ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 1 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 1 10WC 18795 ANDERSON, DOUGLAS C. WILLENBORG HARDWOOD 04/01/10 MEYER, MICHAEL J KNELL LAW LLC 2 10WC 37165 ANDERSON, AMY S WARREN G MURRAY DEVELOPME @ 04/26/10 THE FREDERICK LAW FIRM ILLINOIS ATTORNEY GENERAL 16WC004421 -C 3 11WC 08861 PAYNE, THOMAS L NORTH AMERICAN LIGHTING 02/22/11 NELSON & NELSON LAW OFFICES STEPHEN CARTER 14WC016361 -C 18WC007304 -C 4 12WC 15483 FATHEREE, DEVRA STATE OF ILLINOIS @ 03/05/11 ERIC L TERLIZZI ILLINOIS ATTORNEY GENERAL 5 12WC 20753 19B ROWLAND, ANNETTE F MURRAY DEVELOPMENTAL CENT @ 11/01/10 STRONG LAW OFFICE ILLINOIS ATTORNEY GENERAL 6 12WC 36246 BROWN, GREGG WALGREENS DISTRIBUTION CE 03/22/10 BROWN & BROWN EVANS & DIXON, LLC 7 12WC 36681 MILLER, TINA WARREN G MURRAY CENTER @ 04/23/12 NELSON & NELSON ILLINOIS ATTORNEY GENERAL 8 13WC 02303 BULLARD, BILL CONTINENTAL TIRE 01/29/12 BEMENT & STUBBLEFIELD 9 13WC 05300 HUNT, MICHAEL EDWARD SR GENE L JANSEN D/B/A W 08/27/10 BECKER SCHROADER & CHAPMAN KEVIN M HAZLETT LLC 10 13WC 06868 MEREDITH, DORIS GOOD SAMARITAN 01/26/13 BROWN & BROWN EVANS & DIXON, LLC 13WC010156 -C ST MARYS GOOD SAMARITAN HO 11 13WC 17182 HOWARD, JAMES RCR TRUCKING, INC W 05/04/12 NELSON & NELSON SCOPELITIS GARVIN LIGHT 12 13WC 18559 GREGG, JOHN M LITTLE D DRILLING 04/22/13 WOMICK LAW FIRM CHTD KEEFE & DEPAULI 13 13WC 36352 BANDY, SHARON KAY CROOK HOYLETON YOUTH & FAMILY S 07/19/13 GALANTI LAW OFFICES LITCHFIELD CAVO 14 13WC 38820 ROBERTS, MATTHEW CONTINENTAL TIRE 06/08/13 BEMENT & STUBBLEFIELD KEEFE & DEPAULI 15 13WC 39001 ROBERTS, MATTHEW CONTINENTAL TIRE 09/23/13 BEMENT & STUBBLEFIELD KEEFE & DEPAULI 16 14WC 05194 CROSS, REBECCA WARREN G MURRAY DEVELOPME @ 12/05/13 JEROME LINDSAY SALMI LL ILLINOIS ATTORNEY GENERAL

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 2 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 17 14WC 06466 HOWARD, JAMES UNIMARK TRUCK TRANSPORT L 05/04/12 NELSON & NELSON SCOPELITIS GARVIN LIGHT 18 14WC 09420 KRIBLEY, LAUREN DOLLAR GENERAL 08/18/13 KATZ FRIEDMAN EAGLE ET AL LEAHY EISENBERG & FRAENKEL 14WC024060 -C 19 14WC 17753 19B GORDON, MELISSA MURRAY CENTER @ 02/26/14 CARAWAY FISHER ILLINOIS ATTORNEY GENERAL 20 14WC 21695 SWIFT, DEVAN A WABASH & OHIO VALLEY SPEC 09/10/13 LEVENHAGEN LAW FIRM PC 14WC021696 -C 21 14WC 27729 WILSON, RODNEY MOORE BROTHERS CONTRACTIN 06/09/14 COSTA IVONE LLC STEPHEN H LARSON LAW OFFICE 22 14WC 40654 LEIGH, MARTY PAUL CAMPBELL ENTERPRISES 09/10/14 JEROME LINDSAY SALMI LL STEPHEN H LARSON LAW OFFICE 23 15WC 10077 REEVES, JAMES ROSENS DIVERSIFIED 07/02/14 CHERRY FRAZIER & SABIN HENNESSY & ROACH, PC 24 15WC 22609 WIMBERLY, HEATHER GOOD SAMARITAN REGIONAL H 11/27/13 HASSAKIS & HASSAKIS PC EVANS & DIXON, LLC 25 15WC 26397 BLUE, BRIAN SCHILLI SPECIALIZED, INC. 07/22/15 STRONG LAW OFFICE HEYL ROYSTER VOELKER & ALLEN 26 15WC 29432 HOLLAND, BONNIE WARREN G MURRAY @ 09/03/15 NELSON & NELSON ILLINOIS ATTORNEY GENERAL 27 15WC 31324 SPHAR, JIM EFFINGHAM EQUITY 09/03/15 KATZ FRIEDMAN EAGLE ET AL KEEFE CAMPBELL & ASSOC LLC 28 15WC 34310 GAINES, VICKY COUNTRYSIDE MANOR NURSING 08/10/15 BROWN & BROWN HEYL ROYSTER VOELKER & ALLEN 29 15WC 42176 WINKLER, JODI LYNN BROWNSTOWN SCHOOL DISTRIC 08/06/13 NELSON & NELSON BRADY, CONNOLLY & MASUDA, PC 30 15WC 42481 KUHNERT, CHARLES CONTINENTAL TIRE OF NORTH @ 07/20/15 ALLEMAN LAW FIRM KEEFE & DEPAULI 15WC042482 -C 31 16WC 03895 NICKOL, TIMOTHY JOHN LAWRENCEVILLE COMM SCHOOL 07/22/15 WARREN E DANZ, PC RUSIN & MACIOROWSKI LTD 32 16WC 06877 BRADHAM, JANUARY L DAVITA DIALYSIS 10/10/15 HASSAKIS & HASSAKIS PC WIEDNER & MCAULIFFE LTD 33 16WC 09330 COPE, ERIC NATIONAL RAILWAY EQUIPMEN 11/22/15 BROWN & BROWN GAROFALO SCHREIBER STORM GRA

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 3 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 34 16WC 10590 MEREDITH, DARLENE WALGREENS DISTRIBUTION CE 02/22/16 JEROME LINDSAY SALMI LL EVANS & DIXON, LLC 35 16WC 11116 CRAIG, ROGER CONTINENTAL TIRE 10/24/14 WOMICK LAW FIRM CHTD KEEFE & DEPAULI 36 16WC 13581 WOOD, GLENNA HAMILTON MEMORIAL HOSPITA 09/09/15 GOLDENBERG, HELLER, ANTOGN GAROFALO SCHREIBER STORM GRA 37 16WC 15774 MC DURMAN, GAIL WHITE COUNTY AMBULANCE 05/08/14 MUELHAUSEN & STEFANI KEEFE & DEPAULI 38 16WC 18670 ROBINSON, CHARLES THOMAS ROARK TRUCKING 02/12/14 PETER BLASI LLC JAMES M KELLY 39 16WC 18881 ARNOLD, TONYA AMY SCHULZ CHILD ADVOCACY 05/05/14 DANIELS WILZBACH PC BRADY, CONNOLLY & MASUDA, PC 40 16WC 20095 MORGAN-SMITH, TAYLOR A LOWES, INC 07/11/15 JAMES RUPPERT KEEFE CAMPBELL & ASSOC LLC 41 16WC 23749 TAYLOR, RICKY O'DANIEL TRUCKING 04/26/16 HENNESSY & ROACH 42 16WC 24436 WALLACE, MATHEW L. RESPONDEK RAILROAD 04/17/14 HASSAKIS & HASSAKIS GAROFALO SCHREIBER STORM GRA 43 16WC 25772 WALTZ, PATRICK VANDALIA CORRECTIONAL CEN @ 04/21/16 BECKER SCHROADER & CHAPMAN ASSISTANT ATTORNEY GENERAL 44 16WC 26017 CRAMER, MICHAEL HELLA ELECTRONICS CORP 01/25/16 KATZ FRIEDMAN EAGLE ET AL ROUSE & CARY 45 16WC 28125 DERRINGER, MATTHEW DEFENDER SERVICES, INC 07/13/16 JEROME LINDSAY SALMI LL LAW OFFICE PAUL LARIMORE 46 16WC 28570 SOVA, MATHEW CONTINENTAL TIRE, THE AME 01/24/15 WENDLER LAW PC KEEFE & DEPAULI 47 16WC 29264 SMILLIE, JERRY HAMILTON COUNTY COAL/ ALL 02/05/16 CULLEY FEIST KUPPART & JOR FEIRICH MAGER GREEN & RYAN 48 16WC 30725 KISELEWSKI, PEGGY CONTINENTAL TIRE NA 04/21/16 HANAGAN & MCGOVERN PC KEEFE & DEPAULI 49 16WC 31933 GROSS, HENRY WHITE COUNTY COAL 09/09/16 KOLKER LAW OFFICES FEIRICH MAGER GREEN & RYAN 50 16WC 32329 GONZALES, DAVID INNOVATIVE STAFF SOLUTION 09/07/16 BRUCE WARREN 51 16WC 33102 HUGGINS, JERAD DCA CONSTRUCTION 09/13/16 CERVANTES & ASSOC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 4 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 52 16WC 33350 PHILLIPS, MARK CONTIENTAL TIRE 09/10/16 NELSON & NELSON KEEFE & DEPAULI 53 16WC 35791 ENGLIN, JORDON LEE D.E MARTIN ROOFING COMPAN 11/07/16 BECKER SCHROADER & CHAPMAN JAMES M KELLY 54 16WC 35927 REED, JESSICA NORTH AMERICAN LIGHTING, 09/25/16 DANIELS WILZBACH PC LAW OFFICES STEPHEN CARTER 55 17WC 00058 GOBTOP, TONY UNIFIED STAFFING 10/12/16 GARY L. BEMENT 56 17WC 00909 ARNOLD, GREG STATE OF ILLINOIS @ 12/07/16 CORNFIELD & FELDMAN ILLINOIS ATTORNEY GENERAL 57 17WC 02520 EAGAN-ROBBINS, MARY WALGREENS DISTRIBUTION CT 12/17/14 JEROME LINDSAY SALMI LL EVANS & DIXON, LLC 58 17WC 02719 RHODES, TEODORE J ILLINOIS STATE POLICE @ 02/27/15 RIDGE & DOWNES ASSISTANT ATTORNEY GENERAL 17WC002721 -C 59 17WC 03054 KEOUGH, DAVID FGM LOGISTICS 01/03/17 KEEFE & GRIFFITHS PC 60 17WC 03089 CAMPISE, SAM CHAD NIC PROPERTIES DBA 09/20/16 STRONG LAW OFFICE WIEDNER & MCAULIFFE LTD 61 17WC 03759 MCCLENDON, TAMMY COMPASS GROUP 01/06/16 DWORKIN AND MACIARIELLO GOLDBERG SEGALLA LLC 62 17WC 04149 HUTSON, JANICE WHITE COUNTY COAL 11/13/16 CULLEY FEIST KUPPART & JOR FEIRICH MAGER GREEN & RYAN 63 17WC 06068 COLONI, STEVE ALLIANCE COAL 02/01/16 CULLEY FEIST KUPPART & JOR FEIRICH MAGER GREEN & RYAN 64 17WC 07105 VAIL, BONNIE UPS 09/17/15 HELLER HOLMES & ASSOC MCANANY VANCLEVE & PHILLIPS 65 17WC 07154 GILLENWATER, CARL NORTH AMERICAN LIGHTING 10/04/16 RICH RICH COOKSEY & CHAPPE LAW OFFICES STEPHEN CARTER 66 17WC 07280 BUFF, JOLEEN P MAYCE CLARKSON DBA MAYCE' W 12/07/16 HASSAKIS & HASSAKIS ASSISTANT ATTORNEY GENERAL 67 17WC 08050 BISHOP, DUSTIN J ALLIANCE COAL, LLC 01/15/16 JAMES RUPPERT FEIRICH MAGER GREEN & RYAN 68 17WC 08473 O'HARA, JAMES BIG MUDDY CORRECTIONAL CE @ 03/10/17 WINTERS BREWSTER CROSBY ET ILLINOIS ATTORNEY GENERAL 69 17WC 09516 MULDER, MARK EGYPTIAN EXPOSITION 10/20/16

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 5 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 70 17WC 11664 PEARSON, MELISSA MURRAY DEVELOPMENTAL CTR @ 09/12/16 HASSAKIS & HASSAKIS PC ASSISTANT ATTORNEY GENERAL 71 17WC 12525 NELSON, CHARLENE CEFS ECONOMIC OPPORTUNITY 07/15/14 TAYLOR LAW OFFICES ROBERT L. SMITH 72 17WC 12999 MIDDLETON, TOM TOYOTA BOSHOKU ILLINOIS, 09/01/16 MOSS & MOSS PC HENNESSY & ROACH, PC 73 17WC 13140 MIDDLETON, TOM TOYOTA BOSHOKU ILLINOIS, 09/05/16 MOSS & MOSS PC HENNESSY & ROACH, PC 74 17WC 13485 MISCHKE, MELODY J SSM HEALTH GOOD SAMARITAN 01/22/17 RICH RICH COOKSEY & CHAPPE EVANS & DIXON, LLC 75 17WC 13503 WINTERMANN, JOHN NAL - NORTH AMERICAN LIGH 12/07/16 LAW OFFICES TIMOTHY HENDER STEPHEN CARTER 76 17WC 13762 JOHNSON, DEBRA CIRCLE K 05/04/16 JEROME LINDSAY SALMI LL NYHAN BAMBRICK KINZIE & LOWR 77 17WC 17490 19B HARDY, RANDY THE SHERWIN WILLIAMS COMP 05/01/17 LEVENHAGEN LAW FIRM PC GANAN & SHAPIRO 78 17WC 18886 MANDRELL, SHELLY WALGREENS 06/02/17 BECKER SCHROADER & CHAPMAN EVANS & DIXON, LLC 79 17WC 19448 WILLIS, KAREN VANSEAL CORPORATION 07/25/16 NELSON & NELSON STEPHEN H LARSON LAW OFFICE 80 17WC 20146 BLAIR, MARLON M-CLASS MINING, LLC 08/25/16 CULLEY & WISSORE CRAIG & CRAIG 81 17WC 20204 WILLMORE, TIMOTHY CONTINENTAL TIRE 06/14/17 GARY L. BEMENT KEEFE & DEPAULI 82 17WC 20585 DOWELL, BRITTANY TONY WALKER D/B/A WALK'N 04/18/17 MERKLEY & SHIELDS LLC 83 17WC 21597 FLENER, RUSSELL WABASH VALLEY SERVICE COM 06/14/17 NELSON & NELSON HEYL ROYSTER VOELKER & ALLEN 84 17WC 21812 BUENING, CHERYL MR VERNON TOWNSHIP HSD #2 04/27/17 NELSON & NELSON WIEDNER & MCAULIFFE LTD 85 17WC 22344 PIERCE, ROXIE R WALGREENS FAMILY OF COMPA 03/04/15 HASSAKIS & HASSAKIS PC EVANS & DIXON, LLC 86 17WC 23492 GRINOLS, RHONDA FAIRFIELD HOSPITAL 02/06/17 BROWN & BROWN GAROFALO SCHREIBER STORM GRA 87 17WC 23949 SPENCER, EVA DARLENE NORTH AMERICAN LIGHTING 08/30/16 BROWN & BROWN LAW OFFICES STEPHEN CARTER

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 6 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 88 17WC 24059 BOSNJAKOVIC, BERIZ HAZE TRUCKING, LLC 07/25/17 CANTOR & BURGER 89 17WC 24081 DONALDSON, DALE A MIDLAND STATES BANK 08/25/14 MEYER, MICHAEL J ROUSE & CARY 90 17WC 24551 NIEDBALSKI, KEVIN XPO LOGISTICS, INC 11/05/15 NELSON & NELSON RUSIN & MACIOROWSKI LTD 91 17WC 25138 YOST, SUE WALGREENS 10/05/16 TAYLOR LAW OFFICES 92 17WC 25642 WOLFORD, BILLY HODGSON MILL 03/10/17 SMITH LAW LTD KOPKA, PINKUS DOLIN, PC 93 17WC 25868 PORTER, DAVID E CONTINENTAL TIRE 04/19/17 JAMES RUPPERT KEEFE & DEPAULI 94 17WC 25964 STRAIN, ANTHONY NORTH AMERICAN LIGHTING 05/04/17 CULLEN HASKINS NICHOLSON LAW OFFICES STEPHEN CARTER 95 17WC 26879 GARNER, DAVID WHITE COUNTY COAL 07/14/17 CULLEY FEIST KUPPART & JOR FEIRICH MAGER GREEN & RYAN 96 17WC 27674 BUCKLEY, MICHELLE HERSHEY CO 07/19/16 TAYLOR LAW OFFICES WIEDNER & MCAULIFFE LTD 97 17WC 27992 RAINWATER, PAUL IL DEPT OF CORRECTIONS @ 08/02/17 GARY L. BEMENT ASSISTANT ATTORNEY GENERAL 98 17WC 28175 WILLIAMS, MEGAN MURRAY CENTER @ 06/19/17 HUSTAVA, JOHN H ASSISTANT ATTORNEY GENERAL 99 17WC 28349 LEAF, NELLIE NORTH AMERICAN LIGHTING 08/23/17 DWORKIN AND MACIARIELLO LAW OFFICES STEPHEN CARTER 100 17WC 28399 JOSEPH, STANLEY GREYHOUND LINES INC 09/10/17 101 17WC 30102 JIMENEZ, JEFFREY CAPSTONE LOGISTICS 08/09/17 CARAWAY FISHER HENNESSY & ROACH, PC 102 17WC 30155 HIGGINS, STEVEN BEELMAN READY-MIX, INC 08/23/17 JEROME LINDSAY SALMI LL HARRIS DOWELL FISHER & HARRI 18WC001724 -C 103 17WC 30850 GOTTBERG, CHRISTINA WALGREENS CO 06/30/17 LEVENHAGEN LAW FIRM PC EVANS & DIXON, LLC 104 17WC 30897 WELLS, JONELLE SSM HEALTH ST MARY'S HOSP 04/29/17 RICH RICH COOKSEY & CHAPPE EVANS & DIXON, LLC 105 17WC 31580 NAAS, GARY HAMILTON COUNTY COAL LLC 01/26/17 CULLEY & WISSORE FEIRICH MAGER GREEN & RYAN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 7 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 106 17WC 32250 DELGADO, JOSE A CENTRALIA CORRECTIONAL @ 09/27/17 HASSAKIS & HASSAKIS PC ASSISTANT ATTORNEY GENERAL 107 17WC 32445 WELLS, JONELLE SSM HEALTH ST MARY'S HOSP 08/27/17 RICH RICH COOKSEY & CHAPPE EVANS & DIXON, LLC 108 17WC 33125 LEAF, NELLIE NORTH AMERICAN LIGHTING 08/23/17 DWORKIN AND MACIARIELLO STEPHEN CARTER 109 17WC 33860 LOTT, ROBBY CTC EXPORTS INC 05/13/15 MCCARTHY ROWDEN & BAKER 110 17WC 33997 MCCOY, THOMAS OAK HILL CONTRACTING 10/16/17 HOWERTON, DORRIS & STONE HEYL ROYSTER VOELKER & ALLEN 111 17WC 34348 WHEELER, GABRIEL HAMILTON COUNTY COAL 09/24/17 MATHIS MARIFIAN RICHTER FEIRICH MAGER GREEN & RYAN 112 17WC 34423 ELLER, CHESTER WALGREENS DISTRIBUTION CE 10/14/17 KATZ FRIEDMAN EAGLE ET AL EVANS & DIXON, LLC 113 17WC 34451 BRANTON, JACOB D SHETLEY INVESTMENTS DBA 09/22/17 WALTON TELKEN LLC 114 17WC 35110 OGLESBY, LLOYD HAMILTON COUNTY COAL LLC 11/21/16 JELLIFFE FERRELL DOERGE PH 115 17WC 35443 ELDRIDGE, VERNA WAL-MART 10/16/17 RICH RICH COOKSEY & CHAPPE EARLY & MIRANDA PC 116 17WC 37186 HOLLAND, BONNIE WARREN G MURRAY DEVELOPME @ 05/12/17 NELSON & NELSON ASSISTANT ATTORNEY GENERAL 117 17WC 37355 GONZALEZ-VARGAS, JETZARI CHAD HOLLIS CONSTRUCTION # 08/07/15 BLUNT & ASSOC 118 17WC 37365 ELLIS, DONALD M-CLASS MINING, LLC 11/30/16 CULLEY & WISSORE CRAIG & CRAIG 119 17WC 37459 SHOWALTER, KEVIN DAVIS HOUK MECHANICAL 12/01/17 DWORKIN AND MACIARIELLO STEPHEN H LARSON LAW OFFICE 120 17WC 37618 ESKER, JANET ALDI INC 08/28/16 TAYLOR LAW OFFICES LYNN D BARNETT 121 18WC 00567 FOR ESTATE OF PEGGY DODSO CENTRALIA ESTATES 10/17/17 NELSON & NELSON GANAN & SHAPIRO 122 18WC 01106 GATISON, RICHARD WERNER ENTERPRISE INC 09/26/17 ALEKSY BELCHER SMITH AMUNDSEN LLC 123 18WC 02034 VINYARD, GRETCHEN HARDIN COUNTY COMMUNITY 10/25/16 SAM C MITCHELL & ASSOCIATE

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 8 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 124 18WC 02586 FINDLEY, JENNIFER CONTINENTAL TIRE 05/11/16 WENDLER LAW PC KEEFE & DEPAULI 125 18WC 03137 PORTER, DONTAE CONTINENTAL TIRE 01/08/18 NELSON & NELSON 126 18WC 03817 SMITH, DEVIN W SPS OF ALABAMA, LLC 10/13/17 HUNTER LAW FIRM 127 18WC 04818 SAUNDERS, SHELENE SPS OF ALABAMA 03/02/17 BROWN & BROWN 18WC005325 -C 128 18WC 05349 SOLES, BETH GRUPO ANTOLIN 10/08/17 NELSON & NELSON WIEDNER & MCAULIFFE LTD 18WC005336 -C 18WC005394 -C 129 18WC 06234 JOHNSON, RICHARD L M-CLASS MINING, LLC 08/05/15 CULLEY & WISSORE CRAIG & CRAIG 130 18WC 06244 EUBANKS, ROBERT GMS MINE REPAIR 04/13/17 CULLEY & WISSORE CRAIG & CRAIG 131 18WC 06435 SANDSCHAFER, COREY L SHERWIN-WILLIAMS DISTRIBU 08/11/17 HASSAKIS & HASSAKIS PC 132 18WC 06558 JACOBS, GLENN A WHITE COUNTY COAL, LLC. 11/18/16 CULLEY & WISSORE FEIRICH MAGER GREEN & RYAN 133 18WC 06866 YORK, JASON R LOWERY'S FIBERGLASSING 09/11/17 HEIDI A. HOFFEE STEPHEN H LARSON LAW OFFICE 134 18WC 08588 DAVID, SHARON NORTH AMERICAN LIGHTING 12/01/17 JEROME LINDSAY SALMI LL STEPHEN CARTER 135 18WC 09813 EVANS, JOAN ST ELMO LIBRARY DISTRICT 03/21/16 TAYLOR LAW OFFICES LIVINGSTONE MUELLER ET AL 136 18WC 10098 HIGGINS, ROBERT E II WAREHOUSE DESIGN & SERVIC 08/02/16 SCHUCHAT, COOK & WERNER MCDONALD & BOGDAN 137 18WC 10850 VALDEZ, RANDY STATE OF ILLINOIS @ 03/22/18 ASSISTANT AT0TORNEY GENERAL 138 18WC 11091 FREY, DANETTE ADI REPAIRS 10/09/17 139 18WC 11127 PORTER, DONTAE CAPSTONE LOGISTICS, LLC 01/11/18 NELSON & NELSON 140 18WC 14315 SMITH, KRYSTAL M SSM HEALTH GOOD SAMARITAN 08/29/17 JAMES RUPPERT EVANS & DIXON, LLC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 9 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 141 18WC 15092 MYERS, DAVID M RADIAC ABRASIVES, INC. 03/23/18 HASSAKIS & HASSAKIS PC HENNESSY & ROACH, PC 142 18WC 15282 TONEY, KELSEY UNIFIED STAFFING 02/11/18 DWORKIN AND MACIARIELLO 143 18WC 16245 COMBS, JOSEPH CONTINENTAL TIRE 05/03/17 NELSON & NELSON KEEFE & DEPAULI 144 18WC 16623 PATTERSON, ELIZABETH (WID WALGREENS DISTRIBUTION CE # 04/29/18 KATZ FRIEDMAN EAGLE ET AL EVANS & DIXON, LLC 145 18WC 16700 FARRIS, AMANDA CONTINENTAL TIRE NORTH AM 01/18/18 WINTERS BREWSTER CROSBY SC 146 18WC 16899 FARRIS, AMANDA CONTINENTAL TIRE NO. AMER 11/20/16 WINTERS BREWSTER CROSBY SC 147 18WC 17189 GRAHAM, SHANNON L NORTH AMERICAN LIGHTING 02/15/18 TUNGATE LAW OFFICE STEPHEN CARTER 148 18WC 17736 PAISLEY, ERIC C TRILLIUM CONSTRUCTION 05/03/18 FISHER KERHOVER COFFEY SPIEGEL & CAHILL, PC 149 18WC 19025 DOXIE, JEFF AIR STAMPING, INC. 07/22/15 BLANE OSMAN BRADY, CONNOLLY & MASUDA, PC 150 18WC 19097 HOSICK, KONAN WHITE COUNTY HOUSING AUTH 06/28/17 HANAGAN & MCGOVERN PC RUSIN & MACIOROWSKI LTD 151 18WC 19784 LONGWELL, CHERYL RYAN'S FAMILY STEAK HOUSE 07/17/17 SMITH LAW LTD LAWRENCE COZZI - LAW OFFICE 152 18WC 19984 BROWN, JAY NATIONAL VINEGAR COMPANY 06/13/17 STRONG LAW OFFICE STEPHEN H LARSON LAW OFFICE 153 18WC 20057 WIGGINS, RODNEY G TRIPLE S LAND COMPANY 09/11/17 HUGHES LAW FIRM BRADY, CONNOLLY & MASUDA, PC 154 18WC 20103 BOYER, FREDERICK M CLASS MINING A/K/A 06/15/18 RON D COFFEL & ASSOC LITCHFIELD CAVO 155 18WC 20149 WHITE, CHRISTINE L GSI GROUP, INC 02/14/18 HASSAKIS & HASSAKIS PC FEATHERSTUN GAUMER 156 18WC 20286 ENLOW, CHARLES ADM TRUCKING INC 05/03/18 HELLER HOLMES & ASSOC FEATHERSTUN GAUMER POSTLEWAI 157 18WC 20329 STARR, WILLIAM T XPO LOGISTICS 11/13/15 NELSON & NELSON RUSIN & MACIOROWSKI LTD 158 18WC 20356 LAYBURN, MARK E JOB MATCH PERSONNEL SVS 01/03/18 MEYER, MICHAEL J

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 10 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 159 18WC 20696 CRUM, MICHELLE P PINNACLE FOODS 04/17/18 BROWN & BROWN INMAN & FITZGIBBONS 160 18WC 21031 BRANCH, TERRY NORTH AMERICAN LIGHTING 04/01/18 BROWN & BROWN STEPHEN CARTER 161 18WC 21192 WHIPPLE, PATSY HSHS ST. ANTHONY'S MEMORI 06/25/18 LESKERA LAW FIRM HEYL ROYSTER VOELKER & ALLEN 162 18WC 21720 MOUSER, JASON IDOC 05/23/18 JOHNSTON LAW OFFICE CORI STEWART 163 18WC 21833 DOTY, KENNETH ABF FREIGHT SYSTEM 09/05/17 BURNETT & CARON, LTD 164 18WC 22186 HEMPEN, TODD CENTRALIA POLICE DEPARTME 04/08/18 RIDGE & DOWNES INMAN & FITZGIBBONS 165 18WC 22753 CARTER, RICHARD MT VERNON MOLD WORKS, INC 03/07/18 LEVENHAGEN LAW FIRM PC STEPHEN H LARSON LAW OFFICE 166 18WC 22874 WHARTON, RALEIGH "ANDY" C.D FELLER ENTERPRISE 01/25/17 HELLER HOLMES & ASSOC HOLTKAMP LIESE 167 18WC 23094 MASON, KIRK WAYNE CARTER TRUCKING & 07/09/18 LEVENHAGEN LAW FIRM PC EVANS & DIXON 168 18WC 23103 WOODWARD, CHRISTIAN WARREN G. MURRAY DEVELOPM @ 06/11/18 NELSON & NELSON ASSISTANT ATTORNEY GENERAL 169 18WC 23108 GOTTBERG, CHRISTINA WALGREEN CO 05/24/18 LEVENHAGEN LAW FIRM PC EVANS & DIXON, LLC 170 18WC 23574 QUAID, GINGER JOSHUA MANOR 07/04/18 BECKER SCHROADER & CHAPMAN 171 18WC 23749 LONG, CHRISTOPHER W PRAIRIE FARMS DAIRY, INC. 08/15/17 HASSAKIS & HASSAKIS PC KNAPP, OHL & GREEN 172 18WC 24016 PURCELL, DANA STEVENS INDUSTRIES 01/25/17 HELLER HOLMES & ASSOC THOMAS MAMER & HAUGHEY 173 18WC 24508 MOONEY, STACEY WARREN G MURRAY DEV CTR @ 05/13/18 NELSON & NELSON ASSISTANT ATTORNEY GENERAL 174 18WC 24531 FOULKS, ANTONIO PLACESMART AGENCY 05/25/18 BROWN & BROWN HEYL ROYSTER VOELKER & ALLEN 175 18WC 24546 KIRBY, XAVIER RP COATINGS, INC 01/11/18 BROWN & BROWN HEYL ROYSTER VOELKER & ALLEN 176 18WC 25098 WILSON, JASON EVARD STRANG CONSTRUCTION 06/18/18 GOLDENBERG HELLER ANTOGNOL

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 11 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 177 18WC 25193 HARRIS, CORY CITY OF ALTAMONT 01/16/17 WOLTER BEEMAN AND LYNCH KEEFE & DEPAULI 178 18WC 26011 MASON, BRANDON M CLASS MINING 05/31/18 RON D COFFEL & ASSOC LITCHFIELD CAVO 179 18WC 26527 ATKINS, TRAVIS AMERICAN EQUIPMENT & MACH 02/06/18 BEARD LAW FIRM 180 18WC 26554 CURRY, DUSTIN COMPLIANCE STAFFING AGENC 06/02/18 RON D COFFEL & ASSOC MCANANY VANCLEVE & PHILLIPS 181 18WC 26728 RENFROW, ANTHONY BRYAN MANOR 04/23/18 DANIELS WILZBACH PC BOGGS AVELLINO LACH BOGGS 182 18WC 26906 HARRINGTON, SHASTA THREE Z PRINTING CO INC 08/15/18 WILSON LAW OFFICES LLC STEPHEN H LARSON LAW OFFICE 183 18WC 28408 FEAZELL, LB JR. CRST EXPEDITED 07/27/17 BERG & ROBESON 184 18WC 28546 KING, PATTI CONTINENTAL TIRE 07/05/16 WINTERS BREWSTER CROSBY SC KEEFE & DEPAULI 185 18WC 28965 WILSON, STEPHANIE OAKLAND EDUCATIONAL CENTE 09/10/18 MCGARRY & MALKOVICH HENNESSY & ROACH, PC 186 18WC 29111 MCGUIRE, MICHELLE DOLLAR GENERAL 01/17/18 MCCARTHY ROWDEN LEAHY EISENBERG & FRAENKEL 187 18WC 29241 MINOR, DENISE BIG MUDDY RIVER C.C. @ 05/13/18 RICH RICH COOKSEY & CHAPPE ASSISTANT ATTORNEY GENERAL 188 18WC 29399 MARQUEZ, JACQUELINE WALGREENS DISTRIBUTION CE 08/31/18 BROWN & BROWN EVANS & DIXON, LLC 189 18WC 29435 CAVALETTO, JASON E KASKASKIA COMMUNITY COLLE 12/15/16 DANIELS WILZBACH PC KEEFE & DEPAULI 190 18WC 29776 CLINE, MATTHEW T PIONEER OIL COMPANY 07/11/18 HOFFEE LAW FIRM KOPKA, PINKUS DOLIN, PC 191 18WC 31021 RICHARDSON, GARY D WHITE STALLION ENERGY, LL 06/09/18 192 18WC 31202 SELLERS, HEATHER TOYOTA BOSHOKU IL 11/17/17 HELLER HOLMES & ASSOC HENNESSY & ROACH, PC 18WC031203 -C 193 18WC 31367 APPLEGATE, KYLE D BARR CONSTRUCTION 10/11/17 KEEFE & DEPAULI 194 18WC 31421 GOTTMAN, DARLA WASHINGTON COUNTY HOSPITA 12/04/17 LEVENHAGEN LAW FIRM PC GAROFALO SCHREIBER STORM GRA

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 12 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 195 18WC 31601 BARTON, ROBERT CENTRALIA CC @ 09/21/18 RICH RICH COOKSEY & CHAPPE ASSISTANT ATTORNEY GENERAL 196 18WC 31681 MULLINS, KENNETH XPO LOGISTICS FREIGHT, IN 07/19/18 LEVENHAGEN LAW FIRM PC RUSIN & MACIOROWSKI LTD 197 18WC 31737 WRIGHT, ROGER E WALGREENS DISTRIBUTION CE 08/28/18 JAMES RUPPERT 198 18WC 31934 FELDHAKE, TIM SCHOONOVER TRUCKING 03/14/17 HANAGAN & MCGOVERN PC BRADY, CONNOLLY & MASUDA, PC 199 18WC 32272 NEAL, MICHELLE L WALGREENS DISTRIBUTION CE 03/08/18 HASSAKIS & HASSAKIS PC 200 18WC 32394 WERNER, REBECCA JO NEW YORK BLOWER COMPANY 01/10/18 MEYER, MICHAEL J SMITH AMUNDSEN LLC 201 18WC 32430 TORRES, VANESSA CROMWELL RADIO GROUP 04/26/18 FREDERICK & HAGLE 202 18WC 32973 JOHNSON, DARLENE (WIDOW) FREEMAN UNITED COAL MININ # 06/15/18 CULLEY & WISSORE CRAIG & CRAIG 203 18WC 33054 SULLENS, PAMELA WALGREENS DISTRIBUTION CE 08/21/18 HANAGAN & MCGOVERN PC 204 18WC 33680 MILLER, DENNIS W. BOROWIAKS IGA FOODLINER I 08/08/18 MOLLY WEHKING KNELL O'CONNOR DANIELWICZ 205 18WC 33686 LEIGHTY, ANNETTE L CASEY'S GENERAL STORE 10/12/18 MOLLY WEHKING 206 18WC 35086 THRASHER, PAUL HOWARD CONCRETE PUMPING I 09/29/17 WINTERS BREWSTER CROSBY SC WIEDNER & MCAULIFFE LTD 207 18WC 36762 BEVEL, PATRICIA FORD SQUARE OF MT VERNON 01/15/18 DWORKIN AND MACIARIELLO GANAN & SHAPIRO 208 18WC 37276 DONALDSON, JAMES PINNACLE FOODS 09/06/18 SMITH LAW LTD INMAN & FITZGIBBONS 209 18WC 37444 LYONS, CHANE ENGINEERED FLUID INC 04/15/18 NELSON & NELSON STEPHEN H LARSON LAW OFFICE 210 18WC 37890 CARTER, LINDA ST MARY'S HOSPITAL 05/22/18 BEATTY & MOTIL EVANS & DIXON, LLC 211 18WC 37993 GILLIS, KEVIN MONROE BARTELS INC 09/20/17 CRAIG & CRAIG CHILTON YAMBERT PORTER LLP 212 18WC 38310 WEHKING, BEVERLY SOI MURRAY DEVELOPMENTAL @ 11/26/18 CORNFIELD & FELDMAN ASSISTANT ATTORNEY GENERAL

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 13 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 213 19WC 00492 KNEEZLE, CHRISTOPHER WALGREENS DISTRIBUTION CE 09/03/18 JEROME LINDSAY SALMI LL EVANS & DIXON, LLC 214 19WC 00555 TOOMBS, BRODIE WALGREENS DIST CENTER 10/12/18 BEMENT STUBBLEFIELD EVANS & DIXON, LLC 215 19WC 00570 OWEN, AMANDA CHAMPION LABORATORIES 12/11/18 HANAGAN & MCGOVERN PC HENNESSY & ROACH, PC 216 19WC 01112 KEEF, WILLIAM CONTINENTAL TIRE THE 07/01/16 JEROME LINDSAY SALMI LL KEEFE & DEPAULI 217 19WC 01152 MARTIN, NORA ED LEWIS TRUCKING COMPANY 11/27/18 WINTERS BREWSTER CROSBY SC JAMES M KELLY 218 19WC 01462 CASTLEBERRY, RHONDA CENTRAL ILLINOIS CARE SER 08/20/16 MUELHAUSEN & STEFANI 219 19WC 01662 CROSBY, JUYAM DHS-MURRAY CENTER @ 10/02/18 CARAWAY FISHER ASSISTANT ATTORNEY GENERAL 220 19WC 01743 LARIMER, ADAM TA PETRO 12/06/18 DWORKIN AND MACIARIELLO HENNESSY & ROACH, PC 221 19WC 01982 TOLLIVER, TOM RABEN TIRE COMPANY 10/28/18 SMITH LAW LTD KNELL LAW LLC 222 19WC 02031 ELLIS, JON NATHAN HAAG & HAAG LANDSCAPE & @ W 03/14/18 TAMMI N. JACKSON WINTERS BREWSTER CROSBY SCHA 223 19WC 02159 CHAPMAN, KENNETH SHAWN WALGREENS 03/27/18 MICHAEL MILES EVANS & DIXON, LLC 224 19WC 02173 GARCIA, JOAQUIN RADIAC ABRASIVES 09/13/18 WILLIAMS CAPONI & ASSOC HENNESSY & ROACH, PC 225 19WC 02275 MC DONALD, DWAINE ARBY'S 07/24/18 HANAGAN & MCGOVERN PC 226 19WC 02959 KAMIS, JOYCE C KDDI, INC, D/B/A DRYDEN-K 11/29/18 HASSAKIS & HASSAKIS KEEFE & DEPAULI 227 19WC 03111 STARWALT, ROBERT T PRAIRIE FARMS DAIRY INC 12/28/18 HASSAKIS & HASSAKIS PC KNAPP, OHL & GREEN 228 19WC 03201 LORTON, MELISSA MURRAY DEVELOPMENTAL CENT @ 11/11/17 LEVENHAGEN LAW FIRM PC ASSISTANT ATTORNEY GENERAL 229 19WC 03387 HABING, JEFFREY SUMMIT TOWNSHIP 10/10/17 TAYLOR LAW OFFICES BRADY, CONNOLLY & MASUDA, PC 230 19WC 03413 BROWN, LISA CONTINENTAL TIRE 06/22/18 KEEFE & GRIFFITHS PC KEEFE & DEPAULI

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 14 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 231 19WC 03514 DITTERLINE, KIMBERLY FOR MADISONVILLE MINING, LLC # 01/05/19 RICH RICH COOKSEY & CHAPPE LITCHFIELD CAVO 232 19WC 03543 MCDONALD, DWAINE ARBY'S 07/24/18 HANAGAN & MCGOVERN PC LEAHY EISENBERG & FRAENKEL 233 19WC 04050 RICHARDSON, CHRIS CONTINENTAL TIRE MT VERNO 07/26/18 DWORKIN AND MACIARIELLO KEEFE & DEPAULI 234 19WC 04131 MCNEESE, TODD R WALMART STORES, INC 08/10/17 MEYER, MICHAEL J QUINTAIROS PRIETO WOOD & BOY 235 19WC 04313 HARGIS, KRISTY WARREN G MURRAY DEVELOPME @ 08/06/18 DWORKIN AND MACIARIELLO ASSISTANT ATTORNEY GENERAL 236 19WC 04461 PRUITT, CHRISTINA BURGER KING 01/09/19 WOODRUFF JOHNSON ROUSE & CARY 237 19WC 04793 WOOLFORD, BENJAMIN CPC LOGISTICS 12/19/18 DAVID W MARTAY LEAHY WRIGHT & ASSOC 238 19WC 05118 MILLER, DAVID W MT VERNON WINNELSON CO 01/18/18 FOREMAN & KESSLER, LTD STEPHEN H LARSON LAW OFFICE 239 19WC 05238 MC GOVERN, KEVIN W IDOT, STATE OF ILLINOIS @ 09/17/18 HASSAKIS & HASSAKIS ASSISTANT ATTORNEY GENERAL 240 19WC 05258 LOWERY, SHARON A WALGREENS FAMILY OF COMPA 09/25/17 HASSAKIS & HASSAKIS PC 241 19WC 05427 FREEMAN, RUSSEL LOWE'S HOME CENTERS, INC 06/15/17 REED & BRUHN, PC 242 19WC 05445 BOSOE, TAYLOR MASTER HALCO 04/05/18 WALTON TELKEN LLC STEPHEN H LARSON LAW OFFICE 243 19WC 05569 HURST, BENNY QUAD/GRAPHICS 06/19/18 KATZ FRIEDMAN EAGLE ET AL KNELL O'CONNOR DANIELWICZ 244 19WC 05675 TATE, JODI L USI INSURANCE SERVICES, L 03/20/17 ASHER & SMITH LUCY T. UNGER 245 19WC 05778 SHADRICK, LANCE HEUERMAN TRUCKING 11/27/18 DANIELS WILZBACH PC GANAN & SHAPIRO 246 19WC 05798 MORRIS, ALLEN TUNE TRUCKING 04/02/18 HANAGAN & MCGOVERN PC INMAN & FITZGIBBONS 247 19WC 06079 MARLER, JACK CONTINENTAL MILLS 07/17/18 HELLER HOLMES & ASSOC ROUSE & CARY 248 19WC 06384 HAYES, BETTY HAMILTON MEMORIAL HOSPITA 05/27/16 HANAGAN & MCGOVERN PC GAROFALO SCHREIBER STORM GRA

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 15 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 249 19WC 06561 FORD, SUSAN E CRACKER BARREL 08/09/18 MOLLY WEHKING 250 19WC 06597 RUSSELL, JESSICA UNIFIED STAFFING 11/25/18 BEMENT STUBBLEFIELD 251 19WC 06686 PETRO, MARK CONTINENTAL TIRE THE AMER 02/15/16 KEEFE & DEPAULI 252 19WC 06720 NEWTON, JEFFERY CONTINENTAL TIRE THE 11/28/17 KEEFE & DEPAULI 253 19WC 06812 SAWYER, ALAN VANDALIA CORRECTIONAL CEN @ 03/22/18 BECKER SCHROADER & CHAPMAN CORI STEWART 254 19WC 06844 RODRIGUEZ, RENEE DIRECT SERVICE PERSONNEL 08/15/17 BROWN & BROWN 255 19WC 06849 POOL, LARRY CONTINENTAL TIRE NORTH AM 06/13/18 HANAGAN & MCGOVERN PC KEEFE & DEPAULI 256 19WC 06887 GRAY, TYLER CONTINENTAL TIRE THE AMER 10/11/17 KEEFE & DEPAULI 257 19WC 07154 FULK, SHARON A ST ANTHONY'S MEMORIAL 01/12/19 HASSAKIS & HASSAKIS MC ANDREWS & NORGLE LLC 258 19WC 07276 BASHAM, NANETTE WALGREENS DISTRIBUTION CE 01/18/19 WINTERS BREWSTER CROSBY SC 259 19WC 07388 LEDBETTER, JAMES ST OF IL/BIG MUDDY RIVER @ 01/11/19 RICH RICH COOKSEY & CHAPPE ASSISTANT ATTORNEY GENERAL 260 19WC 07508 WALTRIP, KATHY GRUPO ANTOLIN NASHVILLE 02/08/19 LEVENHAGEN LAW FIRM PC 261 19WC 07615 WEBSTER, TYWON KASKASKIA SPECIAL ED DIST 09/11/18 CARAWAY FISHER WIEDNER & MCAULIFFE LTD 262 19WC 07679 WILKERSON, JOHNNY R RIVER CTY TOWER&CNSTRCTIO 02/05/19 JAMES RUPPERT KNELL LAW LLC 263 19WC 07682 EDWARDS, MALINDA S RURAL KING DISTRIBUTION A 01/04/19 JAMES RUPPERT FEIRICH MAGER GREEN & RYAN 264 19WC 07981 MCELROY, SCOTT L JOHN BOOS & COMPANY INC 02/26/18 NO ATTORNEY 265 19WC 08088 HOFFMAN, LYNSIE FLORA COMMUNITY UNIT SCHO 01/19/18 TAYLOR LAW OFFICES BRYCE DOWNEY & LENKOV LLC 266 19WC 08120 BUTTRUM, ROBERT VILLAGE OF BLUFORD 11/08/18 RICH RICH COOKSEY & CHAPPE KEEFE & DEPAULI

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 16 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 267 19WC 08467 POWELL, STEVEN D PITCHOCO INC 09/11/18 PARK LAW OFFICE 268 19WC 08855 BRANSON, DON R PRIORITY STAFFING 06/06/18 WOMICK LAW FIRM CHTD 269 19WC 08945 SCHLEPER, WANDA V ILLINOIS HEARTLAND LIBRAR @ 03/08/19 HARRIS & JONES 270 19WC 09108 BRANDOL, VICKIE L CENTRAL CITY SCHOOL DIST 02/07/18 GLASS & KOREIN KEEFE & DEPAULI 271 19WC 09243 KAY, KEVIN COAL FIELD CONSTRUCTION C 07/19/17 LITCHFIELD CAVO 272 19WC 09487 COOK IV, JOHN W CONTINENTAL TIRE THE AMER 04/18/18 HASSAKIS & HASSAKIS PC KEEFE & DEPAULI 273 19WC 09618 VANCIL, SEAN COMPLIANCE STAFFING AGENC 08/08/18 WINTERS BREWSTER CROSBY SC 274 19WC 09937 LEWIS, TIM MT VERNON TOWNSHIP HSD #2 01/08/19 HANAGAN & MCGOVERN PC WIEDNER & MCAULIFFE LTD 275 19WC 10023 LAIRD, DARRIN R TRUCK CENTERS, INC. 02/23/17 STEPHEN H LARSON LAW OFFICE 276 19WC 10040 KNIGHT, TIMOTHY RAY BAPTIST CHILDREN'S HOME 11/07/18 HOLTKAMP LIESE 277 19WC 10057 DIEL, COLLIN WAL MART DISTRIBUTION CEN 12/01/18 HANAGAN & MCGOVERN PC 278 19WC 10278 POND, ALEXANDER XPO LOGISTINCS 04/02/19 DAVID W MARTAY 279 19WC 10559 SHANE, KELLY FIREFLY GRILL 03/03/19 RIDGE & DOWNES GANAN & SHAPIRO 280 19WC 11067 HARGETT, CHRISTOPHER CPC LOGISTICS 11/25/18 JAMES RUPPERT LEAHY WRIGHT & ASSOC 281 19WC 11752 KLEIN, STEPHEN SHERWIN WILLIAMS 10/15/18 JOHNSTON LAW OFFICE 282 19WC 11995 JONES, DONNA K WALGREENS DISTRIBUTION CE 03/14/18 EVANS & DIXON, LLC 283 19WC 12075 GONZALEZ, REBECCA HODGSON MILLS 12/18/17 KOPKA, PINKUS DOLIN, PC 284 19WC 12936 HOFFMAN, JERAMY C HODGSON MILLS, INC 02/15/18 KOPKA, PINKUS DOLIN, PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 17 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 285 19WC 12996 TANNAHILL, MARCIA SSM HEALTH ST. MARY'S HOS 11/08/18 EVANS & DIXON, LLC 286 19WC 13125 LUSTIG, THOMAS JOHN BOOS & CO 03/13/19 GOLDFINE & BOWLES STEPHEN H LARSON LAW OFFICE 287 19WC 13146 HAMBLEN, LISA FEDEX FREIGHT INC 11/30/18 SMITH LAW LTD QUINTAIROS PRIETO WOOD & BOY 288 19WC 13221 VESSELS, JAMES SOUTHERN REFRIGERATED TRA 05/02/19 DWORKIN AND MACIARIELLO LEMP & MURPHY 289 19WC 13261 HALL, BILLY MID-EAST TRUCK & TRACTOR 07/16/18 RUSIN & MACIOROWSKI LTD 290 19WC 13428 TOLCH, AMY RURAL KING 09/18/18 TAYLOR LAW OFFICES RURAL KING 291 19WC 13796 HIRES, ANGELA L HSHS ST ANTHONY'S 09/25/18 TAYLOR LAW OFFICES 292 19WC 14824 HERNANDEZ, MAYA BRYAN MANOR 02/16/18 HANAGAN & MCGOVERN PC 293 19WC 15116 MOSCHENROSE, CHRISTOPHER FEDEX SUPPLY CHAIN INC 11/12/18 MOSS & MOSS PC 294 19WC 15197 CARTER, SAMANTHA THE SHERWIN WILLIAMS 11/09/17 SMITH LAW LTD 295 19WC 15678 POLLARD, JACOB L VIBRACOUSTIC USA INC 04/25/19 HASSAKIS & HASSAKIS PC ROSARIO CIBELLA 296 19WC 15981 KENLEY, TASHAUNA S WALGREENS DIST CENTER 02/11/19 BONIFIELD & ROSENSTENGEL P EVANS & DIXON, LLC 297 19WC 16045 BLADES, TIMOTHY CONTINENTAL TIRE 12/17/18 BEMENT STUBBLEFIELD KEEFE & DEPAULI 298 19WC 16065 MAYDEN, SHERRY HALTER TREE SERVICE/ 12/04/17 RITTENBERG BUFFEN 299 19WC 16459 WILLIAMS, CATHY NORTH AMERICAN LIGHTING 09/18/18 HANAGAN & MCGOVERN PC 300 19WC 16571 MC GAHA, NATHANIEL L DOLLAR GENERAL CORPORATIO 12/31/18 HOFFEE LAW FIRM LEAHY EISENBERG & FRAENKEL 301 19WC 16582 OTTO, VERN BENIACH CONSTRUCTION CO 08/31/18 KEEFE & DEPAULI 302 19WC 16668 WILSON, BRANDON COMPLIANCE STAFFING AGENC 05/09/19 RICH RICH COOKSEY & CHAPPE RUSIN & MACIOROWSKI LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 18 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 303 19WC 16771 MULVANEY, CASEY REPUBLIC SERVICES 03/25/19 JEROME LINDSAY SALMI LL LITCHFIELD CAVO 304 19WC 17070 CARTER, RICHARD MT VERNON MOLD WORKS, INC 05/07/19 LEVENHAGEN LAW FIRM PC 305 19WC 17205 MOORE, LISA ACT RESOURCES, INC 02/20/18 CULLEY FEIST KUPPART & JOR ROUSE & CARY 306 19WC 17254 BETTINGER, LORI GAIL CONTINENTAL TIRE 09/09/18 HOWERTON, DORRIS & STONE 307 19WC 17418 BURGOS, FABIAN COAL FIELD CONSTRUCTION 04/25/19 WINTERS BREWSTER CROSBY SC 308 19WC 18080 REEDER, JAMES A ILLINOIS STATE POLICE 03/22/19 CULLEY FEIST KUPPART & JOR CORI STEWART 309 19WC 18790 HICKERSON, KYLE G EN ENGINEERING INC 05/16/19 NELSON & NELSON HOLECEK & ASSOCIATES 310 19WC 18841 BELL, WESLEY R JOSH ADDIS TRUCKING INC. 03/12/19 KATZ FRIEDMAN EAGLE ET AL 311 19WC 18960 MCGUIRE, MARY THE S2 HR GROUP, LLC D/B/ 09/11/18 TAPELLA & EBERSPACHER LLC BRADY CONNOLLY & MASUDA PC 312 19WC 19197 GRAHAM, COREY A JOHN BOOS COMPANY 02/13/19 JAMES RUPPERT STEPHEN H LARSON LAW OFFICE 313 19WC 20123 CARTER, DONNA HOYLETON YOUTH & FAMILY S 06/18/19 RICH RICH COOKSEY & CHAPPE LITCHFIELD CAVO 314 19WC 20171 MEYER, PHAEDRA NORTH AMERICAN LIGHTING I 08/30/17 RICH RICH COOKSEY & CHAPPE STEPHEN CARTER 19WC020172 -C 315 19WC 20472 HRAGA, JANICE M WALMART, INC 06/17/19 GOSNELL BORDEN ENLOE & SLO GANAN & SHAPIRO 316 19WC 21128 MIDDENDORFF, DAVID GRUPO ANTOLIN-NASHVILLE 09/04/18 NELSON & NELSON 317 19WC 21180 MANN, BRAD CONTINENTAL TIRE 05/06/19 JEROME LINDSAY SALMI LL KEEFE & DEPAULI 318 19WC 21287 LANDES, JEFF NORTH AMERICAN LIGHTING, 02/25/19 MICHAEL MILES STEPHEN CARTER 319 19WC 21737 TOMLIN, KENNETH R CENTRAL TRANSPORT LLC 07/27/16 WIEDNER & MCAULIFFE LTD HINSHAW & CULBERTSON 320 19WC 21900 JAWORSKI, STANLEY CONTINENTAL TIRE 01/30/19 RICH RICH COOKSEY & CHAPPE KEEFE & DEPAULI

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 19 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 321 19WC 21993 WILSON, KAYLA WIS INTERNATIONAL 05/29/19 WILLIAMS CAPONI & ASSOC 322 19WC 22483 SHOPINSKI, BETTY CONTINENTAL TIRE 03/28/19 RICH RICH COOKSEY & CHAPPE KEEFE & DEPAULI 323 19WC 22542 KRAHN, DANIEL RADIAC ABRASIVES INC 03/26/19 HANAGAN & MCGOVERN PC 324 19WC 22855 RIGHTNOWAR, TAMMY R WALGREENS DISTRIBUTION CE 06/07/19 MOLLY WEHKING 325 19WC 23048 BARNES, WILLIAM IL DEPT OF TRANSPORTATION @ 07/01/19 WINTERS BREWSTER CROSBY SC 326 19WC 23598 BOLES, REBECCA ELASTEC/AMERICAN MARINE 06/28/19 HOFFEE LAW FIRM RUSIN & MACIOROWSKI LTD 327 19WC 23746 TELLEFSEN, JODI GRAPHIC PACKAGING 09/01/18 CARAWAY FISHER DOHERTY & PROGAR LLC 328 19WC 23886 DUNCAN, ERIC CONTINENTAL TIRE 07/13/19 BEMENT STUBBLEFIELD KEEFE & DEPAULI 329 19WC 24636 GASTON, JACKIE STATE OF ILLINOIS @ 06/19/19 SAUNDERS CONDON & KENNY ASSISTANT ATTORNEY GENERAL 330 19WC 24656 LINGO, ERNEST MANPOWER 06/20/19 RICH RICH COOKSEY & CHAPPE HENNESSY & ROACH, PC 331 19WC 24756 WILDERMAN, CHAD NORTH AMERICAN LIGHTING 08/14/17 RICH RICH COOKSEY & CHAPPE STEPHEN CARTER 332 19WC 24769 STUDER, JAMES ST OF IL- BIG MUDDY RIVER @ 07/26/19 RICH RICH COOKSEY & CHAPPE ASSISTANT ATTORNEY GENERAL 333 19WC 24904 DOEHRING, DYLAN PETCO PETROLEUM CORP 05/14/19 MCCARTHY ROWDEN 334 19WC 25262 PATTERSON, BRIAN XENIA MANUFACTURING, INC 12/15/16 KEEFE & GRIFFITHS PC BRADY, CONNOLLY & MASUDA, PC 335 19WC 25407 CAPE, DAVID W FERRELLGAS, INC 07/25/19 FOREMAN & KESSLER, LTD 336 19WC 25451 BUHKLER, GARY FEDEX 04/01/19 TAYLOR LAW OFFICES SPIEGEL & CAHILL, PC 337 19WC 25477 TORBECK, MARION K HARMON FOODS, INC 05/22/19 HASSAKIS & HASSAKIS EVANS & DIXON 338 19WC 25585 SCHWAPPACH, FRED MASCHOFF TRANSPORT 03/20/18 HUSTAVA, JOHN H CRAIG A HANSEN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 20 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 339 19WC 25867 SCHULTZ, JUSTIN JOHN BOOS & COMPANY 06/13/18 KANOSKI BRESNEY 340 19WC 25894 BARTH, BECCA D SSM HEALTH ST MARY'S 06/17/19 JAMES RUPPERT EVANS & DIXON, LLC 341 19WC 26051 COLVIN, JESSE BIG MUDDY RIVER C C @ 08/08/19 RICH RICH COOKSEY & CHAPPE ASSISTANT ATTORNEY GENERAL 342 19WC 26145 WHITE, DANIEL TA OPERATING, LLC 08/18/19 BEMENT STUBBLEFIELD HENNESSY & ROACH 343 19WC 26247 NEAL, DAMONIMONTEZ J CONTINENTAL TIRE N AMERIC 08/19/19 MOLLY WEHKING 344 19WC 26430 ESTES, JAMES PAUL & DENNIS ALLEN AIRPO 11/30/18 DWORKIN AND MACIARIELLO GANAN & SHAPIRO 345 19WC 26637 KUHLMAN, TIMOTHY RYDER SYSTEM 04/27/19 DWORKIN AND MACIARIELLO HEYL ROYSTER VOELKER & ALLEN 346 19WC 27118 ALEXANDER, LONALYNN GRUPO ANTOLIN 09/01/17 BROWN & BROWN 347 19WC 27148 GREEN, NATHANIEL HAMILTON COUNTY COAL, LLC 08/19/19 WINTERS BREWSTER CROSBY SC FEIRICH MAGER GREEN & RYAN 348 19WC 27207 RUSSELL, ERIC CONTINENTAL TIRE THE AMER 04/23/19 LEVENHAGEN LAW FIRM PC KEEFE & DEPAULI 349 19WC 27378 REED, DREW E HAMILTON COUNTY COAL LLC 02/07/19 SMITHPETERS LAW FIRM FEIRICH MAGER GREEN & RYAN 350 19WC 28105 EARL, STEVEN D GEO. N. MITCHELL DRILLING 06/01/19 HASSAKIS & HASSAKIS PC 351 19WC 28156 GRAMES, HOLLY M JOSH ADDIS TRUCKING, INC 06/13/19 KEEFE & DEPAULI HOLTKAMP LIESE 352 19WC 28196 WILLIAMS, KATHLEEN CONTINENTAL TIRE THE AMER 03/17/19 LAWLER & LAWLER KEEFE & DEPAULI 353 19WC 28617 PRICE, TRAVIS W CONTINENTAL TIRE THE AMER 08/10/18 HASSAKIS & HASSAKIS PC 354 19WC 28883 CHAPPELL, JOANNA TOYOTA BOSHOKU OF ILLINOI 09/03/19 FERGUSON, MARK E LTD HENNESSY & ROACH, PC 355 19WC 29105 CARRUTH, LAMEATRIA J WALGREENS FAMILY OF COMPA 05/30/17 HASSAKIS & HASSAKIS PC EVANS & DIXON, LLC 356 19WC 29271 MITCHELL, BRANDON S&L INDUSTRIES 08/11/19 KIRKPARTICK LAW OFFICES LITCHFIELD CAVO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 21 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 357 19WC 29309 WILLIAMS, KATHLEEN CONTINENTAL TIRE THE AMER 03/13/19 LAWLER & LAWLER KEEFE & DEPAULI 358 19WC 29702 SWIBEL, AMANDA M SMITHFIELD FOODS INC 09/11/19 JAMES RUPPERT WIEDNER & MCAULIFFE LTD 359 19WC 29709 SCOTT, GREGORY BLUE BEACON 02/20/19 TAYLOR LAW OFFICES 360 19WC 29728 GLUCK, DERRICK STATE OF IL/MURRAY CENTER @ 09/07/19 RICH RICH COOKSEY & CHAPPE ASSISTANT ATTORNEY GENERAL 361 19WC 29757 SHIPLEY, WILLIAM RADIAC ABRASIVES 12/18/18 HAMMOND AND SHINNERS PC 362 19WC 29774 GALYEN, JERRY PETRO STOPPING CENTER 10/04/19 DWORKIN AND MACIARIELLO 363 19WC 29858 WILLIAMS, ANGELO M US TRANSPORT 09/19/19 KANOSKI BRESNEY 364 19WC 30293 MITCHELL, BRANDON S&L INDUSTRIES 05/07/19 KIRKPARTICK LAW OFFICES LITCHFIELD CAVO 365 19WC 30414 BOBBETT, ERIC SHERWIN-WILLIAMS 09/27/19 KEEFE & DEPAULI RUSIN & MACIOROWSKI LTD 366 19WC 31044 PHILLIPS, JESSIE L STATE OF ILLINOIS @ 09/25/19 CORNFIELD & FELDMAN ASSISTANT ATTORNEY GENERAL 367 19WC 31179 BAKER, PAMELA J HAMILTON COUNTY COAL, LLC 01/20/17 CULLEY & WISSORE FEIRICH MAGER GREEN & RYAN 368 19WC 31277 GLADNEY, NIEISHA SPERO FAMILY SERVICES 07/17/18 HENNESSY & ROACH 369 19WC 31600 DULANEY, TIFFANY STAFFQUICK 08/22/19 DWORKIN AND MACIARIELLO LEMP & MURPHY 370 19WC 31630 HILLE, LISA THREE-Z PRINTING CO. 05/01/19 KATZ FRIEDMAN EISENSTEIN 371 19WC 31698 SMITH, DONALD HAMILTON COUNTY COAL, LLC 12/16/16 WINTERS BREWSTER CROSBY SC FEIRICH MAGER GREEN & RYAN 372 19WC 31716 BARTLETT, HEATHER L CONTINENTAL TIRE NORTH 07/28/19 NELSON & NELSON KEEFE & DEPAULI 373 19WC 31808 BUTTS, JILL A ALDI STORE #71 03/23/18 KEEFE & DEPAULI 374 19WC 31811 RHEINHARDT, KIRK M MARTIN ENGINEERING 04/09/19 JAMES RUPPERT RUSIN & MACIOROWSKI LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 22 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 375 19WC 31913 VEACH, JOHNNIE VIKING MINE 10/08/19 COOK SHEVLIN YSURSA ET AL 376 19WC 32045 YOUNG, KEVIN F HOCKING OIL COMPANY INC W 08/05/19 JAMES RUPPERT TAYLOR LAW OFFICES 377 19WC 32450 MOFFITT, MARK AT&T 01/25/19 GWC INJURY LAWYERS LLC HENNESSY & ROACH, PC 378 19WC 32977 STOCK, TONYA A SSM HEALTH ST. MARY'S 10/28/18 HASSAKIS & HASSAKIS PC EVANS & DIXON, LLC 379 19WC 33011 KINNEAR, CODY GEO N MITCHELL DRILLING C 10/25/19 HOFFEE LAW FIRM KEEFE & DEPAULI 380 19WC 33143 STEIN, JOSHUA HEARTLAND COCA-COLA 10/17/19 HOWERTON, DORRIS & STONE EVANS & DIXON, LLC 381 19WC 33441 BANDY, SHANNON CONTINENTAL TIRE 08/10/19 RICH RICH COOKSEY & CHAPPE KEEFE & DEPAULI 382 19WC 33583 BISSEY, SUSANNE M CILA CORP 10/05/19 SHORT AND DAUGHERTY HENNESSY & ROACH, PC 383 19WC 33799 KNIGHT, DANNY A HAMILTON COUNTY COAL LLC 04/01/19 CULLEY & WISSORE FEIRICH MAGER GREEN & RYAN 384 19WC 33956 ROBERTS, SHAWN P WAUPACA FOUNDRY INC 02/08/19 MOLLY WEHKING WOLFE & JACOBSON, LTD 385 19WC 34200 DUHON, ASHLEY N CONTINENTAL TIRE THE AMER 10/05/19 JAMES RUPPERT KEEFE & DEPAULI 386 19WC 34257 PEPER, DALE NASCOTE INDUSTRIES, INC 10/26/19 NELSON & NELSON KEEFE & DEPAULI 387 19WC 34508 HALE, MINDY PEPSI MIDAMERICA 08/19/19 KATZ FRIEDMAN EISENSTEIN 388 19WC 34627 DURBIN, MICHAEL A BIG MUDDY RIVER CORRECTIO @ 10/23/19 DEVIN M JONES ASSISTANT ATTORNEY GENERAL 389 19WC 34853 REYNOLDS, APRIL PROGRESSIVE HOUSING, INC 08/06/19 HANAGAN & MCGOVERN PC 390 19WC 34965 ESTES, JAMES PAUL & DENNIS ALLEN 10/01/18 DWORKIN AND MACIARIELLO 391 19WC 35069 ILBERY, CHEYENNE E NAPA AUTO PARTS 09/05/19 JAMES RUPPERT 392 19WC 35133 HERD, JOHN P AUTO ZONE 09/10/18 MEYER, MICHAEL J

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 23 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 393 19WC 35440 PARKS, CARROLL D SIGNATURE LABEL 08/19/19 SHORT AND DAUGHERTY 394 19WC 35483 FARMER, TIMOTHY CONTINENTAL TIRE THE AMER 12/20/18 KEEFE & DEPAULI 395 19WC 35539 ALTHOFF, MOLLY A STATE OF IL-MURRAY CENTER @ 07/21/19 BONIFIELD & ROSENSTENGEL P ASSISTANT ATTORNEY GENERAL 396 19WC 35790 BOYD, LARRY ESKER JB & SONS 06/28/19 DWORKIN AND MACIARIELLO 397 19WC 35981 BROWN, KRISTINA DRURY HOTELS 09/21/19 DWORKIN AND MACIARIELLO HARRIS DOWELL FISHER & HARRI 398 19WC 36213 BOYCE, NICOLE LAKELAND REHABILITATION 10/10/18 DAVID W MARTAY 399 19WC 36324 MEYLOR, MARK COMPLIANCE STAFFING AGENC 02/26/18 RUSIN & MACIOROWSKI LTD 400 19WC 36423 PRICE, JARED MT CARMEL POLICE DEPARTME 09/20/19 WOODRUFF JOHNSON SCHREMPF KELLY & NAPP 401 19WC 36928 BAILEY, DUSTIN D BAILEY FAMILY FREIGHT, LL 11/12/18 HASSAKIS & HASSAKIS PC BRADY, CONNOLLY & MASUDA, PC 402 19WC 37013 NEILANDS, BRENDA S NORTH AMERICAN LIGHTING, 03/05/18 CRAIN MILLER & WERNSMAN LT STEPHEN CARTER 403 19WC 37018 CAIN, DARRYL K EFFINGHAM REGRINDING, INC 10/24/17 JAMES RUPPERT 404 19WC 37091 ROHRSCHEIB, MATTHEW HOLZHAUER AUTO & 03/27/19 PRINCE LAW FIRM 405 19WC 37119 BARTLEY, MICHAEL AMERICANA BUILDING PRODUC 02/28/18 PFAFF GARNER & TERLIZZI GANAN & SHAPIRO 406 19WC 37393 GRAVES, DAVID J LES WILSON, INC 11/21/19 HASSAKIS & HASSAKIS PC 407 19WC 37495 HICKS, W ED WABASH COUNTY, 06/03/17 GOSNELL BORDEN ENLOE & SLO INMAN & FITZGIBBONS 408 19WC 37526 REEDER, DANIEL L GENUINE PARTS COMPANY #10 11/15/19 MOLLY WEHKING KEEFE CAMPBELL BIERY & ASSOC 409 19WC 37587 MARTIN, DYLAN M CONTINENTAL TIRE, 05/24/19 HASSAKIS & HASSAKIS PC 410 20WC 00129 SMITH, LAURA WEXFORD HEALTH SOURCES * 03/17/19 MARK N LEE

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 24 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 411 20WC 00327 JOHNSON, DILLON C WALGREENS FAMILY OF COMPA * 09/27/19 HASSAKIS & HASSAKIS PC EVANS & DIXON, LLC 412 20WC 00339 BELLINGER, JONATHAN M JABAT, INC * 03/25/19 JAMES RUPPERT 413 20WC 00710 ARNOLD, DAVID WALMART, INC * 02/04/19 WIEDNER & MCAULIFFE LTD 414 20WC 00779 GEIER, DANIEL CITY OF OLNEY * 07/03/18 MUELHAUSEN & STEFANI 415 20WC 01360 MILLER, JENNIFER VANSEAL * 10/30/19 STROM & ASSOC 416 20WC 01743 BROCK, SCOTT L DEFENDER SERVICES INC * 01/06/20 HORWITZ HORWITZ & ASSOC GOLDBERG SEGALLA LLC 417 20WC 01993 MENDENALL, STACI ELKS LODGE OF MT VERNON * 01/04/19 BECKER SCHROADER & CHAPMAN 418 20WC 02067 RUSH, RAPHAEL CENTRALIA SCHOOL DISTRICT * 02/07/18 BROWN & BROWN 419 20WC 02218 MORBER, JOSEPH CABLE ONE, INC * 07/30/19 SAM C MITCHELL & ASSOCIATE ROUSE & CARY 420 20WC 02329 ANDREWS, SAMUEL R CONTINENTAL TIRE THE AMER * 08/19/19 KEEFE & DEPAULI 421 20WC 02402 INBODEN, BRAIDEN CONTINENTAL TIRE THE AMER * 09/21/19 ANKIN LAW OFFICE KEEFE & DEPAULI 422 20WC 02942 BARNES, GEORGE MS COMPANIES * 12/18/18 DWORKIN AND MACIARIELLO 423 20WC 03150 NICHOLS, NICK JOHN BOOS & CO. * 01/11/20 HELLER HOLMES & ASSOC 424 20WC 03244 WAYER, HEATHER R THE REPUBLIC OF TEA * 10/01/19 DEVIN M JONES 425 20WC 03687 ARNOLD, CHRISTIAN TEMPCO PRODUCTS CO * 10/21/19 SMITH LAW LTD 426 20WC 04222 EDWARDS, CHRISTOPHER EDWARDS STEEL INC. * 11/15/19 THE BEARD LAW FIRM 427 20WC 04589 LEWIS SR, JAMES A CONTINENTAL TIRE THE AMER * 08/29/19 LEVENHAGEN LAW FIRM PC KEEFE & DEPAULI 428 20WC 04900 POKOJSKI, JOSHUA MURRAY DEVELOPMENTAL CENT @ * 05/19/19 LEVENHAGEN LAW FIRM PC ASSISTANT ATTORNEY GENERAL

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 25 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 429 20WC 04976 CLARK, DESTINEY M CONTINENTAL TIRE THE AMER * 12/11/18 JAMES RUPPERT 430 20WC 05035 ROSBOROUGH, JOSEPH IDOC @ * 08/20/19 LAW OFFICE OF JEROME SALMI 431 20WC 05232 TURNER, LARRY FABICK CAT * 01/15/19 RICH RICH COOKSEY & CHAPPE BRYCE DOWNEY & LENKOV LLC 432 20WC 05256 HUGHEY, MICHAEL ROYAL WHOLESALE * 09/10/19 BEMENT STUBBLEFIELD 433 20WC 05330 JONES, BRAD CITY OF MC LEANSBORO * 08/24/18 LEVENHAGEN LAW FIRM PC INMAN & FITZGIBBONS 434 20WC 05446 BRINK, MARC A NATIONAL RAILWAY EQUIPMEN * 12/10/19 LAW OFFICE OF JEROME SALMI 435 20WC 05450 SMITH, WILLIAM P CONTINENTAL TIRE AMERICAS * 04/22/19 KEEFE & DEPAULI 436 20WC 05638 HUGE, GINA WALGREEN'S DISTRIBUTION C * 12/18/19 BROWN & BROWN 437 20WC 05669 PRICE, PAUL CONTINENTAL TIRE THE AMER * 02/08/19 KEEFE & DEPAULI 438 20WC 05672 WARD, JEREMY CONTINENTAL TIRE THE AMER * 01/17/19 KEEFE & DEPAULI 439 20WC 05743 MASON, DOUGLAS SHERWIN WILLIAMS * 09/19/18 TAYLOR LAW OFFICES 440 20WC 05802 GREIFZU, JAMES CHAMPION LABORATORIES * 06/27/19 HANAGAN & MCGOVERN PC 441 20WC 05863 CATES, JULIE A NORTH AMERICAN LIGHTING I * 10/02/17 HASSAKIS & HASSAKIS PC STEPHEN CARTER 442 20WC 05930 HARRISON, PATRICK VIBRACOUSTIC * 02/10/20 RON D COFFEL & ASSOC 443 20WC 06057 WHITELOW, BRIDGET ST OF IL DEPT OF HUMAN SE @ * 10/04/19 REED & BRUHN, PC 444 20WC 06161 KRUEGER, FRED CONAGRA FOODS * 12/12/19 TAYLOR LAW OFFICES PC 445 20WC 06299 MCVEY, BO CONTINENTAL TIRE THE AMER * 08/17/19 KEEFE & DEPAULI 446 20WC 06715 MASON, MIKAYLA WALGREENS DISTRIBUTION CE * 01/29/20 DWORKIN AND MACIARIELLO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 26 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 447 20WC 06885 CLARKE, GREGORY CONTINENTAL TIRE * 09/30/19 RICH RICH COOKSEY & CHAPPE KEEFE & DEPAULI 448 20WC 07200 BEQUETTE, BENJAMIN R GRAPHIC PACKAGING INTNL I * 01/22/20 ONDERLAW LLC DOHERTY & PROGAR LLC 449 20WC 07446 MALLOY, RICKEY VANSEAL CORPORATION * 08/28/18 HOLTKAMP LIESE 450 20WC 07500 AITKEN, JAMES A&R MECHANICAL CONTRACTOR 01/17/20 DAVID W MARTAY RIPES NELSON BAGGOT KALOBRAT 451 20WC 07583 HUTCHCRAFT, JOSHUA A STATE OF ILLINOIS-LAWRENC @ * 07/07/19 CORNFIELD & FELDMAN 452 20WC 07601 BERNER, JAMES VANSEAL * 07/22/19 DRUMMOND LAW OFFICE 453 20WC 07631 BROWN, EARL AUTO ZONE * 02/14/20 STRONG LAW OFFICE 454 20WC 07837 KING, SHANNON M WALGREENS FAMILY OF COMPA * 01/11/19 HASSAKIS & HASSAKIS PC 455 20WC 07863 RANDLE, JAMES III COMMERCIAL TRANSPORT, INC * 02/05/20 WOLFGRAM & ASSOCIATES 456 20WC 07977 BRESSIER, KENNETH COMPLIANCE STAFFING AGENC * 05/28/19 LAW OFFICE OF JEROME SALMI 457 20WC 07993 TOEDTE, PAUL GRUPO ANTOLIN * 11/04/19 RICH RICH COOKSEY & CHAPPE 458 20WC 08058 RICHARDSON, CHRIS CONTINENTAL TIRE MT VERNO * 02/07/20 DWORKIN AND MACIARIELLO 459 20WC 08106 MITCHELL, NATHAN CONTINENTAL TIRE THE AMER * 08/01/19 KEEFE & DEPAULI 460 20WC 08119 WALKER, MARYSOL CHAMPION LABORATORIES * 09/12/19 HANAGAN & MCGOVERN PC 461 20WC 08178 KLEPZIG, DOUGLAS C WAUPACA FOUNDRY, INC * 06/17/19 JAMES RUPPERT 462 20WC 08216 SMITH, PATRICIA WALGREEN'S * 04/30/19 RICH RICH COOKSEY & CHAPPE 463 20WC 08247 JOHNSON, CODY CONTINENTAL TIRE THE AMER * 10/14/18 KEEFE & DEPAULI 464 20WC 08375 STUCKEY, MARY R MENARDS INC * 10/14/19 HELLER HOLMES & ASSOC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 27 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR MT VERNON 39002 ON 05/05/2020 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 465 20WC 08440 LUMPKINS, FRANKLIN L WALGREENS FAMILY OF COMPA * 02/03/20 HASSAKIS & HASSAKIS PC 466 20WC 08467 MASTERSON, JAMES QUAST CONSTRUCTION * 02/14/20 DWORKIN AND MACIARIELLO 467 20WC 08522 COLLIER, DERIK NORTH AMERICAN LIGHTING, * 05/17/19 KATZ FRIEDMAN EISENSTEIN