, INC. 08/25/16 RUBIN LAW GROUP INMAN & FITZGIBBONS 627 16WC 31834 HAREZLAK, JANICE ROCKFORD MEMORIAL HOSPITA 09/05/16 BLACK & JONES WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 38 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 628 16WC 31894 MASINGILL, NATHAN M JAMCO PRODUCTS, INC 02/16/15 CULLEN HASKINS NICHOLSON HEYL ROYSTER VOELKER & ALLEN 629 16WC 31967 CLARK, LISA ROCK VALLEY COLLEGE 06/12/14 NASH LAW OFFICE PC 630 16WC 31990 COESTER, JESSE SYSCO FOODS 08/09/16 BLACK & JONES GAROFALO SCHREIBER STORM 631 16WC 32062 HEATH-MCNALLY, NANCY D MERCY HEALTH SYSTEM 01/20/16 RICHARD O. GREENFIELD WIEDNER & MCAULIFFE LTD 632 16WC 32099 SVEDBERG, VIKTOR ROCKFORD ICE HOGS 02/14/14 GORDON LAW OFFICES LTD HENNESSY & ROACH PC 633 16WC 32568 BOURNE, DONNA NEIGHBORS NURSING HOME 05/01/16 BLACK & JONES BRADY CONNOLLY & MASUDA PC 16WC032569 -C 634 16WC 32825 BEACH, NICKITA SERVICOM 09/26/16 BLACK & JONES BRADY CONNOLLY & MASUDA PC 635 16WC 32902 DAVIS, PAUL INGERSOLL MACHINE TOOLS I 09/27/16 GESMER LAW OFFICES, PC RUSIN & MACIOROWSKI LTD 636 16WC 32939 BROWN, VINCENT FCA US LLC 10/28/15 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 637 16WC 33133 LEON, ANDREA PORTILLO'S 10/08/16 DWORKIN AND MACIARIELLO 638 16WC 33217 NEWLAND, MARCY L ANDROID INDUSTRIES/ 01/15/15 ALEXANDER, PETER LTD. WIEDNER & MCAULIFFE LTD 639 16WC 33220 HORTON JR., CHARLES ROCKFORD MASS TRANSIT 10/06/16 BLACK & JONES RUSIN & MACIOROWSKI LTD 640 16WC 33223 WARNER, KERRY FCA USA, LLC 08/22/16 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 16WC033224 -C 641 16WC 33266 JAMES, JANICE GUNITE CORPORATION 05/06/16 GESMER LAW OFFICES, PC 642 16WC 33409 BROUGHTON, MICHAEL ORKIN PEST AND TERMITE CO 11/01/14 BLACK & JONES BRADY CONNOLLY & MASUDA PC 643 16WC 33413 BAILEY, ANTHONY TRUGREEN LAWN CARE 09/12/16 BLACK & JONES GAROFALO SCHREIBER STORM 644 16WC 33589 PAXSON, MARILYN L THE HOME DEPOT 10/21/14 REESE & REESE ADELSON TESTAN & BRUNDO 645 16WC 33691 MOORE, TYRONE L ILLINOIS STATE POLICE @ 08/25/16 RIDGE & DOWNES HELEN LOZANO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 39 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 646 16WC 33750 CARLSON, JEFFREY AMERICAN EXTRUSION CORP 02/12/16 RIPES NELSON BAGGOT KALOBRAT 647 16WC 33859 RICE, MELVIN STAFF ON SITE UNITED INC * 10/04/16 TUITE LAW RUSIN & MACIOROWSKI LTD 648 16WC 33864 WEBSTER, HEIDI CITY OF ROCKFORD POLICE D 03/05/15 GESMER LAW OFFICES, PC ODELSON & STERK LTD 649 16WC 33896 REWERTS, CHAD BEST BUY 05/16/16 GESMER LAW OFFICES, PC 650 16WC 34014 BUCHANAN, ARLENE ROCKFORD MASS TRANSIT DIS 07/05/16 DWORKIN AND MACIARIELLO 651 16WC 34036 MYHRE, JEANNE FCA US LLC 03/02/15 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 652 16WC 34061 MILAM, SHANNON EASTER SEALS 08/03/16 BLACK & JONES 653 16WC 34064 HUDSON, FRANK RAC MANAGEMENT CO 10/10/16 BLACK & JONES 654 16WC 34214 KRUEGER, DOUGLAS ROCK RIVER VALLEY FLOORIN 07/02/15 CURTIS S BURKE LAW OFFICE 655 16WC 34591 STOREY, RHONDA AJ KENT, INC D/B/A 09/17/13 HENNESSY & ROACH PC 656 16WC 34828 FLEENER, CONNIE L HARLEM CONSOLIDATED SCHOO 02/29/16 REESE & REESE NYHAN BAMBRICK KINZIE & LOWR 657 16WC 35064 WILKEN, CLIFFORD HONEYWELL INTL, INC 01/20/16 HORWITZ HORWITZ & ASSOC 658 16WC 35147 MORGAN, ROBERT ACCURITE 04/04/16 DWORKIN AND MACIARIELLO RUSIN & MACIOROWSKI LTD 659 16WC 35309 KURTZ, ANTHONY UPS FREIGHT 09/14/16 GOLDBERG WEISMAN & CAIRO L 660 16WC 35390 BARRETT, SANDRA J PRESENCE CARE TRANSFORMAT 06/25/16 TUITE LAW 661 16WC 35435 DAY, LONNIE D BEHR AND SONS 09/10/16 REESE & REESE COZZI & GOGGIN-WARD 662 16WC 35568 TAYLOR, MARY WALMART 01/08/16 BLACK & JONES GANAN & SHAPIRO 663 16WC 35571 FREGOSO, EULOGIO TH FOODS, INC 02/06/16 BLACK & JONES RODDY LAW LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 40 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 664 16WC 35775 LEWIS, LEROY USF HOLLAND 11/29/15 BLACK & JONES 665 16WC 35851 CASTANEDA, JAIME H JOSEPH BEHR & SONS, INC 10/21/16 VELLA & LUND EVANS & DIXON, LLC 666 16WC 36081 TUFTE, JOSHUA WOODWARD 10/19/16 REESE & REESE 667 16WC 36298 SANDERS, MYRTLE CONCENTRIC 09/20/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 668 16WC 36418 WIENEN, TERRY TIMP LANDSCAPING 08/21/15 RUSIN & MACIOROWSKI LTD 669 16WC 36451 ELLIOTT, SHONTAE METRO STAFF INC. 11/21/16 DWORKIN AND MACIARIELLO 670 16WC 36459 BERRONES, ROBERTO ARAMARK CORRECTIONAL SERV 10/15/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 671 16WC 36462 DONEGAN, DELOREAN WALMART 06/06/16 BLACK & JONES QUINTAIROS PRIETO WOOD & BOY 672 16WC 36477 HINES, DAVON SECURITAS SECURITY SERVIC 10/23/16 BLACK & JONES STONE & JOHNSON CHARTERED 673 16WC 36492 MANRIQUEZ, MIGUEL ANDROID II 05/17/16 BLACK & JONES 674 16WC 36753 OWENS, TYRONE A SODEXO 11/15/16 GESMER LAW OFFICES, PC 675 16WC 36956 ORIA, JOE COMPUCOM SYSTEMS, INC 08/10/16 NASH LAW OFFICE PC 676 16WC 37054 GIBBONS, DENISE M SUMMERDALE EARLY * 11/28/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 677 16WC 37058 MILLER, LARRY YRC FREIGHT 07/30/16 RIDGE & DOWNES 678 16WC 37074 BURFIELD, STACY PCI 03/15/16 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 679 16WC 37153 CLENDENING, RANDY D MONDELEZ GLOBAL, LLC 07/09/15 TUITE LAW 680 16WC 37185 SMITH, DENNIS METRO STAFF INC 11/21/16 STRONG LAW OFFICE FRANCIS J DISCIPIO LAW OFFIC 681 16WC 37378 SMITH, K'MARIS METRO STAFF, INC 11/21/16 BLACK & JONES FRANCIS J DISCIPIO LAW OFFIC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 41 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 682 16WC 37502 DELAROSA, AURELLO CITY OF ROCKFORD 10/06/16 FOOTE MIELKE CHAVEZ & O'NE 683 16WC 37702 HUTCHISON, MARCIA HONEYWELL 10/03/16 BLACK & JONES RODDY LAW LTD 684 16WC 37736 MILLS, SCOTT IL DEPT OF TRANSPORTATION @ 10/12/16 WOLFE LAW PC HELEN LOZANO 685 16WC 37798 RUX, FRED STANDARD FORWARDING 03/01/16 BLACK & JONES HENNESSY & ROACH PC 686 16WC 38121 MATHEWSON, RITA K MERIDIAN CUSD #223 09/16/16 TUITE LAW WIEDNER & MCAULIFFE LTD 687 16WC 38130 BOE, BRAD ARACHNID 360 01/16/16 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 688 16WC 38183 WEXLER, SHEPARD FCA US LLC 06/15/15 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 689 16WC 38362 TIMUSH, SAMUEL ADVANCED DISPOSAL SERVICE 08/20/16 FRANKS, GERKIN & MCKENNA P 690 16WC 38514 VALDEZ, SILVIA P ANAM CARE, INC 05/16/16 ROSS TYRRELL 691 16WC 38529 BILLBERRY, CANDACE THERMO FISHER SCIENTIFIC, 07/27/16 FRANCINE B WHITE HOLECEK & ASSOCIATES 692 16WC 38644 FARRAR, SCOTT TITAL TIRE CORP 11/16/15 MILLON & PESKIN LTD 693 16WC 38858 WAGNER, MADENNA MARCY HEALTH 11/11/16 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 694 16WC 38889 JONES, JACOB R&D THIEL, INC 07/21/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 695 16WC 38892 WITHROW, DAVID CASSENS TRANSPORT 12/16/16 BLACK & JONES KNAPP, OHL & GREEN 696 16WC 38899 ROJAS, EFRAIN SWENSON SPREADER 11/05/14 BLACK & JONES 697 16WC 39035 ZAHN, JOHN BEVERLY MATERIALS, LLC 11/21/16 HORWITZ HORWITZ & ASSOC 698 16WC 39215 KUTZ, JEFFREY MEIJER 11/28/16 BLACK & JONES KOPKA, PINKUS DOLIN, PC 699 16WC 39237 CARR, MARY K LOWE'S DISTRIBUTION CENTE 01/26/15 CONSIDINE LAW OFFICES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 42 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 700 16WC 39349 THIELE, JENNA PRESENCE ST JOSEPH CENTER 06/10/16 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 701 16WC 39432 SULLIVAN, DAVID PROTEX INSTALLATIONS INC 09/26/16 BLACK & JONES WOLFE & JACOBSON, LTD 702 17WC 00093 WITT, STEPHANIE M WAL-MART STORES, INC. 03/18/16 LAW OFFICE PHILIP BLOMBERG QUINTAIROS PRIETO WOOD & BOY 703 17WC 00481 SIMPLOT, MELISSA FURSTSTAFFING 12/04/16 MILLON & PESKIN LTD 704 17WC 00536 MIKAROVSKI, TED SPRINGVALLEY FAMILY RESTA 12/21/16 BLACK & JONES KLAUKE LAW GROUP LLC 705 17WC 00685 MIELKE, LOUIS H SYNCREON NORTH AMERICA IN 11/16/16 PAUL W GRAUER & ASSOC WIEDNER & MCAULIFFE LTD 706 17WC 00719 JIMENEZ, FELIPDE GUERRILLA GRAFFIX 05/26/16 GESMER LAW OFFICES, PC 707 17WC 00982 BLAIR, ELGIA GORMAN & COMPANY 07/01/16 BLACK & JONES COZZI & GOGGIN-WARD 708 17WC 00999 MCMILLAN, MICHAEL R ASSURED STAFFING 12/06/16 BLACK & JONES ROSARIO CIBELLA 709 17WC 01002 WATTS, LAURA DICKEY STAFFING SOLUTIONS 06/01/16 BLACK & JONES THOMAS & PORTELA 710 17WC 01444 GARCIA, MARIA OPS EMPLOYMENT GROUP 09/10/16 HORWITZ HORWITZ & ASSOC WOLFE & JACOBSON, LTD 711 17WC 01496 PEAVY, BRENT CASSENS TRANSPORT 12/02/15 BLACK & JONES KNAPP, OHL & GREEN 712 17WC 01806 QUINTERO, ADOLFO JOHNS RESTAURANT 06/15/16 BLACK & JONES INMAN & FITZGIBBONS 713 17WC 01814 HUGHES, SHAKELA GUNITE CORP * 07/14/16 BLACK & JONES RUSIN & MACIOROWSKI LTD 714 17WC 01850 TELLIS, LAKHILA PRN HEALTH SVCS, INC 12/15/16 GESMER LAW OFFICES, PC ROSARIO CIBELLA 715 17WC 01992 WILSON, CURT LOVES PARK POLICE DEPT @ 08/06/14 RIDGE & DOWNES NYHAN BAMBRICK KINZIE & LOWR 716 17WC 02058 HENKE, JEFFREY GKN ROCKFORD, INC 01/20/17 KATZ FRIEDMAN EAGLE ET AL RIPES NELSON BAGGOT KALOBRAT 717 17WC 02224 HANNERS, JEROD ESTES EXPRESS LINES, INC. 11/02/16 MARKS & ASSOCIATES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 43 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 718 17WC 02303 MACKEY, MARTY GENERAL MILLS INC 05/01/16 NASH LAW OFFICE PC BRYCE DOWNEY & LENKOV LLC 719 17WC 02315 ST. VINCENT, ROBERT FCA US LLC 11/16/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 720 17WC 02347 MURRAY, TERESA ST ANTHONY MEDICAL CENTER 08/02/16 DWORKIN AND MACIARIELLO HINSHAW & CULBERTSON 721 17WC 02449 FORD, DAVID UTC AEROSPACE SYSTEMS 08/27/16 KATZ FRIEDMAN EAGLE ET AL MACIOROWSKI SACKMANN & ULRIC 722 17WC 02524 JACKSON, BRUCE BAY VALLEY FOODS 01/09/17 BLACK & JONES KEEFE CAMPBELL & ASSOC LLC 723 17WC 02640 SMITH, CAMERON MIKE HARRIS MASON CONTRAC 04/20/16 BLACK & JONES 724 17WC 02685 STERETT, CODY MP HVAC, INC 08/18/16 GESMER LAW OFFICES, PC 725 17WC 02697 BEITEL, CHAD MOUNT MORRIS POLICE DEPT 01/17/17 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 726 17WC 02740 BRINKER, VICTORIA FREEPORT HOUSING AUTHORIT 01/12/17 DWORKIN AND MACIARIELLO 727 17WC 02824 WOODS, ROBERT J LOWE'S HOME CENTERS, LLC 12/01/16 TUITE LAW 728 17WC 02860 ALBERT, TONY STANDARD FOOD DISTRIBUTOR 06/16/16 BLACK & JONES 729 17WC 02951 MANGRUEM, TIM EVOLUTION STAFFING 01/05/17 WOODRUFF & JOHNSON 730 17WC 03103 READY, STEVE RENTECH ENERGY MIDWEST CO 07/21/15 KATZ FRIEDMAN EAGLE ET AL THOMAS & PORTELA 731 17WC 03130 LEMIEUX, ROBERT RW DUTEMAN CO 05/19/14 DWORKIN AND MACIARIELLO 732 17WC 03496 ADAMS, GARY URBAN EQUITY PROPERTY 01/16/17 GESMER LAW OFFICES, PC RODDY LAW LTD 733 17WC 03641 TOTTEN, JUDY A MILESTONE, INC. * 08/09/16 TUITE LAW 734 17WC 03686 MANALLI, MARK FCA US LLC * 10/31/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 735 17WC 03760 YATTONE, MITCHELL SCHNUCKS * 01/02/17 DWORKIN AND MACIARIELLO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 44 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 736 17WC 03843 KASKE, JOSHUA MODERN ADVANCED * 09/30/16 KATZ FRIEDMAN EAGLE ET AL NYHAN BAMBRICK KINZIE & LOWR 737 17WC 03937 MARTINEZ, EULALIO CMM & ASSOCIATES * 10/17/16 COPLAN & CRANE, LTD 738 17WC 04116 AMES, CRAIG A WALMART * 06/25/16 HAUSER LAW LLC QUINTAIROS PRIETO WOOD & BOY 739 17WC 04171 BURG, BRAD AEROEK * 01/06/17 BLACK & JONES HEYL ROYSTER VOELKER & ALLEN 740 17WC 04230 MONTES, ROMELIA AMERICAN ALUMINUM EXTRUSI * 01/17/17 JONATHAN SCHLACK 741 17WC 04274 ALVARADO, ABRAHAM METALS USA * 02/07/17 DWORKIN AND MACIARIELLO 742 17WC 04584 GRAY, ROBERT TRIBUTE PRECAST * 11/14/14 WOLFE LAW PC 743 17WC 04643 CASTANEDA, ALICIA AUSTIN WESTRAN * 12/05/16 BLACK & JONES WOLFE & JACOBSON, LTD 744 17WC 04664 BROWN, ANTHONY DEARBORN MID-WEST COMPANY * 01/25/17 GESMER LAW OFFICES, PC 745 17WC 04686 JOHNSON JR, LLOYD F GCS SERVICES GROUP, INC * 08/01/16 ROSS TYRRELL 746 17WC 04990 MOHR, PAUL FABRICATORS AND MANUFACTU * 11/10/15 DWORKIN AND MACIARIELLO RUSIN & MACIOROWSKI LTD 747 17WC 05063 MORELL, ANDROCLES SAFEFALL * 01/07/17 BLACK & JONES LITCHFIELD CAVO 748 17WC 05151 REDD, LAURA REMEDIES RENEWING LIVES * 01/17/17 BLACK & JONES 749 17WC 05154 GARSHVA, MARIAN ROCKFORD MEMORIAL HOSPITA * 01/12/17 BLACK & JONES WIEDNER & MCAULIFFE LTD 750 17WC 05198 GONZALEZ, JAMIE RYDER TRUCK RENTAL * 01/03/17 BLACK & JONES 751 17WC 05327 PONCE-TORRES, MARGARITO FCA US LLC * 05/04/15 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 752 17WC 05420 WAINWRIGHT, GREGORY NAPA AUTO PARTS * 02/06/17 DWORKIN AND MACIARIELLO CHILTON YAMBERT PORTER LLP 753 17WC 05616 SCOTT, CHRISTOPHER JOBSMART EMPLOYMENT SVS, * 07/15/15 BLACK & JONES HOLECEK & ASSOCIATES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 45 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 754 17WC 05698 DION, KRISTINA NOODLES AND COMPANY * 02/15/17 DWORKIN AND MACIARIELLO 755 17WC 06004 BLACK, TAYLOR WALMART * 02/14/17 DWORKIN AND MACIARIELLO QUINTAIROS PRIETO WOOD & BOY 756 17WC 06029 WELLS, ELIZABETH A MCDONALD'S OF WINNEBAGO * 10/25/16 CACCIATORE, WILLIAM T BRYCE DOWNEY & LENKOV LLC 757 17WC 06092 ROOS, LAWRENCE BROADHEAD INVESTMENTS, IN * 02/06/17 BLACK & JONES COZZI & GOGGIN-WARD 758 17WC 06261 CLAEYSSEN, SEAN FURST STAFFING * 01/13/17 BLACK & JONES 759 17WC 06269 PEPPERS, LISA ROCKFORD SCHOOL DIST 205 * 04/23/16 BLACK & JONES 760 17WC 06427 EUELLS, TRACY A DELICATE PLASTICS INC * 02/13/17 TUITE LAW 761 17WC 06653 MANZANO, ARTURO EUCLID CHEMICAL * 11/01/14 BLACK & JONES RODDY LAW LTD 762 17WC 06681 MANESS, BRADLEY FED EX * 12/16/16 BLACK & JONES 763 17WC 06684 DAILEY, ANGEL LOWE'S DISTRIBUTION CENTE * 04/07/16 BLACK & JONES KEEFE CAMPBELL & ASSOC LLC 764 17WC 06687 MAYA, ALEJANDRO ROCKFORD TOOLCRAFT INC * 11/16/16 BLACK & JONES INMAN & FITZGIBBONS 765 17WC 06885 RENTERIA, DION FCA US LLC * 02/01/15 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 766 17WC 07045 BREEZ, BRENDA DANFOSS POWER SOLUTIONS * 11/01/15 DWORKIN AND MACIARIELLO 767 17WC 07074 GARCIA, RUBEN MID-STATE CONCRETE INDUST * 05/15/16 BLACK & JONES 768 17WC 07116 PARLEE, KRISTEN L STARBUCKS * 11/05/16 FRANCINE B WHITE 769 17WC 07666 YOCUM, DOUGLAS JP CULLEN & SONS * 01/14/17 HORWITZ HORWITZ & ASSOC 770 17WC 07775 SCUDDER, KHAD ARAMARK * 12/28/16 GESMER LAW OFFICES, PC 771 17WC 07882 MORELL, ANDROCLES MARCCO RODRIGUEZ DBA * 01/07/17 BLACK & JONES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 46 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 772 17WC 07950 KHEMPASEUTH, MONICA LEADING EDGE HYDRAULICS * 07/25/16 BLACK & JONES 773 17WC 07953 MC CLINE, DONTE QPS EMPLOYMENT GROUP * 02/24/17 BLACK & JONES WOLFE & JACOBSON, LTD 774 17WC 08169 MURPHY, STEVE PAYNECREST ELECTRIC, INC * 02/27/17 GESMER LAW OFFICES, PC CLAYBORNE SABO & WAGNER 775 17WC 08195 SWANGREN, NEAL FRITO LAY * 01/18/17 BLACK & JONES 776 17WC 08618 LANE, JOSEPHINE F ACOSTA SALES & MARKETING * 06/15/16 HAUSER LAW LLC SPIEGEL & CAHILL, PC 777 17WC 08684 ORAMA, LUIS CALIBER CONSTRUCTION CO * 02/09/17 BLACK & JONES QUINTAIROS PRIETO WOOD & BOY 778 17WC 08687 BAUMGARTNER, MICHAEL AIRGAS STORE * 11/15/16 BLACK & JONES MC ANDREWS & NORGLE LLC 779 17WC 08708 THOMPSON, ROSIE SNAK KING * 03/06/16 BLACK & JONES 780 17WC 08720 TURNER, DARRELL DASCO PRO, INC * 11/23/15 GESMER LAW OFFICES, PC 781 17WC 08770 FISH, KATHERINE ILLINOIS NATIONAL GUARD @ * 08/14/16 ERIC H CHECK, LAW OFFICES 782 17WC 09060 ROBERTS, EDWARD MARTIN & COMPANY EXCAVATI * 08/28/16 HORWITZ HORWITZ & ASSOC 783 17WC 09076 BOROWICZ, JULIE PARKSIDE WAREHOUSE, INC * 11/01/16 BLACK & JONES RIPES NELSON BAGGOT KALOBRAT 784 17WC 09079 NEEL, DAVID JR IDOT @ * 04/18/16 FRANCINE B WHITE HELEN LOZANO 785 17WC 09090 ALMOND, TINA DANFOSS * 12/14/16 GESMER LAW OFFICES, PC WOLFE & JACOBSON, LTD 786 17WC 09226 MONTES, ELIZABETH WIS INTERNATIONAL * 02/21/17 BLACK & JONES HENNESSY & ROACH PC 787 17WC 09267 ISHAM, STEPHEN YRC WORLDWIDE * 12/18/15 FRANKS, GERKIN & MCKENNA P 788 17WC 09347 NIETO, OSCAR FURST SERVICES CO, D/B/A * 10/31/16 ACCIDENT FUND HOLDINGS 789 17WC 09405 PRINNER, ROBIN UPS FREIGHT * 02/17/14 GESMER LAW OFFICES, PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 47 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 790 17WC 09487 HERNANDEZ, OLIDA MORENO QPS STAFFING SERVICES, IN * 03/04/17 BLACK & JONES 791 17WC 09692 ROCKWOOD, STEVEN ARCHITECTURAL PRODUCTS * 03/02/17 BLACK & JONES NYHAN BAMBRICK KINZIE & LOWR 792 17WC 09696 CACIC, MEJREMA INGERSOLL CUTTING TOOLS * 02/04/15 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 793 17WC 10163 ALVAREZ, FRANCISCO R&D THEIL * 01/20/17 DWORKIN AND MACIARIELLO 794 17WC 10221 PENA, JESUS ROCKNEL FASTENERS INC * 02/27/17 BLACK & JONES 795 17WC 10224 BENNETT, GREG JB CONTRACTING * 03/13/17 BLACK & JONES 796 17WC 10392 RAIH, PATRICIA ADDUS HEALTH CARE * 12/13/16 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 797 17WC 10449 FLINT, JEROME ROCKFORD TWP HIGHWAY OFFI * 03/29/17 BLACK & JONES JAMES M KELLY 798 17WC 10592 JACOBSON, DAVID WINNEBAGO COUNTY SHERIFF * 03/22/17 NASH LAW OFFICE PC 799 17WC 10606 MISIASZEK, MARIUSZ S CITY OF ROCKFORD * 03/29/17 REESE & REESE 800 17WC 10641 STILES, THOMAS CINTAS * 02/18/16 THE ROMAKER LAW FIRM POWER & CRONIN LTD 801 17WC 10711 MOYER, RODNEY C M&N SPROULE CONSTRUCTION * 08/16/16 MCANANY VANCLEVE & PHILLIPS 802 17WC 10811 ASHFORD, PATRICIA M SUPER NURSE, LLC * 01/31/17 REESE & REESE 803 17WC 10963 SMALLEY, DAVID INDEV GAUGING SYSTEMS, IN * 10/01/16 BLACK & JONES 804 17WC 11051 HOLDER, DANIELLE M GENERAL MILLS INC * 01/23/17 TUITE LAW 805 17WC 11056 DAUGHERTY, JENNIFER BERGSTROM MANUFACTURING C * 04/01/15 BLACK & JONES 806 17WC 11066 RODRIGUEZ, NEYEL PEREZ SPHERION STAFFING SERVICE * 03/23/17 BLACK & JONES SLAVIN & SLAVIN 807 17WC 11407 PETERSON, MICHAEL ROCK RIVER DISPOSAL * 03/30/17 BLACK & JONES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 48 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 808 17WC 11539 MCLAUGHLIN, RYAN LDR CONSTRUCTION SERVICES * 04/06/17 DWORKIN AND MACIARIELLO HENNESSY & ROACH PC 809 17WC 11560 HURSH, WILLIAM ROCKFORD SCHOOL DISTRICT * 07/01/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 810 17WC 11620 MERSHON, GARY ILLINOIS BELL TELEPHONE C * 12/16/16 GESMER LAW OFFICES, PC 811 17WC 11680 MCVAY, JORDAN BEHR IRON METAL * 03/01/17 GESMER LAW OFFICES, PC 812 17WC 12066 SCHNEIDER, JAMES TREE HOUSE FOODS INC * 01/20/17 KATZ FRIEDMAN EAGLE ET AL 813 17WC 12124 GROEZINGER, ARLENE S BREWSTER CHEESE * 11/10/16 TUITE LAW 814 17WC 12132 VYBORNY, VERNON J HAMILTON SUNDSTRAND CORP * 02/13/17 TUITE LAW MACIOROWSKI SACKMANN & ULRIC 815 17WC 12488 LUX, CONSTANCE BON TON DISTRIBUTION CTR * 12/27/16 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 816 17WC 12519 MOTA, MARIA CAVE ENTERPRISES D/B/A * 02/22/17 CLARK FROST 817 17WC 12824 HAWKINS, WILLIAM VICTORY OUTREACH CHURCH * 06/28/16 CLARK FROST 818 17WC 12829 BURRELL, CHERRY ANN ABM JANITORIAL SERVICES * 03/24/17 BLACK & JONES 819 17WC 12925 DAVIS, EDWARD CITY OF ROCKFORD * 04/17/17 ANKIN LAW OFFICE 820 17WC 12991 YEOMAN, ERIC BERNER FOODS, INC. * 06/08/15 HAUSER LAW LLC 821 17WC 13129 WHEELER, JACOB CORPORATE SERVICES, INC * 04/06/17 MCNAMARA PHELAN MCSTEEN LL 822 17WC 13175 PHILLIPS, DENNIS FASTENAL * 07/07/16 FRANKS, GERKIN & MCKENNA P 823 17WC 13199 RUIZ, JOHN WELCH BROS, INC * 10/01/14 BLACK & JONES 824 17WC 13202 MACHADO, FELIPE A ROCKFORD MOLDED PRODUCTS * 11/17/16 FRANCINE B WHITE 825 17WC 13215 FERGUSON, SHANTICIA DD HOMES NETWORK * 04/04/17 BLACK & JONES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 49 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45003 ON 06/13/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 826 17WC 13248 SIMS, DIANE INGERSOLL CUTTING TOOL * 10/28/16 JOHN E LUSAK 827 17WC 13340 MAHURIN, DAYNA SEPTRAN, INC * 04/02/15 TIMOTHY J. FREIBERG 828 17WC 13411 BRUGMAN, JAMES A JR. FCA US LLC * 07/21/16 WIEDNER & MCAULIFFE LTD 829 17WC 13433 GREER, JEREMY CARDINAL GLASS * 01/31/17 MEYERS & FLOWERS 830 17WC 13481 JOHNSON, PAUL R.L. LEEK INDUSTRIES * 04/30/11 BLACK & JONES 831 17WC 13557 LAXNER, JOHN KANE TRANSPORT, INC * 08/09/16 KATZ FRIEDMAN EAGLE ET AL 832 17WC 13669 HANSON, MIKE WOODWARD, INC * 11/16/16 BLACK & JONES 833 17WC 13674 HORTON, TYRONE DELICATE PLASTICS * 02/16/17 BLACK & JONES 834 17WC 13753 EAGLESON, SHALENE CITY OF ROCKFORD POLICE D * 03/27/17 GESMER LAW OFFICES, PC 835 17WC 13950 NANO, ESMAEL INTERLINK AUTO TRANSPORT, * 10/08/16 LAW OFFICES OF JOSEPH YOUN 836 17WC 14010 PUMFREY, DONALD W RHOADS RICHARD & MARYANN * 01/06/16 GILDEA & COGHLAN 837 17WC 14084 LIAMBAS, MIKE ROCKFORD ICE HOGS * 10/17/15 FLOYD LAW FIRM 838 17WC 14087 WALTERS, DANE ROCKFORD ICE HOGS * 04/12/15 FLOYD LAW FIRM 839 17WC 14103 FERGUSON, YOLANDA FCA US LLC * 05/23/15 KATZ FRIEDMAN EAGLE ET AL