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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 1 00WC 59313 ROESCH, JUERGEN CRESSWOOD FARMS 09/23/00 CAPRON & AVGERINOS PC SUGAR FELSENTHAL GRAIS HAMME 2 03WC 49534 CLEAVELAND, COREY A NICOR 07/29/03 ROMANUCCI & BLANDIN MACIOROWSKI SACKMANN ULRICH 05WC046199 -C 3 05WC 39390 BUTTERFIELD, SHARON BLACKHAWK COLLEGE 12/09/03 NELSON KEYS & KEYS RUSIN & MACIOROWSKI LTD 4 06WC 21006 19B KPAYEDO, AKUAUI FARMLAND FOODS 07/05/04 'LANRE O AMU STEPHEN P. KELLY 5 06WC 51959 SANCHEZ, ROMAN GREAT DANE TRAILERS 06/13/06 BLACK & JONES SPIEGEL & CAHILL, PC 6 07WC 40759 19B BARBARO, TERRI J.B. HUNT TRANSPORT SERVI 08/16/07 JOHN J CASTANEDA RUSIN MACIOROWSKI & FRIEDMAN 7 08WC 00985 AMEGNRAN, YAWOVI FEDEX GROUND 10/06/07 SCOPELITIS GARVIN LIGHT 8 08WC 13496 MILLER, TERRY JOHN DEERE 01/16/08 JAMES M RIDGE & ASSOC PC CALIFF & HARPER PC 9 08WC 16193 AGBEZOUHLON, KOAMI TYSON FOODS INCWORKERS'CO 01/29/08 LEADERS LAW CENTER LLC GANAN & SHAPIRO 10 08WC 18828 FRY, DAVID L DEMPSEY & SONS CONSTRUCTI @ 03/16/08 DAVID W MANDRGOC LAW OFFIC ASSISTANT ATTORNEY GENERAL 11 08WC 34425 GARCIA, SARAH L WALMART #891 04/17/08 PERONA, PETERLIN, ANDREONI GANAN & SHAPIRO 12 08WC 47636 ASHLEY, DOUGLAS NORFOLK IRON & METAL 01/23/08 HOPKINS & HUEBNER PC GAROFALO SCHREIBER STORM 13 08WC 47799 JACKSON, DENNIS FARMLAND FOODS 08/30/08 STRONG LAW OFFICE STEPHEN P. KELLY 08WC047933 -C 14 08WC 48559 SHARBONEAU, MICHAEL E CONWAY FREIGHT INC 03/21/06 PIGNATELLI & MERTES PC RUSIN MACIOROWSKI & FRIEDMAN 10WC028145 -C 15 08WC 51564 WATKINS, TRAVIS HEARTLAND PLACEMENT 11/06/08 STRONG LAW OFFICE BRADY, CONNOLLY & MASUDA, PC 08WC056812 -C 10WC032753 -C 16 09WC 38276 MC INTIRE, DENNIS JOHN DEERE HARVESTER 02/27/07 AMES LAW OFFICES CALIFF & HARPER PC 17 09WC 47468 MONTEGNA, ROBERT HILAND TOYOTA SCION 11/19/08 WHITESIDE & GOLDBERG LTD GAROFALO SCHREIBER STORM

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 18 09WC 52793 QUINTERO, JESSICA FARMLAND FOODS 01/10/09 SIMPSON PETERSON STEPHEN P. KELLY 19 10WC 01856 ENGELS, KIMBERLY EYE SURGEONS ASSOCIATES P 07/13/09 CULLEN HASKINS NICHOLSON LAW OFFICES JOSEPH MARCINIAK 20 10WC 02225 FALL, LORI ROGER HAGERTY APPRAISALS 01/11/10 CROWLEY BUNGER PRILL GANAN & SHAPIRO 21 10WC 09659 FISHER, JEANNA ROCK ISLAND COUNTY 02/09/10 WARNER & ZIMMERLE RUSIN & MACIOROWSKI LTD 22 10WC 35295 JOHNSON, DUANE "ROB" MAPLE LEAF, INC D/B/A CUL 01/09/08 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 23 10WC 38233 GOMEZ, CIPRIANO JOHN DEERE HARVESTER 03/23/09 MARSZALEK AND MARSZALEK BOZEMAN NEIGHBOUR PATTON & N 24 10WC 38394 MCINTIRE, DENNIS J JOHN DEERE HARVESTER 03/06/09 AMES LAW OFFICES CALIFF & HARPER PC 25 11WC 04481 HERNANDEZ, ANA TYSON FOODS, INC. 10/29/10 HOPKINS & HUEBNER PC GANAN & SHAPIRO 26 11WC 07212 MADRIGAL, ARTEMIO KAISER'S CONTRACT CLEANIN 10/31/09 HOPKINS & HUEBNER PC HEYL ROYSTER VOELKER & ALLEN 27 11WC 24429 HOUSSOU, KPENAGNI A TYSON FRESH MEATS INC 02/15/11 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 28 11WC 28604 MARTINEZ DE NEVAREZ, GUAD TYSON FOODS 09/04/09 HOPKINS & HUEBNER PC GANAN & SHAPIRO 29 11WC 30676 LACOURSE, TIMOTHY A CHADCO INC 07/08/11 KANOSKI BRESNEY HENNESSY & ROACH 30 11WC 33221 PINTER, ERIK TYSON 05/12/09 CAPRON & AVGERINOS PC GANAN & SHAPIRO 31 11WC 39458 MILLER, ROBERT GALESBURG CASTINGS INC 11/08/10 REHN & SKINNER LLC RUSIN MACIOROWSKI & FRIEDMAN 32 11WC 41222 DE LA ROSA, JOSEPH XPAC 02/08/11 GILLIES, WILLIAM G RUSIN MACIOROWSKI & FRIEDMAN 14WC041161 -C 33 11WC 44878 BURCH, LISHA MCLAUGHLIN BODY 09/02/11 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 34 11WC 45512 SABIEL, AMKALSOUM TYSON FRESH MEATS INC 12/02/09 LEADERS LAW CENTER LLC GANAN & SHAPIRO 35 12WC 04147 ASHLEY, BRIAN GENIE TEMPORARY SRV 09/24/11 REHN & SKINNER LLC STONE & JOHNSON CHARTERED

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 36 12WC 04917 MYERS, CHARLES W BRAMM'S TREE SERVICE W 01/03/12 PIGNATELLI & ASSOCIATES MERTES & MERTES PC 37 12WC 07147 JONES, MICHAEL TY WARREN COUNTY 11/01/11 JAMES M RIDGE & ASSOC PC RUSIN MACIOROWSKI & FRIEDMAN 38 12WC 10258 GLISAN, BRYCE W FARMLAND FOODS, INC 10/23/10 LAW OFFICES KENNETH MAHAFF STEPHEN P. KELLY 39 12WC 20509 TRICIC, ELDIN ATKINSON LANDFILL COMPANY @ 05/09/12 STRONG LAW OFFICE 40 12WC 20987 PORTUGUE, WILLIAM L DEERE & CO/SEEDING GROUP 02/22/12 KATZ HUNTOON & FIEWEGER P CALIFF & HARPER, P.C. 41 12WC 21323 CHANDLER, PATRICK EXCELON/COMMONWEALTH EDIS 05/04/12 GOLDBERG WEISMAN & CAIRO L HENNESSY & ROACH PC 42 12WC 23308 FIGG, RONALD JR QUAD CITIES AUTISM CTR 01/08/12 STRONG LAW OFFICE RUSIN MACIOROWSKI & FRIEDMAN 43 12WC 23855 SIMONEAUX, DEAN ALL FEED PROCESSING & 05/17/10 VANDERGINST LAW PC ARNETT LAW GROUP 44 12WC 24366 HAND, RUTH WAHL CLIPPER CORP 03/07/11 TURNER & SACKETT LLC HEYL ROYSTER VOELKER & ALLEN 45 12WC 24447 BURCH, LISHA MCLAUGHLIN BODY COMPANY 07/03/12 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 46 12WC 27627 WOLF, CINNAMON UPS 06/06/12 PIGNATELLI & ASSOCIATES NYHAN BAMBRICK KINZIE & LOWR 47 12WC 29134 JESPERSEN, WAYNE S COUNTY WASTE SYSTEMS INC 06/11/12 KATZ HUNTOON & FIEWEGER P LARRY WOODWARD 48 12WC 30200 OSBORNE, TABITHA MULTIBAND CORP 05/16/10 AMES LAW OFFICES THOMAS & ASSOCIATES 14WC021098 -C 49 12WC 32756 WAGER, LOUIS JR ILLINOIS YOUTH CENTER KEW @ 08/16/12 STRONG LAW OFFICE ASSISTANT ATTORNEY GENERAL 50 12WC 34072 CALLETANO, MARIA (WIDOW) MCNEILL LABOR MANAGEMENT # 07/19/11 ATSAVES, LOUIS G LTD RUSIN & MACIOROWSKI LTD 51 12WC 34786 PASOWICZ, RON RYDER/TOTAL LOGISTIC 07/22/12 WOODRUFF & JOHNSON HEYL ROYSTER VOELKER & ALLEN

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 52 12WC 34912 KOMASSI, KOKOUTSE TYSON FRESH MEATS, INC 01/18/12 LEADERS LAW CENTER GANAN & SHAPIRO 53 12WC 36253 CORDER, BRYAN PLASTIC PRODUCTS CO 02/10/12 WINSTEIN KAVENSKY & WALLAC HENNESSY & ROACH PC 13WC031420 -C 14WC021117 -C 54 12WC 36721 STATON, JENNELL SOUTHTOWN TERRANCE 05/15/12 MARTIN V KUGIA GANAN & SHAPIRO 55 12WC 37112 BENSON, DAVID MENK USA 09/06/12 PIGNATELLI & ASSOCIATES GRANT & FANNING 56 12WC 37353 CAMPAGNA, ANTHONY KVF QUAD CORP 06/01/12 MARSZALEK AND MARSZALEK QUINN JOHNSTON HENDERSON ETA 57 12WC 37470 JOHNSON, DON J YEMM CHEVROLET 03/22/11 JAMES M RIDGE & ASSOC PC HEYL ROYSTER VOELKER & ALLEN 58 12WC 37887 LATHROP, DANIEL L STATE OF ILL DEPT OF @ 08/08/12 JOHN LESANGANICH ASSISTANT ATTORNEY GENERAL 59 12WC 38987 WELLMEIER, MICHAEL A BOB WHITE MASONRY INC 10/18/11 KATZ HUNTOON & FIEWEGER P PERRY GENTILE 60 12WC 40663 JENNINGS, CHADWICK JOHN DEERE HARVESTER 01/23/12 BELCHER LAW OFFICE KNAPP, OHL & GREEN 61 12WC 40770 FENWICK, MARTIN MENARDS 09/01/11 LAW OFFICE OF CHRIS DOSCOT GANAN & SHAPIRO 62 12WC 44539 MURRAY, LYN LMT INC 09/04/12 JAMES M RIDGE & ASSOC PC RUSIN MACIOROWSKI & FRIEDMAN 63 13WC 01672 HAENNI, SHERRI WAHL CLIPPER CORP 07/06/09 BLACK & JONES HEYL ROYSTER VOELKER & ALLEN 13WC001673 -C 13WC001674 -C 64 13WC 02240 STRUCK, WILLIAM KNOX COLLEGE 04/26/10 PETER D CORTI LAW GROUP GANAN & SHAPIRO 13WC002241 -C 65 13WC 03759 FRANCIS, RITA JOHNSON OIL SHELL 11/02/12 A RANDOLPH COMBA LAW OFFICES OF 66 13WC 03985 KOSSIGBO, OTHELLO TYSON FRESH MEATS INC 08/03/12 WINSTEIN KAVENSKY & CUNNIN GANAN & SHAPIRO

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 67 13WC 04619 RANDALL, JEFFREY EXPORT PACKAGING 11/29/12 CAPRON & AVGERINOS PC RUSIN & MACIOROWSKI LTD 68 13WC 06162 LANDRUM, BENJAMIN EAST MOLINE FD 02/01/02 STEVEN J SEIDMAN LAW OFFIC MCCARTHY, CALLAS & FEENEY PC 13WC006163 -C 69 13WC 06818 MUETING, DUSTIN JOHN DEERE HARVESTER 07/13/10 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 70 13WC 07041 ZIRZOW, DAVID EAST MOLINE SCHOOL 01/24/12 HOPKINS & HUEBNER PC MACIOROWSKI SACKMANN & ULRIC 71 13WC 07148 MATHIS, MELISSA JOHN DEERE HARVESTER 10/03/12 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 13WC007149 -C 15WC033155 -C 15WC033653 -C 72 13WC 09759 RITZERT, JEFFREY HAPY TEMPS @ W 04/18/10 WOODRUFF & JOHNSON ASSISTANT ATTORNEY GENERAL 73 13WC 11240 CURPHY, MERLE TRINITY MEDICAL CENTER 12/06/12 MARSZALEK AND MARSZALEK CALIFF & HARPER PC 74 13WC 12069 SCHRADER, AARON R WAL MART DISTRIBUTION CEN 03/27/13 REESE & REESE 75 13WC 12074 ADAMS, DANIEL ROCK ISLAND SCHOOL DISTRI 11/04/11 WINSTEIN KAVENSKY & CUNNIN INMAN & FITZGIBBONS 76 13WC 13323 SOGLOHUN, DENISE A IRC GENESIS SENIOR LIVING 12/06/11 LEADERS LAW CENTER HOPKINS & HUEBNER PC 77 13WC 15744 STRADER, ROSE A CGH MEDICAL CENTER 01/27/13 REESE & REESE WIEDNER & MCAULIFFE LTD 78 13WC 18312 AUSTIN, MARIA JOHANNES BUS SERVICE 04/22/13 STRONG LAW OFFICE JAMES M KELLY 13WC035706 -C 79 13WC 20345 TRUSSEN, JOHN, III JOHN DEERE PARTS DISTRIBU 05/18/13 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 80 13WC 21999 WAINSCOTT, KATINA CASEY'S GENERAL STORE 03/14/13 VANDERGINST LAW PC HEYL ROYSTER VOELKER & ALLEN 81 13WC 22794 ROSALES, MARIA LA RANCHERITA MEXICAN 06/25/13 WINSTEIN KAVENSKY & WALLAC 82 13WC 25476 COGSDIL, TERESA A THE ARC OF THE 02/24/13 KATZ HUNTOON & FIEWEGER P 83 13WC 26816 KENT, PATRICK GROUP O 05/10/13 KATZ HUNTOON & FIEWEGER P KNELL LAW LLC

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 84 13WC 28004 COLUNGA, SERGIO DIVERSIFIED MAINTENANCE 09/26/12 HOPKINS & HUEBNER PC HOLECEK & ASSOCIATES 85 13WC 28126 WEST, PAULA A WALMART DISTRIBUTING CENT 08/30/10 RIDGE & DOWNES LLC QUINTAIROS PRIETO WOOD & BOY 86 13WC 28129 LONG, MYRA L XPAC 08/11/13 RIDGE & DOWNES LLC RUSIN MACIOROWSKI & FRIEDMAN 87 13WC 29744 HARRIS, SHANEA OCTAPHARMA PLASMA 03/03/13 KEYS LAW OFFICES COZZI & GOGGIN-WARD 88 13WC 30353 PETTERSEN, BRANDT C PERKIN'S FAMILY RESTAURAN 09/06/12 KANOSKI BRESNEY BRADY, CONNOLLY & MASUDA, PC 89 13WC 31886 MINST, DOMINIQUE WALMART 06/14/13 MEYERS & FLOWERS WIEDNER & MCAULIFFE LTD 90 13WC 32374 GROSS, THOMAS JOHN DEERE HARVESTER WORK 12/05/12 VANDERGINST LAW PC BOZEMAN NEIGHBOUR PATTON & N 91 13WC 32427 WUORINEN, DAWN XPAC 05/22/13 NELSON KEYS & KEYS RUSIN MACIOROWSKI & FRIEDMAN 92 13WC 33033 CAVAZOS, EDMUNDO CASA GUANAJUATO QUAD CITI 09/18/13 WINSTEIN KAVENSKY & WALLAC RUSIN MACIOROWSKI & FRIEDMAN 93 13WC 33875 HAYNES, EDWARD DEPARTMENT OF TRANSPORTAT @ 08/17/12 RIDGE & DOWNES LLC ASSISTANT ATTORNEY GENERAL 94 13WC 34313 PIERCE, RONALD GREAT DANE 06/21/13 STRONG LAW OFFICE SPIEGEL & CAHILL, PC 95 13WC 34844 QUINN, KELLY R ALEDO REHAB & HEALTH CARE 05/16/13 LAW OFFICE OF CHRIS DOSCOT KNELL LAW LLC 96 13WC 36814 YOCUM, PTRICK J MIDAS 09/11/13 PIGNATELLI & ASSOCIATES WIEDNER & MCAULIFFE LTD 97 13WC 37467 FREEMAN, SARAH G ROCK ISLAND/MILAN 04/30/13 HOPKINS & HUEBNER PC INMAN & FITZGIBBONS 98 13WC 37791 MCMILLAN, DARREN QUAD CITY MALLARD 11/19/10 THE FLOYD LAW FIRM 99 13WC 38061 DIXON, BRADLEY ROCK ISLAND COUNTY 10/24/13 RIDGE & DOWNES LLC BROOKS LAW FIRM 100 13WC 38361 EDWARDS, DOROTHY SUPERIOR GLOBAL SOLUTIONS 10/25/13 WINSTEIN KAVENSKY & WALLAC HENNESSY & ROACH 101 13WC 38726 HELFTER, KENDRA HELFTER ENTERPRISES, INC. 08/07/12 AMES LAW OFFICES THOMAS & PORTELA

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 7 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 102 13WC 39687 CRANE, CASANDRA FARMLAND FOODS 02/01/13 WILLIAMS & SWEE STEPHEN P. KELLY 103 13WC 41385 KUEHL, LUKE B ILLINOIS STATE POLICE @ 11/22/13 RIDGE & DOWNES ASSISTANT ATTORNEY GENERAL 104 13WC 42269 GADEGBESSO, KOFFI FARMLAND FOOD 11/06/13 LEADERS LAW CENTER LLC STEPHEN P. KELLY 105 14WC 00167 NAAB, CHRISTIAN S CITY OF ROCK ISLAND 06/28/13 THOMAS W DUDA BETTY NEUMAN & MCMAHON 106 14WC 01347 LUNCSFORD, RICHARD C NOOTER CONSTRUCTION CO 11/22/13 RIDGE & DOWNES GAROFALO SCHREIBER STORM 107 14WC 02271 POCI, BENJAMIN G & P TRUCK LINE INC 02/15/11 WINSTEIN KAVENSKY & CUNNIN 14WC002387 -C 14WC002388 -C 108 14WC 03812 NGUYEN, MINH TYSON FOODS, INC 08/01/13 WINSTEIN KAVENSKY & WALLAC BRYCE DOWNEY & LENKOV LLC 109 14WC 05127 QUIROZ, RODRIGO VALLEY GROUP 11/27/13 DWORKIN AND MACIARIELLO 110 14WC 05993 SHERIFF-BAKER, LESLEY GOLD STAR 06/13/13 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 111 14WC 06588 BERTRAM, ROBERT K AGRI KING 01/30/13 RIDGE & DOWNES 112 14WC 07835 CARNES, WILLIAM COOTS MATERIALS 06/25/13 LAW OFFICE OF CHRIS DOSCOT HEYL ROYSTER VOELKER & ALLEN 113 14WC 11047 SALAZAR, MARIA E TYSON FRESH MEATS 03/11/14 KATZ FRIEDMAN EAGLE ET AL GANAN & SHAPIRO 114 14WC 11828 STRUCK, MARY STATE OF ILLINOIS @ 01/29/14 PETER D CORTI LAW GROUP ASSISTANT ATTORNEY GENERAL 115 14WC 12939 BAKER, DAVID ADEL WHOLESALERS, INC. 09/13/13 WINSTEIN KAVENSKY & WALLAC BETTY NEUMAN & MCMAHON 116 14WC 13338 OGOUBI, AFI TYSON FOODS INC 03/27/13 LEADERS LAW CENTER LLC BRYCE DOWNEY & LENKOV LLC 117 14WC 13515 PUCKETT, DAVID AG-VIEW FS, INC 01/10/13 SCHWEICKERT & GANASSIN RUSIN MACIOROWSKI & FRIEDMAN 118 14WC 14117 LANDRY, STEVEN WAYNE STOHL & SONS PLASTE 06/16/13 LEE, MARK N LAW OFFICE 119 14WC 15138 ALLEN, CHERYAL D XPAC 03/05/14 CAPRON & AVGERINOS PC RUSIN MACIOROWSKI & FRIEDMAN

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 120 14WC 16184 PALOS, MELISSA A REGALIA MANUFACTURING COM 02/21/14 KATZ HUNTOON & FIEWEGER P EDWARD JANUSZKIEWICZ 121 14WC 16530 GRIFFITH, BILLY KONE 02/12/14 WINSTEIN KAVENSKY & WALLAC GAROFALO SCHREIBER STORM 122 14WC 18482 TEMPLETON, GENE O JR EAST MOLINE METAL PRODUCT 02/27/12 KATZ HUNTOON & FIEWEGER P PERRY GENTILE 123 14WC 18737 HAYOSTEK, SUZANNE HELP AT HOME INC 03/18/14 HOPKINS & HUEBNER PC COZZI & GOGGIN-WARD 124 14WC 20657 PRICE, KEVIN L DUPONT NUTRITION & HEALTH 09/16/13 REESE & REESE RUSIN & MACIOROWSKI LTD 14WC020658 -C 125 14WC 20730 SANDOVAL, FILOMENO DIAZ FCA MANUFACTURING COMPANY 11/20/11 HOPKINS & HUEBNER PC HOLECEK & ASSOCIATES 14WC020731 -C 126 14WC 23222 JACKSON, JAMES JOHN DEERE HARVESTER 11/06/13 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 127 14WC 23455 ARNOLD, MICHELLE GENESIS SENIOR LIVING ALE 05/10/14 RIDGE & DOWNES LLC HOPKINS & HUEBNER PC 128 14WC 24119 PEREZ, GRWUASLLY XPAC 03/28/14 ANDREW BRIBRIESCO RUSIN MACIOROWSKI & FRIEDMAN 14WC024120 -C 15WC012941 -C 129 14WC 24286 BARDELL, TINA ARTHUR WOLF 05/20/13 MEYERS & FLOWERS WARD MURRAY PACE & JOHNSON P 130 14WC 25261 SIMMONS, BARRY A AUTO ZONE 04/13/14 JOHN LESAGANICH QUINN JOHNSTON HENDERSON ETA 131 14WC 25377 SCHULTZ, MICHAEL TYSON FRESH MEATS 12/13/13 STRONG LAW OFFICE GANAN & SHAPIRO 132 14WC 25575 ROBINSON, KATRINA SPARTAN STAFING 05/07/14 PIGNATELLI & ASSOCIATES GANAN & SHAPIRO 14WC028382 -C 133 14WC 25634 THOMPSON, SUSAN FIRST STUDENT 06/09/14 PIGNATELLI & ASSOCIATES 134 14WC 26799 TERRONEZ, BRANDON L ARROWHEAD RANCH 07/11/13 KATZ HUNTOON & FIEWEGER P COZZI & GOGGIN-WARD 135 14WC 26843 HALLOWAY, AUDY BALLARD TREE & @ W 05/23/13 PETER F FERRACUTI & ASSOCI ASSISTANT ATTORNEY GENERAL 136 14WC 27185 POLTON, MIKE HURST MANUFACTURING COMPA 05/16/14 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 137 14WC 28122 COIL, RICK DOHRN TRANSFER COMPANY 07/21/14 BLACK & JONES GANAN & SHAPIRO 138 14WC 29872 WARNER, BREE J JOHN DEERE HARVESTER 04/14/14 MARSZALEK AND MARSZALEK CALIFF & HARPER PC 139 14WC 30934 DOOLEY, DAN JOHN DEERE HARVESTER 08/15/14 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 140 14WC 32387 NAUGLE, BETH HILLCREST HOME 12/29/13 RIDGE & DOWNES INMAN & FITZGIBBONS 141 14WC 32447 SMITH, T MICHAEL KOPPERS COMPANY INC 04/16/13 ELFENBAUM EVERS & AMARILIO RUSIN & MACIOROWSKI LTD 142 14WC 33108 BYRGE, BRAD JOHN DEERE PARTS DISTRIBU 05/12/14 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 143 14WC 33169 PALMER, JANA OSF HOME CARE SERVICES 12/10/13 REHN & SKINNER LLC 144 14WC 33397 SCHONE, RONALD DEPARTMENT OF TRANSPORTAT @ 05/03/14 RIDGE & DOWNES LLC ASSISTANT ATTORNEY GENERAL 145 14WC 33530 HANES, JOHN ENVIRONMENTAL SERVICES IN 09/16/14 WINSTEIN KAVENSKY & WALLAC 146 14WC 34347 HURTADO, MARIO CONCRETE SERVICE LTD 06/25/13 ELFENBAUM EVERS & AMARILIO BRADY, CONNOLLY & MASUDA, PC 147 14WC 34547 CHRISTENSEN, KERRI L HOPE CREEK/ROCK ISLAND CO 05/29/14 KATZ HUNTOON & FIEWEGER P BROOKS LAW FIRM 15WC009962 -C 148 14WC 34725 GORGAS, MARTIN A STATE OF IL @ 07/06/14 VITELL & SPITZ LTD ASSISTANT ATTORNEY GENERAL 149 14WC 35503 DELONG, THOMAS ILLINOIS CIVIL CONTRACTOR 08/11/14 JOHN LESAGANICH RUSIN & MACIOROWSKI LTD 150 14WC 35990 HERNANDEZ, RIGOBERTO PACKERS SANITATION SVCS I 05/01/14 KATZ FRIEDMAN EAGLE ET AL RUSIN & MACIOROWSKI LTD 14WC035991 -C 151 14WC 36403 ENSLEY, PAUL BOMAG AMERICAS 04/24/13 WARNER & ZIMMERLE LAW OFFICES JOSEPH MARCINIAK 152 14WC 37237 CHIPMAN, ANTHONY EAST MOLINE SHEET METAL 08/21/14 WINSTEIN KAVENSKY & WALLAC MACIOROWSKI SACKMANN & ULRIC 153 14WC 39065 ANDERSON, ALLISON (FRIEND EAST MOLINE F.D. # 06/23/13 SEIDMAN MARGULIS & FAIRMAN MCCARTHY, CALLAS & FEENEY PC 154 14WC 39364 WOOD, ORYN MIDSTATE MANUFACTURING CO 06/15/14 RIDGE & DOWNES LLC GANAN & SHAPIRO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 10 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 155 14WC 40052 DEHM, SANDRA STATE OF ILLINOIS @ 04/22/14 WARNER & ZIMMERLE ASSISTANT ATTORNEY GENERAL 156 14WC 40057 GENTRY, LINDA LONG JOHN SILVERS 03/11/14 WINSTEIN KAVENSKY & WALLAC EDWARD JANUSZKIEWICZ 157 14WC 40293 GAYTAN, ROMANA JOHN DEERE HARVESTER 08/14/13 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 158 14WC 40550 SOTHMANN, SAMUEL IL YOUTH CENTER - KEWANEE @ 03/26/14 RIDGE & DOWNES LLC ASSISTANT ATTORNEY GENERAL 159 14WC 40662 MC KINLEY, ERIC ADRIAN CARRIERS 02/18/14 STRONG LAW OFFICE 160 14WC 40767 LANG, NECIA R GENESIS HEALTH SYSTEM D/B 09/03/14 KATZ HUNTOON & FIEWEGER P HOPKINS & HUEBNER PC 161 14WC 41030 LAYNE, TROY M ILLINOIS STATE POLICE @ 05/04/12 FIGLIOLI, DAVID ASSISTANT ATTORNEY GENERAL 162 14WC 41055 WINTERS, DELBERT AG-VIEW FS, INC 04/19/14 SCHWEICKERT & GANASSIN RUSIN & MACIOROWSKI LTD 163 14WC 41228 DANIELS, KIMBERLY CARE PRO INC 09/12/14 SCHWEICKERT & GANASSIN HOLTKAMP LIESE ET AL 164 14WC 41933 FRANCISKO, STEVEN ILLINOIS DEPARTMENT OF @ 11/22/13 RIDGE & DOWNES ASSISTANT ATTORNEY GENERAL 165 14WC 42339 JOHN, TUNZA TYSON FOODS INC 09/18/13 HOPKINS & HUEBNER PC BRYCE DOWNEY & LENKOV LLC 166 14WC 42761 TENSLEY, NOLAN JEWEL FOOD STORE 10/27/14 MARKS & ASSOCIATES 167 14WC 43062 BLAKE, CHARLES J ANGELO'S III 11/09/13 EDWARD JANUSZKIEWICZ 168 14WC 43258 KING, JEFF CAMEY CONSTRUCTION @ W 03/31/14 LAW OFFICE OF CHRIS DOSCOT 169 14WC 47261 TENSLEY, NOLAN JEWEL FOOD STORES 10/27/14 MARKS & ASSOCIATES 170 15WC 00038 FAY, BRIAN GALAXY 1 MARKETING INC 02/28/13 KEEFE CAMPBELL & ASSOC LLC 171 15WC 00938 NELSON, MERISSA THE ARC OF THE QUAD CITIE 03/24/14 HOPKINS & HUEBNER PC 172 15WC 01752 BOUATIAOUI, MOHAMED TYSON FOODS 08/11/14 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 11 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 173 15WC 03673 CHAPPELL, SUSAN JOHN DEERE HARVESTER 05/09/12 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 174 15WC 03822 HAMILTON, KAREN METROLINK 01/21/15 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 175 15WC 04096 PALMER, MARY A ROCK ISLAND COUNTY 02/14/14 BRUCE CARMEN BROOKS LAW FIRM 15WC004097 -C 176 15WC 04337 SOUTHERLAND, HARGUS ILLINOIS YOUTH CENTER KEW @ 01/07/15 RIDGE & DOWNES LLC ASSISTANT ATTORNEY GENERAL 177 15WC 04352 PANDYA, VIBHAKAR ILLINOIS YOUTH CENTER KEW @ 01/24/15 RIDGE & DOWNES ASSISTANT ATTORNEY GENERAL 178 15WC 04387 PEDIGO, TYSON KOPPERS INC 01/19/15 REHN & SKINNER LLC RUSIN & MACIOROWSKI LTD 179 15WC 04434 GRAGERT, ERNA COVENTRY LIVING CENTER 07/26/12 WOLFE LAW PC WOLFE & JACOBSON, LTD 15WC004435 -C 180 15WC 05442 BALLARD, JULIA K. WARREN ACHIEVEMENT CENTER 04/16/14 GOLDBERG WEISMAN & CAIRO L STELLATO & SCHWARTZ 181 15WC 05655 RODRIGUEZ, JOSE DIRECT TRUCKING 01/26/15 PORRO NIERMANN & PETERSEN JAMES M KELLY 182 15WC 06433 HUSKEY, RANDAL ROCK ISLAND MILAN S DIST 05/02/14 WINSTEIN KAVENSKY & WALLAC INMAN & FITZGIBBONS 183 15WC 07623 TEMPLETON, HOLLYWOOD ROCK ISLAND COUNTY 03/21/12 KATZ HUNTOON & FIEWEGER P BROOKS LAW FIRM 184 15WC 08298 LICHTENAUER, EARL "BUD" CORRECT ELECTRIC INC 12/17/14 GOLDBERG WEISMAN & CAIRO L RUSIN & MACIOROWSKI LTD 185 15WC 08383 ORWITZ, MATTHEW MCLAUGHLIN BODY CO 09/26/14 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 186 15WC 08517 DUARTE, CLEMENTE PROGRESS RAIL 02/10/15 MCDONALD WOODWARD & CARLSO GOLDBERG SEGALLA LLC 187 15WC 09558 ILES, JAMIELYNN GALESBURG COTTAGE HOSPITA 11/23/14 SIMPSON PETERSON POWER & CRONIN LTD 188 15WC 10121 ELLIS, JOYCE WALGREENS 06/09/14 VANDERGINST LAW PC GILDEA & COGHLAN 189 15WC 10179 DANIELSON, THOMAS DEPARTMENT OF TRANSPORTAT @ 02/25/15 RIDGE & DOWNES LLC ASSISTANT ATTORNEY GENERAL 190 15WC 10320 PEARSON, ROBERT UNITED TOWNSHIP HIGH SCHO 09/10/13 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 191 15WC 10689 HINOJOSA, MARTA X-PAC 01/28/15 HOPKINS & HUEBNER PC RUSIN & MACIOROWSKI LTD 192 15WC 10731 CLAUSON, GARY L USF HOLLAND 11/05/13 RIDGE & DOWNES LLC HENNESSY & ROACH PC 193 15WC 10814 MILLER, VALERIE CHRISTIAN BROS SERVICES/ 12/30/12 THE NEPPL LAW CENTRE 194 15WC 11261 VANDIERENDONCK, JAMES ILLINOIS YOUTH CENTER @ 03/05/15 RIDGE & DOWNES LLC ASSISTANT ATTORNEY GENERAL 195 15WC 11767 DIAZ-SANDOVAL, FILOMENO FCA MANUFACTURING CO 02/25/14 HOPKINS & HUEBNER PC HOLECEK & ASSOCIATES 196 15WC 11936 HAMILTON, JOSHUA KING FOOD SERVICES INC 12/30/14 STRONG LAW OFFICE RUSIN & MACIOROWSKI LTD 197 15WC 12767 LEOS, EVA A TYSON FOODS INC 01/27/12 WINSTEIN KAVENSKY & WALLAC BRYCE DOWNEY & LENKOV LLC 198 15WC 12947 FEATHER, DARCY L AVONLEA COTTAGE 02/16/15 MERTES & MERTES PC KEEFE CAMPBELL & ASSOC LLC 199 15WC 13087 DINGMAN, BEN ILLINOIS YOUTH @ 03/18/15 RIDGE & DOWNES LLC ASSISTANT ATTORNEY GENERAL 200 15WC 13341 HARRISON, CHRISTINE WAHL CLIPPER CORP. 05/17/13 DWORKIN AND MACIARIELLO HEYL ROYSTER VOELKER & ALLEN 201 15WC 13757 SAGE, SHIRLEY MONMOUTH COLLEGE 08/29/14 REHN & SKINNER LLC INMAN & FITZGIBBONS 202 15WC 14020 MCDOUGLE, LAKESE FARMLAND FOODS 03/27/14 DWORKIN AND MACIARIELLO STEPHEN P. KELLY 203 15WC 14662 PERSON, BRIAN R XENA INTERNATIONAL 01/24/15 GESMER LAW OFFICES, PC 204 15WC 14866 SEBAHAR, GREGORY ESTATE O KONE, INC # 04/05/15 LAW OFFICE OF KEVIN O'BRIE GAROFALO SCHREIBER STORM 205 15WC 14998 SODAWASSER, GRACE WALGREENS 01/18/15 WOODRUFF & JOHNSON GILDEA & COGHLAN 206 15WC 15243 PICKREL, JAMES A CARL A NELSON & CO 12/31/14 STRONG LAW OFFICE 207 15WC 15410 WEATHERS, PENNIE MAID FOR YOU 02/17/14 DWORKIN AND MACIARIELLO HANSON LAW OFFICE 208 15WC 15465 KOENIG, DALE JOHN DEERE HARVESTER 03/28/14 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 209 15WC 15914 SEIDEL, CRAIG STERLING STEEL CO 03/05/15 DWORKIN AND MACIARIELLO RUSIN & MACIOROWSKI LTD 210 15WC 16982 WILLIAMS, GLENNA E UNITED FACILITIES 01/30/15 RIDGE & DOWNES LLC COZZI & GOGGIN-WARD 211 15WC 17055 FICKLING, PATRICIA STATE OF IL @ 12/06/11 RIDGE & DOWNES LLC ASSISTANT ATTORNEY GENERAL 212 15WC 17204 CHAPMAN, JAMEY M JOHN DEERE HARVESTER WORK 05/08/14 HOPKINS & HUEBNER PC CALIFF & HARPER PC 213 15WC 17345 EGAN, RICHARD ASTEC MOBILE SCREENS, INC 10/07/13 MAURICE E DUSKY PC COZZI & GOGGIN-WARD 214 15WC 17704 CARPENTER, AARON KOREY FARM EQUIPMENT LLC 08/08/13 KATZ HUNTOON & FIEWEGER P WIEDNER & MCAULIFFE LTD 16WC023457 -C KORY FARM EQUIPMENT, LLC 16WC025383 -C 215 15WC 17790 SIMMON, TY M CITY OF MOLINE 05/18/15 THOMAS W DUDA CALIFF & HARPER PC 15WC017791 -C 216 15WC 17948 HAGA, DENNIS RIVER VALLEY COOPERATIVE 01/07/13 SPIROS LAW PC BRYCE DOWNEY & LENKOV LLC 217 15WC 18197 TAETS, DONALD XL CONSTRUCTION DBA 05/02/14 ANESI OZMON RODIN NOVAK KO KNELL LAW LLC 218 15WC 18451 LEITZEN, JEREMY CITY OF FULTON POLICE DEP 05/26/15 RIDGE & DOWNES LLC NYHAN BAMBRICK KINZIE & LOWR 219 15WC 18494 GASKIN, ANGELA L FEDEX FREIGHT CORP 09/05/12 CERVATES & GORDON PLC QUINTAIROS PRIETO WOOD & BOY 220 15WC 18607 HELFTER, KENDRA HELFTER ENTERPRISES, INC. 09/12/13 AMES LAW OFFICES 221 15WC 18743 MOHAMMED, YAHIA TYSON FRESH MEATS, INC. 07/13/12 PARAD LAW OFFICES PC GANAN & SHAPIRO 222 15WC 18805 KIRK, REBECCA A JOHN DEERE HARVESTER 04/15/15 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 223 15WC 18950 CRAWFORD, MARY KAY STATE OF ILLINOIS @ 05/21/15 WINSTEIN KAVENSKY & WALLAC ASSISTANT ATTORNEY GENERAL 224 15WC 19151 KIRK, TYLER LEGGETT & PLATT D/B/A 05/12/15 PETER F FERRACUTI & ASSOCI 225 15WC 19375 STORM, MICHELLE ROCK TENN 10/15/13 CROWLEY BUNGER PRILL GAROFALO SCHREIBER STORM

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 226 15WC 19470 CERVANTES, JORGE MICRO INDUSTRIES 05/20/15 PIGNATELLI & ASSOCIATES HENNESSY & ROACH PC 227 15WC 20028 WOODS, JOE L TYSON FRESH MEATS 12/29/14 FRANK WICKER BRYCE DOWNEY & LENKOV LLC 228 15WC 20036 ZI, KHING MA TYSON FOODS INC 05/14/14 WINSTEIN KAVENSKY & WALLAC BRYCE DOWNEY & LENKOV LLC 229 15WC 20076 WICKERSHAM, JOHN VALLEY CONSTRUCTION 06/13/14 ELFENBAUM EVERS & AMARILIO 230 15WC 20215 BELL, EDWARD G OSF HEALTHCARE ST LUKE-KE 02/01/15 LAW OFFICES KENNETH MAHAFF 231 15WC 20381 WHEELER, MICHAEL DEERE HARVESTER 11/05/09 VANDERGINST LAW PC CALIFF & HARPER PC 232 15WC 20755 METTLER, KIMBERLY MONMOUTH NURSING HOME 06/05/15 LAW OFFICE DAVID HUNT HOLTKAMP LIESE ET AL 233 15WC 21166 LAGE, JEREMY A SEDONA STAFFING 06/09/15 MERTES & MERTES PC BETTY NEUMAN & MCMAHON 234 15WC 21591 MADRIGAL, PEDRO TYSON FRESH MEATS INC 10/27/14 ELFENBAUM EVERS & AMARILIO GANAN & SHAPIRO 235 15WC 21821 DAMP, ROSEANNA ARAMARK SERVICES, INC. 10/12/12 THE NEPPL LAW CENTRE 236 15WC 22660 PEREZ-HERNANDEZ, ROSA FARMLAND FOODS 09/25/14 VANDERGINST LAW PC STEPHEN P. KELLY 237 15WC 22740 PUGA, JAIME TYSON FRESH MEATSINC 03/23/15 GANAN & SHAPIRO 238 15WC 22871 SCHONE, RONALD DEPARTMENT OF TRANSPORTAT @ 04/13/15 RIDGE & DOWNES LLC ASSISTANT ATTORNEY GENERAL 239 15WC 23073 BASARICH, DAVID W STERLING RESTORATIONS 12/15/14 MERTES & MERTES PC RUSIN & MACIOROWSKI LTD 240 15WC 23146 DULLA, ALAN D TAXI-PLUS 01/02/14 AMES LAW OFFICES 241 15WC 23375 THOMAS, JASON ACE PEST MANAGEMENT INC @ W 03/04/15 MCDONALD WOODWARD & CARLSO ASSISTANT ATTORNEY GENERAL 242 15WC 23389 OGOUBI, KOKOU TYSON FOODS 03/16/15 HOPKINS & HUEBNER PC GANAN & SHAPIRO 243 15WC 23568 CARR, HEIDI M CASEY'S RETAIL CO 09/10/13 KATZ HUNTOON & FIEWEGER P HEYL ROYSTER VOELKER & ALLEN

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 244 15WC 23803 GOODELL, SCOTT SMITHFIELD/FARMLAND FOODS 03/20/15 CAPRON & AVGERINOS PC STEPHEN P. KELLY 245 15WC 23928 GRIGGS, DAVID MOLINE POLICE DEPT 05/28/15 RIDGE & DOWNES LLC CITY OF MOLINE 246 15WC 24063 KIDDY, LARRY UNION CONTRACTING 05/28/14 RIDGE & DOWNES 247 15WC 25498 HUFNAGEL, ED TKO GRAPHIX 05/18/15 LAW OFFICE OF CHRIS DOSCOT COZZI & GOGGIN-WARD 248 15WC 26003 GOUDY, LARRY GALESBURG CUSD #205 08/18/14 LEE, MARK N LAW OFFICE KNELL LAW LLC 249 15WC 26097 BECKMAN, ESTHER WALMART SUPER CENTER 04/03/15 WINSTEIN KAVENSKY & WALLAC QUINTAIROS PRIETO WOOD & BOY 250 15WC 26200 PRESTON, JODY RUDOLPH MASONRY, INC. 07/30/14 WOLFE LAW PC BRADY CONNOLLY & MASUDA PC 251 15WC 26820 HAMPTON, PRENTICE GATES CORPORATION 07/23/15 REHN & SKINNER LLC 252 15WC 27387 MARLOW, ADALINE STATE OF IL DIVISION OF @ 05/22/15 WINSTEIN KAVENSKY & WALLAC ASSISTANT ATTORNEY GENERAL 253 15WC 27496 MURPHY, DENNIS GROUP O 05/11/15 WINSTEIN KAVENSKY & WALLAC KNELL LAW LLC 254 15WC 27635 DAVIS, ROXAN D WAL-MART STORES INC 08/25/14 KATZ HUNTOON & FIEWEGER P GANAN & SHAPIRO 255 15WC 28279 MOKWANGA, NANCY FARMLAND FOODS 05/01/15 LAW OFFICE DAVID HUNT STEPHEN P. KELLY 256 15WC 28410 WILEMAN, MARTIN STATE OF ILLINOIS @ 08/07/15 GOLDBERG WEISMAN & CAIRO L NYHAN BAMBRICK KINZIE & LOWR 257 15WC 28919 CLEWELL, RAYMOND L UNITED FACILITIES 06/24/15 RIDGE & DOWNES COZZI & GOGGIN-WARD 258 15WC 29374 KELLY, TIMOTLHY JOHN DEERE HARVESTER 06/12/14 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 259 15WC 29716 MOLANDER, DON B STRATESIC RESOURCES INC 12/17/14 CAPRON & AVGERINOS PC LAW OFFICES JOSEPH MARCINIAK 260 15WC 30090 GRIFFITH, BILLY KONE 05/13/15 WINSTEIN KAVENSKY & WALLAC 261 15WC 30743 ALVEAR, MARLON CLEARY BUILDING CORP 05/18/15 LAW OFFICE DAVID HUNT STONE & JOHNSON CHARTERED

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 262 15WC 31334 HOLDEN, BRADLEY JASON GENERAL ELECTRIC 03/14/15 O'CONNOR & NAKOS MACIOROWSKI SACKMANN & ULRIC 263 15WC 31877 LOVIC, ELVIR PROJECT NOW 08/24/15 WINSTEIN KAVENSKY & WALLAC PERRY GENTILE 264 15WC 32241 MOORE, JAMES BRAND ENERGY 03/27/15 CULLEN HASKINS NICHOLSON BRADY, CONNOLLY & MASUDA, PC 265 15WC 32380 HEINSEN, WADE DEPARTMENT OF TRANSPORTAT @ 08/27/15 RIDGE & DOWNES LLC ASSISTANT ATTORNEY GENERAL 266 15WC 32762 RODRIQUEZ, JESSIE ILLINOIS YOUTH 09/24/15 RIDGE & DOWNES KRISTINA D DION 267 15WC 32841 RUIZ, BRIAN PPC PLASTIC PRODUCTS CO. 08/30/15 WINSTEIN KAVENSKY & WALLAC HENNESSY & ROACH PC 268 15WC 33440 HARRISON, QUINN O TED & TRISHA KOSTER FARM 06/12/15 GOLDBERG WEISMAN & CAIRO L WARD MURRAY PACE & JOHNSON P 269 15WC 33486 DIAZ, HERLINDA TYSON FOODS 06/01/14 MEYERS & FLOWERS BRYCE DOWNEY & LENKOV LLC 270 15WC 33581 BRANDNER, KAY CEE LIGHTHOUSE OF SILVIS 07/11/15 THOMAS W DUDA RUSIN & MACIOROWSKI LTD 271 15WC 34019 WILLIAMS, CHRISTINA HOME TOWN EXPRESS 08/03/15 REHN & SKINNER LLC QUINN JOHNSTON HENDERSON ETA 272 15WC 34168 COOK, STEVEN M IFH GROUP 10/15/14 MERTES & MERTES PC PERRY GENTILE 273 15WC 34442 PAR, SIMI TYSON FRESH MEATS 10/19/11 VANDERGINST LAW PC 274 15WC 34929 DOTSON, SHEENA SUPER 8 MOTEL 09/25/15 REHN & SKINNER LLC GANAN & SHAPIRO 275 15WC 35074 OLALDE, DEBRA L EXCEPTIONAL CARE & 10/08/14 MERTES & MERTES PC LAW OFFICES FRANCESCA LARSEN 276 15WC 35133 O'CONNOR, JANE DICK BLICK MATERIALS 09/21/15 LAW OFFICE DAVID HUNT LAW OFFICES JOSEPH MARCINIAK 277 15WC 35242 LEWIS, KRISTOPHER JOHN DEERE PARTS 01/26/15 WINSTEIN KAVENSKY & WALLAC 278 15WC 35272 BARNES, DENNIS ILLINOIS YOUTH CENTER KEW @ 03/04/15 RIDGE & DOWNES ASSISTANT ATTORNEY GENERAL 279 15WC 35452 WAY, JOELLEN R DERBY SUPPLY CHAIN SOLUTI 07/07/15 RIDGE & DOWNES LAW OFFICES JOSEPH MARCINIAK

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 280 15WC 35558 19B GOUDY, LARRY CUSD #205 09/10/15 LEE, MARK N LAW OFFICE KNELL LAW LLC 281 15WC 35753 BEIN, VERNON JOHN DEERE HARVESTER 08/26/15 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 282 15WC 35782 CHAPMAN, JASON JOHN DEERE HARVESTER 06/22/15 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 283 15WC 35830 GAMBLE, TYLER M AMC ENTERTAINMENT 12/14/14 BOSHARDY LAW OFFICE PC HINSHAW & CULBERTSON 284 15WC 36910 RILEY, CHERYLE DORS 06/13/15 WOLFE LAW PC ASSISTANT ATTORNEY GENERAL 15WC036911 -C 15WC036912 -C 285 15WC 37717 WATTS, DEREK COCA-COLA ENTERPRISES, IN 08/27/15 WINSTEIN KAVENSKY & WALLAC BRADY, CONNOLLY & MASUDA, PC 286 15WC 38230 MCKILLIP, ANGELA UNITY POINT HOSPITAL 07/18/14 VANDERGINST LAW PC CALIFF & HARPER PC 287 15WC 38468 YOUNGBLOOD, ASHLEY US SECURITY ASSOCIATES 10/27/15 GOLDFINE & BOWLES COZZI & GOGGIN-WARD 288 15WC 38577 MOUKHLIS, AZEDINE TYSON 02/13/15 WINSTEIN KAVENSKY & WALLAC BRYCE DOWNEY & LENKOV LLC 289 15WC 38853 MCFADDEN, JEFF G&M DISTRIBUTORS INC 10/14/15 STRONG LAW OFFICE HEYL ROYSTER VOELKER & ALLEN 290 15WC 39314 TAMAYO, NORA M GARCIA XPAC 07/25/15 ANDREW BRIBRIESCO RUSIN & MACIOROWSKI LTD 291 15WC 39626 WELBECK, MARIE TYSON FRESH MEATS 10/04/14 STRONG LAW OFFICE GANAN & SHAPIRO 292 15WC 39801 BAYONA, BENJAMIN SKOOG LANDSCAPE AND DESIG 06/07/15 EPSTEIN, JACK R LAW OFFICE WIEDNER & MCAULIFFE LTD 293 15WC 39914 SINGLETON, VICTOR RATCLIFF ENTERPRISES W 08/17/15 LAW OFFICE OF CHRIS DOSCOT 294 15WC 39969 KOBBEMAN, JOSH SCHOFF FARM SRVC INC 04/16/15 MERTES & MERTES PC BRADY, CONNOLLY & MASUDA, PC 295 15WC 41316 COLLINS, DEWEY DOWERS ROOFING 05/06/14 BLACK & JONES RIPES NELSON BAGGOT KALOBRAT 296 15WC 41386 PALMER, ANGELA HENRY COUNTY 02/24/15 WINSTEIN KAVENSKY & WALLAC INMAN & FITZGIBBONS 297 15WC 41452 CARLE, MICHAEL CONSOLIDATED GRAIN & BARG 09/04/14 WOODRUFF & JOHNSON CAPUANI & SCHNEIDER

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 298 15WC 41565 CLARK, GENI FIRST STUDENT, INC. 08/31/15 PETER F FERRACUTI & ASSOCI WIEDNER & MCAULIFFE LTD 299 15WC 41702 BOLEA, ANNETTE BAKUBILA A FARMLAND FOODS 06/06/15 LAW OFFICE DAVID HUNT STEPHEN P. KELLY 300 15WC 41705 KING, PATSY A KNOX CLINIC CORP 05/07/15 SIMPSON PETERSON 301 15WC 42054 DAVIS, ALVIN WOODARD & CURRAN 10/27/15 LAW OFFICE OF CHRIS DOSCOT LAW OFFICE PAUL LARIMORE 302 15WC 42170 BATES, CAROL WALMART 09/09/14 REHN & SKINNER LLC 303 15WC 42350 MALEK, COREY A. STATE OF IL-IL. STATE POL @ 11/16/15 JOHN LESAGANICH ASSISTANT ATTORNEY GENERAL 304 15WC 42582 ANDERSON, JUSTIN PRAIRIE FARMS DAIRY 07/17/15 WINSTEIN KAVENSKY & WALLAC KNAPP, OHL & GREEN 305 15WC 42900 KYSER, DENNIS J II FEDEX FREIGHT INC 01/06/13 KATZ HUNTOON & FIEWEGER P 306 16WC 00315 BROWN, TODD USF HOLLAND 11/23/15 RIDGE & DOWNES HENNESSY & ROACH PC 16WC015580 -C 307 16WC 00544 RILEY, MARK DICK BLICK 10/19/15 DWORKIN AND MACIARIELLO 308 16WC 00742 RETHERFORD, DAWN E WAHL CLIPPER 06/18/14 REESE & REESE HEYL ROYSTER VOELKER & ALLEN 309 16WC 00960 ALBERTSON, DANIEL THOMPSON TRUCK TRAILER 04/01/15 PIGNATELLI & ASSOCIATES RUSIN & MACIOROWSKI LTD 310 16WC 01104 SEIDEL, CRAIG A STERLING STEEL COMPANY, A 10/01/15 REESE & REESE RUSIN & MACIOROWSKI LTD 311 16WC 01267 JAKEOB LOTHRIDGE ARAMARK UNIFORM SERVICES 12/29/15 WINSTEIN KAVENSKY & WALLAC STONE & JOHNSON CHARTERED 312 16WC 01374 GONZALEZ, MANUAL BLACK HAWK COLLEGE 12/16/14 DWORKIN AND MACIARIELLO 313 16WC 01461 ESSER, COREY E ILLINOIS YOUTH CENTER KEW @ 05/16/15 RIDGE & DOWNES ASSISTANT ATTORNEY GENERAL 16WC011669 -C 314 16WC 01585 GORANSON, MICHAEL JOHN DEERE 08/05/15 ANKIN LAW OFFICE BOZEMAN NEIGHBOUR PATTON & N 315 16WC 01872 PAILLE, NATALIE HELP AT HOME, INC. 12/31/15 DWORKIN AND MACIARIELLO

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 316 16WC 02335 PASLEY, JOSHUA WALMART DISTRIBUTION CENT 12/08/15 RIDGE & DOWNES 317 16WC 02725 FIGUEROA, RAFAEL TRAMEC HILL FASTENER, LLC 12/03/15 WHITESIDE & GOLDBERG LTD 318 16WC 03155 FREW, KENNETH JOHN DEERE SEEDING GROUP 12/09/15 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 319 16WC 03222 WHEELER, MICHAEL DEERE HARVESTER 12/04/09 VANDERGINST LAW PC CALIFF & HARPER PC 320 16WC 03488 TAYLOR, GARY COWSER INC 02/12/15 GOLDFINE & BOWLES 321 16WC 03697 HOFFMANN, FRED JOHN DEER HARVESTER WORKS 11/12/13 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 322 16WC 04035 CISSE, MOUSTAPHA TYSON FRESH MEATS INC 04/17/15 WARNER & ZIMMERLE BRYCE DOWNEY & LENKOV LLC 323 16WC 04449 BRATHALL, CHRIS D & G REAL ESTATE 07/17/15 WINSTEIN KAVENSKY & WALLAC 324 16WC 04481 MAYES, DAVID REPUBLIC SERVICES INC 01/02/16 RIDGE & DOWNES GILDEA & COGHLAN 325 16WC 04840 PETTORINI, KIMBERLY LUTHERN SOCIAL 10/21/15 DWORKIN AND MACIARIELLO GAROFALO SCHREIBER STORM 326 16WC 04927 SOTO RODRIGUEZ, RAHIHAN FARMLAND FOODS 05/01/15 RIDGE & DOWNES STEPHEN P. KELLY 327 16WC 04983 TAETS, DONALD L STERLING COMMERCIAL ROOFI 11/04/14 ANESI OZMON RODIN NOVAK KO 328 16WC 05685 WEST, WADE W. DAV AND TY ENTERPRISES, I 12/23/15 STENGEL BAILEY ROBERTSON 329 16WC 05727 LEAF, STEVEN K DOWERS ROOFING 08/11/15 GOLDBERG WEISMAN & CAIRO L 330 16WC 05748 ZAAGMAN, CANDACE ST OF IL COMPTROLLER 01/15/16 PIGNATELLI & ASSOCIATES ASSISTANT ATTORNEY GENERAL 331 16WC 05895 DAMITZ, DARRYL MCLAUGHLIN BODY 08/11/14 WINSTEIN KAVENSKY & WALLAC 332 16WC 06142 ROSSELL, LINDSAY GREAT DANE L P 01/25/16 REHN & SKINNER LLC SPIEGEL & CAHILL, PC 333 16WC 06422 MAGER, STACY M WALMART DISTRUBUTION CENT 09/26/14 REESE & REESE QUINTAIROS PRIETO WOOD & BOY

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 334 16WC 06597 COVEMAKER, KEVIN RIVERSTONE GROUP INC 01/08/16 KATZ HUNTOON & FIEWEGER P BETTY NEUMAN & MCMAHON 335 16WC 06615 MELINE, DEBRA KCCDD 02/14/14 REHN & SKINNER LLC 336 16WC 07132 SCOTT, CORTNEY R B D H ROCK ISLAND PAWN, L 02/02/16 AMES LAW OFFICES HOLECEK & ASSOCIATES 337 16WC 07306 HAGEMEIER, MARK E JOHN DEERE 02/04/16 MERTES & MERTES PC BOZEMAN NEIGHBOUR PATTON & N 338 16WC 07319 EYGABROAD, TRAVIS J CITY OF ROCK ISLAND 01/16/16 STENGEL BAILEY ROBERTSON BETTY NEUMAN & MCMAHON 339 16WC 07337 AVILA, PENNY J GANA-A'YOO SERVICES CORP 09/08/15 KATZ HUNTOON & FIEWEGER P COZZI & GOGGIN-WARD 340 16WC 07427 REH, POE SMITHFIELD FARMLAND FOODS 08/27/15 STANSELL WHITMAN & BABER STEPHEN P. KELLY 341 16WC 07584 BAKER, JONATHAN J. FARMLAND FOODS 01/15/15 REHN & SKINNER LLC STEPHEN P. KELLY 342 16WC 07703 SNYDER, CHARLES TYSON FOODS 02/16/16 DWORKIN AND MACIARIELLO GANAN & SHAPIRO 343 16WC 07720 WAITKUS, RICHARD MOLINE FORGE 08/26/15 WINSTEIN KAVENSKY & WALLAC 344 16WC 07742 HARDING, JOHN BREAKTHRU BEVERAGE IL F/K 03/04/15 GOLDBERG WEISMAN & CAIRO L 345 16WC 07849 MARIANI-TEAGUE, ZUMA HCI MARKETING, LLC 03/04/14 GOMEZ MAY LLP HEYL ROYSTER VOELKER & ALLEN 346 16WC 07951 MARQUEZ, LUIS ASPLUNDH TREE EXPERT CO 06/02/15 WINSTEIN KAVENSKY & WALLAC KNELL & O'CONNOR 347 16WC 08025 YOUNG, PAMELA A WESTERN IL UNIVERSITY @ 09/08/15 RIDGE & DOWNES KRISTINA D DION 348 16WC 08223 DOUTY, BEYEM B TYSON FRESH MEATS INC 05/24/14 BROOKS LAW FIRM GANAN & SHAPIRO 349 16WC 08375 HAAN, DARREN JOHN DEERE HARVESTER 09/25/15 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 350 16WC 08751 PIERCE, PATRICK GARY SPENCE 01/05/16 REHN & SKINNER LLC BOZEMAN NEIGHBOUR PATTON & N 351 16WC 08898 WOMBLES, ALICIA IL YOUTH CENTER KEWANEE @ 03/13/16 RIDGE & DOWNES LLC KRISTINA D DION

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 352 16WC 08911 ROYCE, JANE E MEL FOSTER COMPANY INC 02/14/14 BOZEMAN NEIGHBOUR PATTON & 353 16WC 09058 FELDHAN, GARRETT VALSPAR CORP 10/22/14 RUSIN & MACIOROWSKI LTD 354 16WC 09309 JOHNSON, KENT JOHN DEERE HARVESTER 09/10/15 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 355 16WC 09460 MEDRANO, RUBICELIO TYSON FRESH MEATS 02/25/15 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 356 16WC 09468 HAHN, DAN DEERE & CO INC/ 02/22/15 SCHWEICKERT & GANASSIN LANE & WATERMAN 357 16WC 09679 DECRANE KAHA, SAMANTHA L. HYVEE, INC. 01/11/16 VANDERGINST LAW PC HOPKINS & HUEBNER PC 358 16WC 09706 WATSON, HEATHER E AVONLEA COTTAGE 02/20/16 VANDERGINST LAW PC HEYL ROYSTER VOELKER & ALLEN 359 16WC 09800 KUKLOK, TAMARA DAL GLOBAL SERVICES, LLC 10/19/13 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 360 16WC 09879 BOKEN, SANDRA K WALMART 03/02/16 CULLEN HASKINS NICHOLSON QUINTAIROS PRIETO WOOD & BOY 361 16WC 09927 KOLANI, KANTIME TYSON FOODS 01/07/14 WARNER & ZIMMERLE GANAN & SHAPIRO 362 16WC 10598 SAGE, MICHELLE JOHN DEERE HARVESTER WORK 06/15/14 STRONG LAW OFFICE BOZEMAN NEIGHBOUR PATTON & N 363 16WC 10652 MITAL, MICHAEL JOHN DEERE SEEDING 08/14/14 MARSZALEK AND MARSZALEK CALIFF & HARPER PC 364 16WC 10656 CROWDER, GREGORY JOHN DEERE HARVESTER 01/23/15 MARSZALEK AND MARSZALEK BOZEMAN NEIGHBOUR PATTON & N 365 16WC 10728 MILES, CASSANDRA M ROCK ISLAND COUNTY 05/31/13 VANDERGINST LAW PC BROOKS LAW FIRM 366 16WC 10753 WAITKUS, RICHARD MOLINE FORGE 12/10/15 WINSTEIN KAVENSKY & WALLAC 367 16WC 10919 PEMBERTON, PATRICK ILLINOIS YOUTH CENTER KEW @ 03/24/16 RIDGE & DOWNES KRISTINA D DION 368 16WC 11212 PICKREL-MONKUS, ANITA BREAK TIME 01/29/15 THE NEPPL LAW CENTRE 369 16WC 11380 JOHNSON, CHIQUITA OSF ST MARYS 03/18/16 STRONG LAW OFFICE

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 22 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 370 16WC 11700 COLE, RICHARD A. CAMERON GRAIN CORPORATION 08/14/15 HARVEY & STUCKEL EVANS & DIXON, LLC 371 16WC 11817 BERGREN, GARY ILLINOIS YOUTH CENTER KEW 03/24/16 STRONG LAW OFFICE KRISTINA D DION 372 16WC 12036 SIGEL, GORDON R KIMBALL MIDWEST 02/15/16 REESE & REESE LAW OFFICES JOSEPH MARCINIAK 373 16WC 12491 TESSIER, ANTHONY JOHN DEERE HARVESTER WORK 08/12/15 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 374 16WC 12658 NICOL, ROBERT MATERIAL CONTROL SYSTEM 11/11/14 WINSTEIN KAVENSKY & WALLAC 375 16WC 12866 NGUMBU, SERGE LUMUUNGA FARMLAND FOODS 09/15/15 LAW OFFICE DAVID HUNT STEPHEN P. KELLY 376 16WC 12878 GOULD, TRUDY JOHN DEERE 10/27/15 MERTES & MERTES PC BOZEMAN NEIGHBOUR PATTON & N 377 16WC 12903 ALONSO, MANUEL TYSON FRESH MEATS 02/17/15 BUSH MOTTO CREEN KOURY BRYCE DOWNEY & LENKOV LLC 16WC012904 -C 378 16WC 13082 ANDERSON, JAMES ROADRUNNER TRANSPORTATION 04/09/15 RIDGE & DOWNES HINSHAW & CULBERTSON 379 16WC 13374 HUDSON, ALPHONSE THE BEDDING GROUP, INC. 02/19/16 HEIPLE LAW OFFICE PERRY GENTILE 380 16WC 13390 ANDERSON, JEREMY CPC LOGISTICS 11/15/15 WINSTEIN KAVENSKY & WALLAC GAROFALO SCHREIBER STORM 381 16WC 13530 STEDER, TODD JOHN DEERE CYLINDER 02/04/16 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 382 16WC 13652 KUSHMER, JONATHAN ELECTRIC DOCTOR 06/17/15 ELFENBAUM EVERS & AMARILIO STONE & JOHNSON CHARTERED 383 16WC 13785 YODTS, DARRELL MTS TRANSPORTATION 02/09/16 DWORKIN AND MACIARIELLO PERRY GENTILE 384 16WC 14005 DYNES, PAM HENRY COUNTY SHERIFF 11/22/15 LAW OFFICE OF CHRIS DOSCOT INMAN & FITZGIBBONS 385 16WC 14025 DUBLO, DAVID W CORPORATE SERVICES INC 03/24/16 MERTES & MERTES PC SLAVIN & SLAVIN 386 16WC 14164 BROWNSON, JOANNE L CASEY'S GENERAL STORES IN 05/15/15 KATZ HUNTOON & FIEWEGER P 387 16WC 14670 DOUMASHIE, AKU TYSON FOODS, INC. 05/21/14 WINSTEIN KAVENSKY & WALLAC BRYCE DOWNEY & LENKOV LLC

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 388 16WC 14700 HARRIS, TABITHA KNOX COUNTY NURSING HOME 09/05/14 REHN & SKINNER LLC BUSH MOTTO CREEN KOURY 389 16WC 14949 SALZ, BRIAN ILLINOIS YOUTH CENTER KEW @ 05/05/16 RIDGE & DOWNES KRISTINA D DION 390 16WC 15099 BARTOSCH, MICHAEL JOHN DEERE 03/13/14 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 391 16WC 15581 PETERSON, KATHY F EXPORT PACKAGING CO, INC. 09/09/13 KATZ HUNTOON & FIEWEGER P RUSIN & MACIOROWSKI LTD 392 16WC 15942 RADER, RONALD JOHN DEERE HARVESTER 06/23/14 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 393 16WC 15953 DELOS SANTOS, REY FRANTZ MANUFACTURING 05/06/16 PIGNATELLI & ASSOCIATES MCANANY VANCLEVE & PHILLIPS 394 16WC 16051 HARRISON, BEN D ARROWHEAD RANCH INC 12/17/14 KATZ HUNTOON & FIEWEGER P COZZI & GOGGIN-WARD 395 16WC 16161 MINARD, JEREMY L. JOHN DEERE PARTS 10/30/15 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 396 16WC 16297 SENTERAS, BEVERLY HACIENDA BAR & GRILL 04/27/16 HOLECEK & ASSOCIATES 397 16WC 16447 BERRYMAN, PATRICIA UNITY POINT CLINIC 11/20/15 MARKS & ASSOCIATES BETTY NEUMAN & MCMAHON 398 16WC 16509 JILES, JESSICA FARMLAND FOODS 02/27/15 DODD & MAATUKA LLC STEPHEN P. KELLY 399 16WC 16776 LEWIS, BONNIE M HELP AT HOME HOLDINGS INC 01/11/16 PIGNATELLI & ASSOCIATES INMAN & FITZGIBBONS 400 16WC 17049 BYRD, MICHAEL WAL-MART, INC. 09/14/15 QUINTAIROS PRIETO WOOD & BOY 401 16WC 17062 TOSMIC, DAVID JOHN DEERE CYLINDER 07/11/12 WINSTEIN KAVENSKY & WALLAC 402 16WC 17199 BEARD, TRISHA ACOSTA SALES & MARKETING 12/08/14 REESE & REESE SPIEGEL & CAHILL, PC 403 16WC 17628 TORRES, MARIA RICO FARMLAND FOODS INC. 02/03/16 WOODRUFF & JOHNSON STEPHEN P. KELLY 404 16WC 17681 FRANKS, JENNIFER AUTO ZONE 04/30/15 HOPKINS & HUEBNER PC GILDEA & COGHLAN 405 16WC 18209 RICHARDS, KAMI L JOHN DEERE HARVESTER WORK 11/20/15 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 406 16WC 18478 MEINCKE, JENNY GENESIS MEDICAL CENTER 05/09/16 DWORKIN AND MACIARIELLO HOPKINS & HUEBNER PC 407 16WC 18539 ATTWOOD, STEVE JOHN DEERE HARVESTER WORK 04/10/14 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 408 16WC 18545 SWIFT, JUSTIN E ROCK RIVER VLY SELFHELP E 05/11/16 REESE & REESE PERRY GENTILE 409 16WC 18613 JOHNSON, BRUCE D JOHN DEERE HARVESTER 03/02/15 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 410 16WC 18780 SHAPPARD, HELVETTIA WALMART DISTRIBUTION CENT 04/03/16 RIDGE & DOWNES GANAN & SHAPIRO 411 16WC 19436 NICHOLSON, SHEILA M STATE OF ILLINOIS @ 05/17/16 RIDGE & DOWNES ASSISTANT ATTORNEY GENERAL 412 16WC 20247 HELLER, JOHN S CITY OF MOLINE 05/17/16 THOMAS W DUDA CALIFF & HARPER PC 413 16WC 20602 VANCE, KENNETH XPAC 06/08/16 LEFANTE LAW OFFICES RUSIN & MACIOROWSKI LTD 414 16WC 20886 BEESON, MARK THE WALLMAN OPTICAL CO 06/15/16 KATZ HUNTOON & FIEWEGER P 415 16WC 21321 AULT, BRANDON PROGRESS RAIL SERVICES 03/18/15 GOLDBERG SEGALLA LLC 416 16WC 21361 HAMILTON, KAYTLIN EXCEPTIONAL CARE & TRAINI 08/31/15 PIGNATELLI & ASSOCIATES 417 16WC 21974 KIVISTO, GRACE KCCDD 04/22/16 SIMPSON PETERSON 418 16WC 22353 FLANNERY JR, CURTIS JOHN DEERE HARVESTER 11/13/14 WINSTEIN KAVENSKY & WALLAC 419 16WC 22522 HOFFERT, REBECCA BRADFORD COMMUNITY UNIT S 07/30/13 ANTHONY C RACCUGLIA & ASSO 420 16WC 22891 JACO, AMANDA REZENBERGER 04/14/16 GOLDFINE & BOWLES 421 16WC 23140 AMEGANDJIN, COFFI XPAC 02/02/16 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 422 16WC 23706 BOLEYN, JOHN LEANDER CONSTRUCTION INC 04/15/16 HORWITZ HORWITZ & ASSOC PERRY GENTILE 423 16WC 23804 THORPE, PAMELA UNITYPOINT HEALTH TRINITY 11/25/15 WINSTEIN KAVENSKY & WALLAC

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 424 16WC 23950 SCARSELLA, HOPE JOHN DEERE SEEDING 06/19/12 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 425 16WC 24386 OWENS, EDWARD GATES CORPORATION 02/04/16 RIDGE & DOWNES 426 16WC 24435 KIEL, HOWARD R&L CARRIERS, INC. 02/04/16 VANDERGINST LAW PC 427 16WC 24479 LATHROP, PAUL STATE OF ILLINOIS-DEPT @ 06/29/16 PIGNATELLI & ASSOCIATES ASSISTANT ATTORNEY GENERAL 428 16WC 24525 WALLACE, ANTHONY ILLINOIS DEPARTMENT OF 08/07/16 DWORKIN AND MACIARIELLO ASSISTANT ATTORNEY GENERAL 429 16WC 24571 BRAMM, JOSEPH M UOI URBAN OUTLET 03/10/16 MERTES & MERTES PC RUSIN & MACIOROWSKI LTD 430 16WC 24698 MAGEE, TOM KOPPERS 01/03/15 JAY H JANSSEN RUSIN & MACIOROWSKI LTD 431 16WC 25103 SEBARANZI, ADONIS TYSON FRESH MEATS, INC 08/19/13 BUSH MOTTO CREEN KOURY 432 16WC 25130 SHEFFIELD, JOHNNY MANPOWER 07/03/16 DWORKIN AND MACIARIELLO 433 16WC 25166 BERHILI, RACHID TYSON FOODS, INC 07/11/16 WINSTEIN KAVENSKY & WALLAC BRYCE DOWNEY & LENKOV LLC 434 16WC 25303 BUTRYN, MARIUSZ CASSENS TRANSPORT CO. 08/09/16 HORWITZ HORWITZ & ASSOC KNAPP, OHL & GREEN 435 16WC 25665 CASTILLO, MIRNA PETERSEN HEALTH CARE INC 07/18/16 REESE & REESE KNELL LAW LLC 436 16WC 25676 BALLARD, DANIEL ROCK ISLAND COUNTY FOREST 07/26/15 WINSTEIN KAVENSKY & WALLAC STATES ATTY OF ROCK ISLAND 437 16WC 25834 WHAN, MICHAEL RI-MILAN SCHOOL DIST #41 05/07/15 VANDERGINST LAW PC GANAN & SHAPIRO 438 16WC 25864 MBOUNGOU, FAUVETTE SMITHFIELD FARMLAND 02/28/16 RIDGE & DOWNES 439 16WC 25925 RUBINGH, KRISTINA JOHN DEERE HARVESTER 04/21/10 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 440 16WC 26420 NOBLE, TONY L MILLER CONTAINER CORPORAT 07/14/16 STENGEL BAILEY ROBERTSON 441 16WC 27117 AKERS, MICHAEL I80 EQUIPMENT 08/12/16 RUSIN & MACIOROWSKI LTD

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 442 16WC 27159 HENDRICKS, PEGGY WEXFORD HEALTH SOURCES 12/17/15 LAW OFFICE DAVID HUNT RUSIN & MACIOROWSKI LTD 443 16WC 27547 SAGE, MICHELLE JOHN DEERE 02/16/16 GOLDFINE & BOWLES BOZEMAN NEIGHBOUR PATTON & N 444 16WC 27561 CEJA, RICARDO JOHN DEERE SEEDING GROUP 10/09/15 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 445 16WC 27651 ACEVEDO, MARY D SAM'S CLUB/WALMART STORES 07/26/16 HOPKINS & HUEBNER PC QUINTAIROS PRIETO WOOD & BOY 446 16WC 27653 ABBOT, TONY R BUHS AGRI-INTERMODAL SVS, 08/01/16 MEYERS & FLOWERS 447 16WC 27738 LARSON, DENNIS JOHN DEERE CYLINDER 09/15/15 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 448 16WC 27830 SUMMERS, JOSH SENSIENT FLAVORS INT'L IN 03/30/16 SCHWEICKERT & GANASSIN 449 16WC 28140 FLANNERY, CURTIS JR JOHN DEERE HARVESTER 03/23/15 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 450 16WC 28183 STARCEVICH, LINDA MERCER COUNTY SHERRIFF'S 05/12/16 CROWLEY BUNGER PRILL INMAN & FITZGIBBONS 451 16WC 28204 WILLIAMS, JARRED JOHN DEERE HARVESTER WORK 10/22/13 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 452 16WC 28331 LOPEZ, JORGE MCI MCCARTHY IMPROVEMENT 06/28/16 ANESI OZMON RODIN NOVAK KO BETTY NEUMAN & MCMAHON 453 16WC 28532 RILEY, CHRISTOPHER IL CORP SERVICE C REGISTE 08/16/16 RIDGE & DOWNES LLC 454 16WC 28657 JILL, ALIER TYSON FRESH MEATS 09/03/15 VANDERGINST LAW PC GANAN & SHAPIRO 455 16WC 29073 CALDWELL, JUSTIN LIFT SYSTEMS INC 03/16/16 WINSTEIN KAVENSKY & WALLAC 456 16WC 29140 TAYLOR, CHARLENE APERION CARE 09/10/16 WINSTEIN KAVENSKY & WALLAC 457 16WC 29151 SWANSON, KENNETH E GOEHL BUILDERS 08/27/14 SIMPSON PETERSON 458 16WC 29249 BEST, DOUGLAS PEPSICO 06/16/16 LAW OFFICE DAVID HUNT GILDEA & COGHLAN 459 16WC 29352 HANTZ, WENDY JOHN DEERE HARVESTER WORK 11/16/15 HOPKINS & HUEBNER PC BOZEMAN NEIGHBOUR PATTON & N

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 ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 460 16WC 29428 TUCKER, WILLIA A ALL SOURCE 07/16/15 CAPRON & AVGERINOS PC 461 16WC 29593 MORRIS, TERRI L O'REILLY AUTO ENTERPRISES 08/27/16 TUITE LAW 462 16WC 29736 DUNSWORTH, KELLEY MID-AMERICAN ENERGY CO 05/01/15 CHRISTINE A KEYS PC 463 16WC 29826 MANNING, PATRICIA STATE OF IL/DORS @ 08/23/16 BLACK & JONES 464 16WC 29917 CHAMPION, TODD JOHN DEER HARVESTER 02/27/14 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 465 16WC 29927 AVILA, MINERVA TYSON FOODS, INC 01/05/16 HOPKINS & HUEBNER PC BRYCE DOWNEY & LENKOV LLC 466 16WC 30141 CONTRERAS, LAZARO LEGGETT & PLATT STERLING 07/11/15 STROW LAW LLC 467 16WC 30154 LOPER, CLIFFORD BLICK ART MATERIALS 09/10/16 STRONG LAW OFFICE LAW OFFICES JOSEPH MARCINIAK 468 16WC 30412 CLAY, RICHARD GATES RUBBER CO 08/01/16 SAUNDERS CONDON & KENNY 469 16WC 31023 BROCKETT, KIRK GATES MANUFACTURING 12/23/15 STEPHEN P. KELLY QUINTAIROS PRIETO WOOD & BOY 470 16WC 31100 ZWEIFEL, BETSI J CHRISTOPHER & BANKS 09/12/16 MERTES & MERTES PC COZZI & GOGGIN-WARD 471 16WC 31445 MOWER, MICHAEL J ROCK GATE CAPITAL, LLC 12/24/15 KATZ HUNTOON & FIEWEGER P 472 16WC 31531 CROTHERS, TARA WALMART DISTRIBUTION CTR 05/31/16 WOLFE LAW PC QUINTAIROS PRIETO WOOD & BOY 473 16WC 31578 WISE, CINDY SMITHFIELD FOODS 03/07/14 HARVEY & STUCKEL STEPHEN P. KELLY 474 16WC 31725 QAMHI, NAWAL TYSON FOODS INC 08/12/14 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 475 16WC 31833 JEFFERS, CHRISTOPHER GREEN GABLES 09/19/16 BLACK & JONES BRADY, CONNOLLY & MASUDA, PC 476 16WC 31897 CLARK, BETTY REHABILITATION SVCS 08/19/16 DWORKIN AND MACIARIELLO 477 16WC 32210 JORDAN, JOSHUA NATHANIEL FEDEX GROUND 09/23/16

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 28 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 478 16WC 32392 GROSS, TRACY BOONE CABLE WORKS 09/14/16 FREDERICK & HAGLE HEYL ROYSTER VOELKER & ALLEN 479 16WC 32406 PATTERSON, SANDRA J FULTON CORP 04/05/16 THOMAS E CADY 480 16WC 32522 FAVELA, JOSE GREAT DANE TRAILERS 01/28/16 PETER F FERRACUTI & ASSOCI 481 16WC 32586 MORGAN, MICHAEL SR JOHN DEERE HARVESTER WORK 03/24/15 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 482 16WC 32754 CHAVEZ, LINDA XPAC 03/13/14 VANDERGINST LAW PC RUSIN & MACIOROWSKI LTD 483 16WC 32810 DANIELSEN, JEAN A LA LEASING, INC DBA 03/18/16 THOMAS E CADY 484 16WC 32873 HOKE, ROGER JOHN DEERE CYLINDER 10/30/15 LAW OFFICE DAVID HUNT BOZEMAN NEIGHBOUR PATTON & N 485 16WC 33148 ALI, OSAMA TYSON FOODS 04/20/16 WINSTEIN KAVENSKY & WALLAC BRYCE DOWNEY & LENKOV LLC 486 16WC 33357 MCDONALD, TOM WAHL CLIPPER 07/10/16 LAW OFFICE OF CHRIS DOSCOT HEYL ROYSTER VOELKER & ALLEN 487 16WC 33757 TOWNSEND, KEVIN USF HOLLAND 09/30/16 RIDGE & DOWNES 488 16WC 33858 NOUR, SOMAYA TYSON FRESH MEATS, INC 12/09/14 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 489 16WC 34625 THERIAC, TRACI JOHN DEERE HARVESTER 06/11/15 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 490 16WC 35111 WOOD, CONNIE JOHN DEERE HARVESTER 03/31/16 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 491 16WC 35356 TOPORAN, MUJO TYSON FOODS INC 04/22/15 WINSTEIN KAVENSKY & WALLAC 492 16WC 35432 DYER, HOWARD JOHN DEERE HARVESTER 07/31/15 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 493 16WC 35557 PETTERA, JEFFERY R METFORM 03/27/15 PIGNATELLI & ASSOCIATES 494 16WC 35919 DAH-TOHOUENOU, ANSELME TYSON FOODS, INC 03/07/16 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 495 16WC 36126 JAQUET, JODLE VITAS HEALTHCARE CORPORAT 10/07/16

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 29 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 496 16WC 36248 SCHUELER, DOUG WALMART 05/04/16 JAY H JANSSEN 497 16WC 36370 CLOUGH, STEPHEN CAMBRIDGE CUSD #227 01/29/14 KNELL LAW LLC 498 16WC 36409 PETERSON, SHAWN STATE OF ILLINOIS IDOT @ 11/10/16 JOHN LESAGANICH ASSISTANT ATTORNEY GENERAL 499 16WC 36618 BUSHMAN, DAVID A STERLIGN RAIL SERVICES, L * 11/15/16 REESE & REESE 500 16WC 36953 BIRD, DONALD ALL EVENT SVCS RS COMPANI * 08/17/16 VANDERGINST LAW PC RUSIN & MACIOROWSKI LTD 501 16WC 37208 MITAL, MICHAEL JOHN DEERE SEEDING * 01/15/15 MARSZALEK AND MARSZALEK CALIFF & HARPER PC 502 16WC 37249 PRINS, MICHELE M FARMERS AUTO MGMT CO DBA * 09/20/16 THOMAS E CADY HEYL ROYSTER VOELKER & ALLEN 503 16WC 37273 BRABSON, ANDREW VILLAGE HOME STORES * 10/15/14 504 16WC 37336 DEVILDER, DARRELL CITY OF ROCK ISLAND * 09/28/16 THOMAS W DUDA BETTY NEUMAN & MCMAHON 505 16WC 37449 LOGSDON, DAVID S GABRIEL M HILLS DBA * 06/24/16 THOMAS E CADY RUSIN & MACIOROWSKI LTD 506 16WC 37802 LEATHERS, JAY AMEREN * 11/04/16 LAW OFFICE DAVID HUNT WINNE LAW OFFICE LLC 507 16WC 38062 LEATHERS, JAY AMEEN * 08/29/16 LAW OFFICE DAVID HUNT WINNE LAW OFFICE LLC 508 16WC 38106 TOMS, JAMES GREAT DANE TRAILERS * 12/04/15 DWORKIN AND MACIARIELLO 509 16WC 38556 FOSTER, JIM RICK SCOTT, LOANING EMPLO * 12/10/16 JAY H JANSSEN HENNESSY & ROACH PC 510 16WC 38663 HODGES, THOMAS F JR PAR ELECTRICAL CONTRACTOR * 10/31/16 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 511 16WC 38897 JONIAK, MICHEAL J COWSER, INC * 11/19/16 FISHER, JOHN W 512 16WC 39414 QUICK, KEITH E CITY OF ROCK ISLAND * 10/31/16 THOMAS W DUDA BETTY NEUMAN & MCMAHON 513 17WC 00298 HOLMAN, RICHARD EAST MOLINE POLICE DEPART * 01/13/16 RIDGE & DOWNES MCCARTHY, CALLAS & FEENEY PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 30 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 514 17WC 00469 KNIGHT, PATSY WARREN ACHIEVEMENT * 02/26/16 JAY H JANSSEN 515 17WC 00892 MORRIS, JOHN YEMM FORD * 12/21/16 LAW OFFICE DAVID HUNT 516 17WC 01137 BATEMAN, PAUL SERVICE STEEL * 03/14/16 DONOVAN ROBERTSON 517 17WC 01546 SULLIVAN, SHERRY MISSISSIPPI VALLEY REGION * 11/20/14 WINSTEIN KAVENSKY & WALLAC PERRY GENTILE 518 17WC 01663 NICHOLSON, DIANE MAURICES * 06/29/16 CUSACK FLEMING GILFILLAN E 519 17WC 01678 GUERIN, BONNIE DICK BLICK * 12/31/15 REHN & SKINNER LLC 520 17WC 01855 MAYNARD, CHRISTOPER JOHN DEERE CYLINDER * 11/21/16 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 521 17WC 01940 MARQUEZ, LUIS ASPLUNDH TREE EXPERT CO * 01/03/17 WINSTEIN KAVENSKY & WALLAC 522 17WC 02286 PETERSON, SHAWN STATE OF ILLINOIS IDOT @ * 10/06/15 JOHN LESAGANICH 523 17WC 02569 LAY, SHERI MERCER COUNTY HEALTH DEPT * 06/20/16 HOPKINS & HUEBNER PC 524 17WC 02616 AHRENS, JEREMY TRAPKUS BUILD * 01/24/17 DWORKIN AND MACIARIELLO 525 17WC 02754 DUFFIELD, NICOLETTE ILLINOIS DEPARTMENT OF @ * 09/22/15 SCHWEICKERT & GANASSIN ASSISTANT ATTORNEY GENERAL 526 17WC 02817 AGUE-BECHT, DOTTIE L JOHN MANGEMENT GROUP LLC * 03/02/16 THOMAS E CADY 527 17WC 02896 SMITH, DANIEL JC ASSOCIATES * 07/11/15 MC HARGUE, JAMES P LAW OFF 528 17WC 02949 DORSEY, JEREMY ARROWHEAD RANCH, INC * 05/11/16 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 529 17WC 03017 ROUSH, PATRICIA CITY OF EAST MOLINE * 04/02/15 CORNFIELD & FELDMAN MCCARTHY, CALLAS & FEENEY PC 530 17WC 03072 LEES, JEFF KEWANEE SALE BARN * 09/10/16 VANDERGINST LAW PC 531 17WC 03205 GODFREY, CONNIE KNOX COLLEGE * 11/02/16 RIDGE & DOWNES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 31 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 532 17WC 03333 RICE, PAUL KELLY SERVICES * 11/28/16 CAPRON & AVGERINOS PC 533 17WC 03402 MACLENNAN, SCOTT AIRLAND TRANSPORT SERVICE * 02/03/15 CHRISTINE A KEYS PC 534 17WC 03533 EARL, MARCY A WALMART DISTRIBUTION CENT * 10/18/16 BLACK & JONES QUINTAIROS PRIETO WOOD & BOY 535 17WC 03747 CHRISTISON, DONALD RIVERSTONE GROUP * 07/06/16 DWORKIN AND MACIARIELLO BETTY NEUMAN & MCMAHON 536 17WC 03987 DYE, KEGIN CHARTWELL STAFFING SERVIC * 08/08/16 PETER F FERRACUTI & ASSOCI 537 17WC 04304 DENT, MYRON TYSON FRESH MEATS, INC * 12/29/14 GOLDBERG WEISMAN & CAIRO L BRYCE DOWNEY & LENKOV LLC 538 17WC 04382 KRUG, COLTON WALMART SUPERCENTER * 12/20/16 DWORKIN AND MACIARIELLO 539 17WC 04522 BRENTISE, CHARLES E HILL CORRECTIONAL CENTER * 10/29/14 MARIO J PEREZ 540 17WC 04833 PASCHAL, NANCY ADDUS HEALTH CARE * 04/20/16 VANDERGINST LAW PC 541 17WC 05023 SCOVEL, KELLY J MIDWEST UNDERGROUND INC. * 12/26/14 ANESI OZMON RODIN NOVAK KO 542 17WC 05066 MOLINA, PHILLIP SMITHFIELD FARMLAND * 02/03/17 GOLDFINE & BOWLES 543 17WC 05178 NEULEIB, LADONNA JOHN DEERE HARVESTER * 03/16/15 CALIFF & HARPER PC 544 17WC 05182 JANVIER, NICOLE J JOHN DEERE HARVESTER * 03/27/15 CALIFF & HARPER PC 545 17WC 05185 MCMAHON, SEAN M JOHN DEERE HARVESTER * 01/08/15 CALIFF & HARPER PC 546 17WC 05295 STARK, RYAN GALESBURG CUSD #205 * 11/10/16 KNELL LAW LLC 547 17WC 05340 KIRK, TYLER LEGGETT & PLATT * 02/14/17 PETER F FERRACUTI & ASSOCI 548 17WC 05343 ALLEN, JOSHUA C NIEMANN FOODS INC * 10/14/16 HEYL ROYSTER VOELKER & ALLEN 549 17WC 05596 SERRANO, JUAN L DEERE & CO/HARVESTER WORK * 02/06/17 THOMAS E CADY

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 32 C A S E H E A R I N G S Y S T E M NOWAK, MICHAEL 094 ARBITRATION CALL FOR ROCK ISLAND 44001 ON 04/03/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 550 17WC 05630 WING, POL TYSON FRESH MEATS INC * 01/26/15 GANAN & SHAPIRO 551 17WC 05773 BENHOFF, MICHAEL ILLINOIS TOLLWAY @ * 01/31/17 WOLFE LAW PC 552 17WC 05947 DENNIS, DWAYNE L JOHN DEERE HARVESTER * 03/02/15 CALIFF & HARPER PC 553 17WC 06005 ARRINGTON, JOHNATHAN CHC SOLUTIONS * 02/22/17 DWORKIN AND MACIARIELLO 554 17WC 06058 VELOZ, ARMANDO JOHN DEERE HARVESTER * 10/07/15 WINSTEIN KAVENSKY & WALLAC 555 17WC 06216 ENGLE, TERRENCE VILLAGE OF HAMPTON * 11/01/16 CHRISTINE A KEYS PC 556 17WC 06284 THAYER, TOMMY L AUTOZONE * 11/20/16 MERTES & MERTES PC 557 17WC 06434 BOEH, GARY NATIONAL RAILWAY EQUIPMEN * 06/23/16 WINSTEIN KAVENSKY & WALLAC