ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 1 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 1 05WC 32131 19B TAYLOR, DENNIS SENICA'S INTERSTATE TOWIN 03/18/04 PORRO NIERMANN LAW GROUP HEYL ROYSTER VOELKER & ALLEN 2 05WC 36562 DIROSA, FAITH STATE OF ILL DEPT OF VETE @# 09/17/02 ANTHONY C RACCUGLIA & ASSO 05WC036563 -C 3 07WC 49390 FANCHI, ELIZABETH CHD OF PRESTRESS ENGINEERING COR # 12/19/06 BOGGS & FILLENWARTH HOLECEK & ASSOCIATES 4 08WC 03868 FRISCH, SHERRY SAVANNA ENTERPRISES INC 09/04/07 PERONA, PETERLIN, ANDREONI GAROFALO SCHREIBER STORM GRA 5 08WC 30028 19B BLAND, ROLLAND STATE OF ILLINOIS @ 03/01/07 GOLDSTEIN FISHMAN BENDER E ASSISTANT ATTORNEY GENERAL 6 09WC 00940 19B MOSSBERGER, RICK BERRYMAN TRANSFER 09/30/08 HORWITZ HORWITZ & ASSOC JAMES M KELLY 7 10WC 25107 KING, JODY LASALLE VETERANS' HOME 03/17/10 PETER F FERRACUTI & ASSOCI SHUAIB A. AHMED 8 10WC 33780 KIPER, DEBRA D & S FOODS INC 04/19/09 PETER F FERRACUTI & ASSOCI WOLFE & JACOBSON, LTD 11WC019025 -C D&S FOODS INC. 9 11WC 07249 WISNER, WILLIAM STAPLES 10/27/10 ANTHONY C RACCUGLIA & ASSO BRADY CONNOLLY & MASUDA PC 10 11WC 21564 SIMON, MARK A STATE OF ILLINOIS @ 01/25/11 MATTHEW T. GUBBINS PC SHUAIB A. AHMED 12WC038780 -C 11 11WC 27835 SHERVY, MARK A ST OF IL SHERIDAN CORRECT @ 02/27/10 DREW J FERRACUTI ASSISTANT ATTORNEY GENERAL 12 11WC 28681 JOHNSON, PAMELA L STATE OF ILLINOIS @ 04/30/09 WOODRUFF & JOHNSON ASSISTANT ATTORNEY GENERAL 13 11WC 33805 ZULFIC, ALEN SHERIDAN CORRECTIONAL CEN @ 11/04/10 DREW J FERRACUTI ASSISTANT ATTORNEY GENERAL 14 11WC 34245 ETSCHEID, JACQUELINE DCFS @ 05/21/10 MISKELL LAW CENTER ASSISTANT ATTORNEY GENERAL 15 11WC 36394 ALFARO, VICTOR WAL-MART DISTRIBUTION CEN 08/06/11 PETER F FERRACUTI & ASSOCI WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 2 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 16 11WC 47687 METTILLE, PAULETTE J GREEN PLANET GROUP D/B/A W 06/14/09 DREW J FERRACUTI 17 12WC 07511 ERWIN, JMES JAMES HARDIE BUILDING 04/29/08 DAVID W OLIVERO LITCHFIELD CAVO 12WC009036 -C 18 12WC 12495 DORSETT, BERNADINE A OTTAWA PUBLISHING CO THE 04/12/11 SCHWEICKERT & GANASSIN HOLECEK & ASSOCIATES 19 12WC 14048 BROWN, ANNA AMY MOUNCE D/B/A A & J'S @ W 03/31/12 STRONG LAW OFFICE 20 12WC 16158 PUMFREY, JOEL D DEL MONTE FOODS 04/09/12 DREW J FERRACUTI 21 12WC 18620 19B LANE, PENNY ST OF IL DEPT OF CORRECTI @ 02/25/12 SCHWEICKERT & GANASSIN ASSISTANT ATTORNEY GENERAL 22 12WC 25183 KING, JODY L ILLINOIS VETERAN'S HOME 06/07/12 PETER F FERRACUTI & ASSOCI COLIN KICKLIGHTER 23 12WC 32606 DORSETT, BERNADINE A OTTA PUBLISHING CO THE TI 08/20/12 SCHWEICKERT & GANASSIN HOLECEK & ASSOCIATES 24 12WC 33795 LAIDLAW, LORI STATE OF ILLINOIS @ 07/23/12 CORNFIELD & FELDMAN ASSISTANT ATTORNEY GENERAL 25 12WC 39347 CARRILLO, THERESA J PARKER NURSING AND REHAB 09/06/11 CHRIS DOSCOTCH MICHAEL D JACOBS 14WC010400 -C 26 12WC 42562 EARLE, SANDRA TJX COMPANIES/MARSHALLS 09/08/12 PERONA, PETERLIN, ANDREONI BRADY CONNOLLY & MASUDA PC 27 13WC 00136 O'NEAL, DARLA K HILLTOP FIREPIT RESTAURAN 08/29/11 LAW OFFICES JOSEPH MARCINIAK 28 13WC 01058 IVY, LLOYD II HOUSING AUTHORITY OF 04/27/10 EMMANUEL F GUYON GILDEA & COGHLAN 29 13WC 01207 LEE, DALE HEARTH LTD W 11/28/12 SOSTRIN AND SOSTRIN PC 30 13WC 06369 PAPPAS, BETTY IL VETERANS HOME AT LASAL @ 10/18/12 O'CONNOR & NAKOS ASSISTANT ATTORNEY GENERAL 31 13WC 09690 19B GOULD, KRIS FED EX 07/20/12 DAVID W OLIVERO QUINTAIROS PRIETO WOOD & BOY 32 13WC 14080 SPIEGEL, DIANE ILLINOIS VETERANS HOME @ 09/19/12 ANTHONY C RACCUGLIA & ASSO ASSISTANT ATTORNEY GENERAL 33 13WC 14947 NEWBORN, ALEXANDER JWK ENTERPRISES @ W 04/17/13 STEVEN J SEIDMAN LAW OFFIC JAMES L. HARDEMON

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 3 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 34 13WC 22868 KOSCIEWICZ, JOHN LCN DOOR CLOSERS 05/10/13 HERBOLSHEIMER LANNON ET AL HOLECEK & ASSOCIATES 35 13WC 23098 DALEY, THOMAS ST OF IL CENTRAL @ 07/02/12 PERONA, PETERLIN, ANDREONI ASSISTANT ATTORNEY GENERAL 36 13WC 25341 ALLISON, ANTHONY IL DEPT OF TRANSPORTATION @ 07/26/13 SCHWEICKERT & GANASSIN ASSISTANT ATTORNEY GENERAL 37 13WC 30091 COMMISSO, TIMOTHY J ST OF IL DEPT OF CORRECTI @ 12/27/12 ANESI OZMON RODIN NOVAK KO ASSISTANT ATTORNEY GENERAL 14WC014138 -C 38 13WC 35360 RUSH, EDWARD CON WAY FREIGHT 12/07/12 SAUNDERS CONDON & KENNY RUSIN & MACIOROWSKI LTD 39 13WC 37690 MOODIE, CATHERINE DEPARTMENT OF CORRECTIONS @ 10/16/13 PETER F FERRACUTI & ASSOCI COLIN KICKLIGHTER 40 13WC 39593 MAYCHSZAK, GUY WOODHAVEN LAKES ASSOC 10/13/13 FOOTE MIELKE CHAVEZ & O'NE WIEDNER & MCAULIFFE LTD 41 13WC 42587 RUSHANI, BEDRIJIE PETERSON HEALTH CARE INC 10/30/12 MARKER & ASSOCIATES KNELL LAW LLC 42 14WC 11338 COONS, JOHN CASEY'S CORP 12/13/13 SCHWEICKERT & GANASSIN RODDY LAW LTD 43 14WC 21052 FOX, PATRICIA, WIDOW/DEPE LUCKEY TRANSFER LLC 01/30/14 STROW LAW LLC JAMES M KELLY 44 14WC 26729 TAMEZ, RICK SABIC INNOVATIVE PLASTICS 07/03/14 NILSON STOOKAL GLEASON CAP MC ANDREWS & NORGLE LLC 45 14WC 28077 STARKEY, JEFF FEDEX FREIGHT 03/03/14 HORWITZ HORWITZ & ASSOC QUINTAIROS PRIETO WOOD & BOY 46 14WC 29634 HALLAM, DAWN M LASALLE COUNTY NURSING HO 06/12/14 RUBIN LAW GROUP HERBOLSHEIMER LANNON ET AL 47 14WC 32259 WALKUP, WILLIAM FGB ENTERTAINMENT AND 01/30/13 BLOCK, KLUKAS & MANZELLA P 48 14WC 32339 BERRIOS, ADRIA ILLINOIS VETERANS HOME 08/16/14 MISKELL LAW CENTER ILLINOIS ATTORNEY GENERAL 49 14WC 34031 HENDERICKSON, N THOMAS ILLINOIS CEMENT COMPANY 09/02/14 ANTHONY C RACCUGLIA & ASSO SPIEGEL & CAHILL, PC 50 14WC 35426 BIANCHI, ANTHONY AT&T 04/17/14 MCNAMARA PHELAN MCSTEEN LL INMAN & FITZGIBBONS 51 14WC 36193 AUSTILL, MARK STATE'S ATTY APPELLATE PR 02/07/14 WILLIAMS & SWEE ASSISTANT ATTORNEY GENERAL

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 4 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 52 14WC 42164 IVY, LLOYD II HOUSING AUTHORITY OF 04/17/10 EMMANUEL F GUYON GILDEA & COGHLAN 53 15WC 06949 CANNON, PAMELA S WALMART SUPERCENTER 07/01/14 DREW J FERRACUTI GANAN & SHAPIRO 15WC006948 -C 54 15WC 07873 HUBBARD, RANDY(ESTATE OF) FLINK CO 02/03/15 PETER F FERRACUTI & ASSOCI 55 15WC 08081 MC CLAIN, CANDACE AMERICAN RED CROSS 02/13/15 LAW OFFICE OF CHRIS DOSCOT POWER & CRONIN LTD 56 15WC 09051 CEJA, BRANDY CLANCEY MANLY BROTHERS OF 01/06/15 SCHWEICKERT & GANASSIN BRADY, CONNOLLY & MASUDA, PC 57 15WC 09654 BASHTON, MAUREEN FRESENIUS MEDICAL CARE 01/01/14 WHITESIDE & GOLDBERG LTD HENNESSY & ROACH PC 15WC016294 -C 58 15WC 14339 APPENZELLER, TIMOTHY UPM RAFLATAC 04/07/15 HORWITZ HORWITZ & ASSOC 59 15WC 14793 JOHNSON, BRETT A. WHITTAKER CONSTRUCTION & 04/14/14 DAVID W OLIVERO WOLF LAW LTD 60 15WC 18152 19B MALLIE, KEVIN ILLINOIS CEMENT CO 02/03/15 PERONA, PETERLIN, ANDREONI SPIEGEL & CAHILL, PC 61 15WC 23106 HUISMAN, APRIL AEGIS THERAPIES 12/04/14 CAPRON & AVGERINOS PC EVANS & DIXON, LLC 62 15WC 23173 BOTTOMS, GARRETT FRESH AIR DUCT CLEANING 09/21/13 ANESI OZMON RODIN NOVAK KO 63 15WC 23498 BOYLE, BARRY TRI-CITY ELECTRIC CO 06/22/15 HORWITZ HORWITZ & ASSOC CACCHILLO LAW GROUP LLC 64 15WC 23856 HERRERA, MARICELA HERITAGE WOODS OF YORKVIL 07/21/15 PORRO NIERMANN LAW GROUP SLAVIN & SLAVIN 65 15WC 26395 QUICK, KENNETH JB HUNT TRANSPORT SERVICE 04/20/15 DAVID W OLIVERO KEEFE CAMPBELL & ASSOC LLC 66 15WC 28089 HAYS, CLARISSA J. OWENS-BROCKWAY GLASS CONT 06/14/15 SCHWEICKERT & GANASSIN POWER & CRONIN LTD 67 15WC 29570 GOTCH, WILLIAM STREATOR ELEMENTARY SCHOO 02/04/15 STEPHEN P. KELLY RUSIN & MACIOROWSKI LTD 15WC029571 -C 15WC029572 -C 16WC017488 -C 68 15WC 29811 SCHULTZ, BRAD E. GLEN-GERY BRICK 08/27/15 STROW LAW LLC HOLECEK & ASSOCIATES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 5 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 69 15WC 33996 HAMILTON, LEANN ADDUS HEALTH CARE 09/23/15 STROW LAW LLC HENNESSY & ROACH PC 70 15WC 35054 CHAFFER, LAUREN M SVD HOSPITALITY & RESORTS 02/21/15 ANTHONY C RACCUGLIA & ASSO MCCARTHY LEONARD KAEMMER 71 15WC 36124 CHRONISTER, JOHNNY JAMES HARDIE BUILDING 09/14/15 SCHWEICKERT & GANASSIN LITCHFIELD CAVO 15WC036278 -C 15WC042166 -C 15WC042168 -C 72 15WC 38641 WILLIAMS, TERRY ST MARY CEMENT 11/10/15 DWORKIN AND MACIARIELLO GAROFALO SCHREIBER STORM GRA 73 15WC 39711 SPANOS, DANIEL J JR HERITAGE ENTERPRISES 01/07/14 STROW LAW LLC 74 15WC 39874 ANDERSON, TIM AT&T 11/26/13 CORTINA & MUELLER 75 15WC 39995 BOYER, DARRIN B CITY OF PLANO 11/13/15 PERONA, PETERLIN, ANDREONI RUSIN & MACIOROWSKI LTD 16WC005576 -C 17WC002101 -C 76 15WC 41450 DAVIS-SCHAUM, PATRICIA KENDALL COUNTY SPECIAL 11/05/15 WOODRUFF & JOHNSON INMAN & FITZGIBBONS 77 15WC 41574 ALMARAZ, THERESA MENARDS DISTRIBUTION CENT 12/06/14 R GARY GOODING, LTD 78 15WC 41696 HARVEY, TIMOTHY G HCC INC 09/22/15 KATZ FRIEDMAN EAGLE ET AL MACIOROWSKI SACKMANN & ULRIC 79 16WC 01100 BLIVEN, JEFFREY MORSE ELECTRIC 12/14/15 GESMER & REYNOLDS PC CACCHILLO LAW GROUP LLC 80 16WC 03779 DARM, KAREN HERITAGE ENTERPRISES, INC 06/17/14 ANTHONY C RACCUGLIA & ASSO RIPES NELSON BAGGOT KALOBRAT 16WC003780 -C 81 16WC 04448 ROSSI, JONATHAN IL DEPT OF TRANSPORTATION 11/03/15 PETER F FERRACUTI & ASSOCI ASSISTANT ATTORNEY GENERAL 82 16WC 04515 MORALES, CARLOS R UTILITY CONCRETE PRODUCTS 02/04/16 RUBIN LAW GROUP BRYCE DOWNEY & LENKOV LLC 83 16WC 05687 KNAFELC, GREG ILLINI PRECAST, LLC. 02/08/16 SCHWEICKERT & GANASSIN GILDEA & COGHLAN 84 16WC 06504 JENSEN, MONICA JACK MABLEY DEVELOPMENTAL 01/16/16 DWORKIN AND MACIARIELLO ASSISTANT ATTORNEY GENERAL

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 6 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 85 16WC 07410 SARVER, KYLE E BALLARD'S TREE & STUMP RE W 01/29/16 MERTES & MERTES PC LAW OFFICE OF MAHAFFEY & LEE 86 16WC 07917 HALL, JODY M. FRESENIUS MEDICAL CARE 09/04/14 KATZ FRIEDMAN EAGLE ET AL HENNESSY & ROACH PC 87 16WC 08302 POE, JULIA A RURAL KING SUPPLY 01/28/16 ANESI OZMON RODIN NOVAK KO KEEFE CAMPBELL & ASSOC LLC 88 16WC 08526 LAIR, MADONNA MC DONLAD'S 02/11/14 MEYERS & FLOWERS 89 16WC 09845 LANDRUM, JOHN III INVENERGY 03/01/16 HORWITZ HORWITZ & ASSOC HENNESSY & ROACH PC 90 16WC 10219 ROSALES NUNEZ, DALIA MIDWEST MANUFACTURING D/B 09/25/15 BUDIN LAW OFFICES 91 16WC 10772 BOULT, STEVE KALUZNY BROTHERS INC 02/19/16 HORWITZ HORWITZ & ASSOC CAPUANI, FRANK S 92 16WC 11174 HAYWOOD, CODY CULVER'S 11/11/14 LAW OFFICES MICHAEL HELLMA RUSIN & MACIOROWSKI LTD 93 16WC 12378 FASSO, JONELL MENARD'S DISTRIBUTION CEN 04/12/16 STROW LAW LLC RODDY LAW LTD 94 16WC 12746 BALZARINE, JAMES O'REILLY AUTO PARTS, LLC 03/24/16 SCHWEICKERT & GANASSIN HENNESSY & ROACH PC 95 16WC 14644 WIEKERT, MORGAN PARK POINTE HEALTHCARE & 11/25/15 WHITESIDE & GOLDBERG LTD BRADY, CONNOLLY & MASUDA, PC 96 16WC 14827 WNENK, ROBERT NEWARK COMMUNITY HIGH SCH 01/04/16 MILLON & PESKIN LTD RODDY LAW LTD 97 16WC 15991 TULLY, MICHAEL CB & I 11/10/15 JASINSKI, GEORGE J RIPES NELSON BAGGOT KALOBRAT 98 16WC 17598 MALDONADO, ABEL MIDWEST MANUFACTORING/MEN 12/15/15 MC HARGUE & JONES 99 16WC 17939 VALENCIK, SCOTT KENDALL COUNTY SHERIFF'S 04/12/16 O'CONNOR & NAKOS INMAN & FITZGIBBONS 100 16WC 18247 MEYER, LARRY ST OF IL, DEPT OF CORRECT 11/22/15 PIGNATELLI & ASSOCIATES ASSISTANT ATTORNEY GENERAL 101 16WC 18621 ROBINSON, DERRICK FASTENAL 01/29/16 DWORKIN AND MACIARIELLO HOLECEK & ASSOCIATES 102 16WC 18927 MASQUIDA, OSWALDO NICOR GAS 06/23/15 GOLDBERG WEISMAN & CAIRO L MACIOROWSKI SACKMANN & ULRIC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 7 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 103 16WC 19535 CHAMBERLAIN, MARIAN CLIFFORD W ESTES CO 04/21/16 SCHWEICKERT & GANASSIN 104 16WC 21307 PAPENBURG, NIKKI DOLLAR GENERAL 05/21/16 PETER F FERRACUTI & ASSOCI 105 16WC 21801 GREEN, WANDA THE KROGER COMPANY 05/05/16 DREW J FERRACUTI GANAN & SHAPIRO 106 16WC 22467 ALCARAZ, ELSA (WIDOW OF) MENARDS 08/19/15 PORRO NIERMANN LAW GROUP RODDY LAW LTD 107 16WC 22517 HICKS, VERRONDA D. DIXON ELKS LODGE 779 03/04/11 REESE & REESE HENNESSY & ROACH PC 108 16WC 23805 LAABS, TROY INFRA-METALS 09/15/14 CORTINA & MUELLER POULOS & DIBENEDETTO LAW 109 16WC 25005 MUNOZ, TAMMY THE FRESH MARKET 08/04/15 JOHN LESAGANICH HENNESSY & ROACH PC 110 16WC 26502 HOWARD, AUTY MENARDS 05/17/16 DWORKIN AND MACIARIELLO RODDY LAW LTD 111 16WC 26748 FRANTZEN, BRUCE J PEPSI BEVERAGES COMPANY 07/21/15 WOODRUFF & JOHNSON BRYCE DOWNEY & LENKOV LLC 16WC032974 -C 112 16WC 27252 CHALKEY, DENNIS FLINK COMPANY 02/03/15 PETER F FERRACUTI & ASSOCI RIPES NELSON BAGGOT KALOBRAT 113 16WC 28011 ZURMELY, MARTHA WALMART 06/27/16 PETER F FERRACUTI & ASSOCI QUINTAIROS PRIETO WOOD & BOY 114 16WC 28298 BARBARD, CHARLES EXELON CORPORATION 07/22/16 HERBOLSHEIMER LANNON ET AL RUSIN & MACIOROWSKI LTD 115 16WC 28365 BOYCE, STEPHEN C THE HOME DEPOT 09/18/14 ANTHONY C RACCUGLIA & ASSO MC ANDREWS & NORGLE LLC 116 16WC 28996 SEROKA, ROBERT M FLINK CO. 02/05/15 SCHWEICKERT & GANASSIN RIPES NELSON BAGGOT KALOBRAT 117 16WC 29019 VICICH, DEREK LASALLE COUNTY SHERIFFS O 08/05/16 SCHWEICKERT & GANASSIN HERBOLSHEIMER LANNON ET AL 118 16WC 29349 MARTINEZ, MARISSA SISTER ACT INC. 02/22/16 PORRO NIERMANN LAW GROUP NYHAN BAMBRICK KINZIE & LOWR 16WC029350 -C 119 16WC 29655 RODRIGUEZ, ADRIANA OAK STREET PRODUCTS, INC 06/16/16 ELFENBAUM EVERS & AMARILIO KNELL LAW LLC 120 16WC 29844 DELGADO, BLAS NEWLY WEDS FOODS INC 07/08/16 WOODRUFF & JOHNSON WOLFE & JACOBSON, LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 8 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 121 16WC 30726 ACKERMAN, JENNIFER MENDOTA LUTHERAN HOME 08/23/16 SCHWEICKERT & GANASSIN KEEFE CAMPBELL & ASSOC LLC 122 16WC 30886 GARCIA, MARIA E MENARD, INC 01/22/15 LAWRENCE A SCORDINO RODDY LAW LTD 17WC033569 -C 17WC033570 -C 123 16WC 30923 MENENDEZ, MIGUEL ANGEL MEXICAN ROOFING 08/17/16 CHEPOV & SCOTT LLC HOLECEK & ASSOCIATES 124 16WC 31529 GUZMAN, NOEMI MONTEREY MUSHROOMS, INC 02/18/15 SCHWEICKERT & GANASSIN BRADY CONNOLLY & MASUDA PC 16WC031545 -C 16WC031565 -C 125 16WC 32690 PICCIOLI, CRYSTAL IL DEPT OF VETERANS AFFAI 07/10/16 HORWITZ HORWITZ & ASSOC MATTHEW J KELLER 126 16WC 33261 SCHAAL, JUSTIN HENDERSON ENGINEERING CO 07/01/16 SCHWEICKERT & GANASSIN LAW OFFICES JOSEPH MARCINIAK 127 16WC 33726 IMEL, MATTHEW BELLINI'S CUSTOM WELDING 09/16/16 DWORKIN AND MACIARIELLO BRADY, CONNOLLY & MASUDA, PC 16WC033727 -C 128 16WC 34140 GUERRERO, DONIELLE WALMART DISTRIBUTION CENT 02/22/16 PETER F FERRACUTI & ASSOCI QUINTAIROS PRIETO WOOD & BOY 129 16WC 35739 DUNN, ROGER DILLON TRANSPORT 09/29/16 SEIDMAN MARGULIS & FAIRMAN ROSARIO CIBELLA 130 16WC 36949 NOVACEK, MILO OSF HEALTHCARE SYSTEM,ET 11/08/16 LANZILLOTTI GRIBBEN & MARC HERBOLSHEIMER LANNON ET AL 131 16WC 38829 ORIGEL, TEODOCIO AGG CONSTRUCTION, INC. 07/15/16 OSVALDO RODRIGUEZ PC 132 16WC 39136 ESTES, LINDA OWENS-ILLINOIS 09/02/16 SCHWEICKERT & GANASSIN POWER & CRONIN LTD 133 17WC 00737 MESSER, DORA AS EXECUTOR DELMONTE FOODS 09/17/16 PETER F FERRACUTI & ASSOCI RODDY LAW LTD 134 17WC 03334 BRYER, ERIC CCA MIDWEST 01/09/17 CAPRON & AVGERINOS PC WIEDNER & MCAULIFFE LTD 135 17WC 04070 PACIONE, MICHAEL M H EQUIPMENT 01/12/17 CULLEN HASKINS NICHOLSON HENNESSY & ROACH PC 136 17WC 04165 HICKS, DENA FREESENIUS MEDICAL CARE 04/19/16 SCHWEICKERT & GANASSIN HENNESSY & ROACH PC 137 17WC 04658 LUCAS, J SCOTT PLANO SCHOOL DIST 88 09/29/16 MEYERS & FLOWERS RIPES NELSON BAGGOT KALOBRAT

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 9 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 138 17WC 04719 DELHOTAL, JEAN STATE OF ILLINOID - OOC @ 11/30/16 PIGNATELLI & ASSOCIATES ASSISTANT ATTORNEY GENERAL 139 17WC 04971 LIJEWSKI, THOMAS CITY OF LASALLE 11/15/16 SCHWEICKERT & GANASSIN POWER & CRONIN LTD 140 17WC 05893 ZURINSKI, DAVID L IL DEPT OF TRANSPORTATION @ 11/30/16 SCHWEICKERT & GANASSIN ASSISTANT ATTORNEY GENERAL 141 17WC 06574 SHEDOSKY, JENNIFER STATE OF IL JACK MABLEY @ 12/20/16 FOOTE MIELKE CHAVEZ & O'NE MATTHEW J KELLER 142 17WC 06874 DZIUBA, RICHARD CGS, LLC 08/31/16 STROW LAW LLC HOLECEK & ASSOCIATES 17WC006875 -C CGS LLC 143 17WC 07588 DUPLER, CYNTHIA S MORRIS HOSPITAL & 06/28/16 MEYERS & FLOWERS STEPHEN P. KELLY 144 17WC 07654 POLICKY, RICHARD NL MORTON BUILDINGS 11/17/16 GEARHART, GARY L & ASSOCS 145 17WC 09008 GEBHARDT, GREG DOUBLE D EXPRESS INC 12/01/16 TIMOTHY CANTLIN JAMES M KELLY 146 17WC 09063 GERKITZ, DAVID FLINK COMPANY 08/22/16 HORWITZ HORWITZ & ASSOC RIPES NELSON BAGGOT KALOBRAT 147 17WC 09450 VARGAS, FRANCISCO SBA NETWORK SERVICES 10/31/16 WOODRUFF & JOHNSON 148 17WC 09494 CARLS, JOSEPH GRAYMONT COOP 06/01/16 STRONG LAW OFFICE CAPUANI, FRANK S 149 17WC 09623 LONDENBACK, CHANCE TRAVEL CENTERS OF AMERICA 02/10/17 RATHBUN CSEVENYAK & KOZOL HENNESSY & ROACH PC 150 17WC 09638 HEILMAN, MISTY OTTAWA PAVILION LTD 01/15/17 SCHWEICKERT & GANASSIN POWER & CRONIN LTD 151 17WC 09884 MCCONNELL, PAMELA CORVEL CORP 04/03/15 DWORKIN AND MACIARIELLO ROSARIO CIBELLA 152 17WC 10112 ANGUIANO, MARIA WRIGLEY 04/14/16 WOODRUFF & JOHNSON GAROFALO SCHREIBER STORM GRA 153 17WC 10424 EINHAUS, LORI OPTIMUM FULLFILLMENT 01/13/17 RATHBUN CSEVENYAK & KOZOL RIPES NELSON BAGGOT KALOBRAT 154 17WC 11530 KRAMER, ERIN M BRISTOL/KENDALL FIRE 06/16/15 THOMAS W DUDA RUSIN & MACIOROWSKI LTD 155 17WC 11666 MARTINEZ, SANTANA KREIDER SVCS 08/12/16 GESMER & REYNOLDS PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 10 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 156 17WC 12236 MILLER, ROBIN DONALDSON COMPANY INC 08/22/16 GOLDFINE & BOWLES LEAHY EISENBERG & FRAENKEL 157 17WC 12565 STOREY, FLOYD E WALMART SUPERCENTER 11/13/16 SCHWEICKERT & GANASSIN QUINTAIROS PRIETO WOOD & BOY 158 17WC 12568 TINOCO, MANUEL A/K/A REHIG PACIFIC LOGISTICS 11/01/16 SCHWEICKERT & GANASSIN BRYCE DOWNEY & LENKOV LLC 159 17WC 12944 ARROYO, DONNA HEARTHSIDE FOODS, INC 08/01/16 BRASSFIELD KRUEGER & RAMLO WIEDNER & MCAULIFFE LTD 160 17WC 13131 MIRELES, JUAN DURA CAST, INC 08/25/16 TURNER & SACKETT LLC HOLECEK & ASSOCIATES 17WC013147 -C 161 17WC 13256 MISENER, TOD A RJ REYNOLDS TOBACCO CO 03/06/15 DREW J FERRACUTI HENNESSY & ROACH PC 162 17WC 13726 PARR, RENEE NEWLY WEDS FOODS 03/31/17 JOHN E LUSAK GAROFALO SCHREIBER STORM GRA 163 17WC 13858 HOFFMAN, CATHERINE WALMART SUPERCENTER 03/04/17 SCHWEICKERT & GANASSIN QUINTAIROS PRIETO WOOD & BOY 164 17WC 13960 DYE, MICHAEL UNYTITE 10/01/14 KINNALLY FLAHERTY KRENTZ & BORGELT POWELL 165 17WC 14134 STABLER, LINDSAY LW SCHNEIDER INC 03/16/17 LAW OFFICE DAVID HUNT 166 17WC 15133 LEE, RONNIE A LCN-ALLEGION 04/24/17 DREW J FERRACUTI HOLECEK & ASSOCIATES 167 17WC 15443 VANDA, DONALD L STREATOR DEPENDABLE 03/01/17 EMMANUEL F GUYON NYHAN BAMBRICK KINZIE & LOWR 168 17WC 15526 SEROWKA, JIM BRAND ENERGY SVCS 01/28/16 HORWITZ HORWITZ & ASSOC GOLDBERG SEGALLA LLC 169 17WC 15750 TOOLEY, TONY E OWENS-BROCKWAY GLASS CONT 05/17/16 DREW J FERRACUTI 170 17WC 17031 BASS, ELIZABETH PERRY MEMORIAL HOSPITAL 12/13/16 SCHWEICKERT & GANASSIN NYHAN BAMBRICK KINZIE & LOWR 171 17WC 17163 MCLNERNEY, MICHAEL SHERWIN WILLIAMS CO 05/04/15 CULLEN HASKINS NICHOLSON ROBERT L. SMITH 17WC017164 -C 172 17WC 18404 FLAKE, MICHAEL FMC CORPORATION 06/06/17 CHRIS DOSCOTCH BRADY CONNOLLY & MASUDA PC 173 17WC 18482 GLADD, KRISTI DAIRY QUEEN 05/18/17 PETER F FERRACUTI & ASSOCI HOLECEK & ASSOCIATES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 11 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 174 17WC 18729 JENSEN, ALAN OLD DOMINION FREIGHT LINE 02/09/17 SCHWEICKERT & GANASSIN RODDY LAW LTD 175 17WC 18863 FOWLER, STEPHANIE A STATE OF ILLINOIS-JACK MA @ 06/02/17 REESE & REESE 176 17WC 19020 COVER, WILLIAM CREST FOODS 08/19/16 REESE & REESE 177 17WC 20029 TOOLEY, TONY E OWENS-BROCKWAY GLASS CONT 04/03/15 DREW J FERRACUTI 178 17WC 20416 SHANKS, TERENCE GENSINI EXCAVATING, INC. 07/19/16 SCHWEICKERT & GANASSIN PATRICK JENNETTEN 179 17WC 21036 SHIELDS, CHAS, DEPENDENT FIRST NATIONAL BANK OF AM # 06/21/17 FIGLIOLI, DAVID INMAN & FITZGIBBONS 180 17WC 22165 SALAS, JOSE G PIRTANO CONSTRUCTION CO 07/10/17 DAVID W MARTAY ACCIDENT FUND HOLDINGS 181 17WC 23094 WERRY, JOHN FAIRBANKS SCALES INC 07/17/17 STRONG LAW OFFICE 182 17WC 23510 WARREN, JO ELLEN TRINITY LUTHERAN CHURCH 06/27/17 SCHWEICKERT & GANASSIN BRYCE DOWNEY & LENKOV LLC 183 17WC 24269 ALLSHOUSE, JEREMY RENEWAL REHAB, LLC 08/30/16 HOPKINS & HUEBNER PC ACCIDENT FUND HOLDINGS 184 17WC 24617 REUTER, JEFFREY M DIXON TOWNSHIP 06/29/17 REESE & REESE JAMES M KELLY 17WC024618 -C 18WC017026 -C 185 17WC 24781 GALITZ, ERIC EXELON CORPORATION 07/31/17 CORBOY & DEMETRIO PC HENNESSY & ROACH PC 186 17WC 25494 CLASSON, MICHELLE ILLINOIS DEPT OF CORRECTI @ 07/17/17 PETER F FERRACUTI & ASSOCI ASSISTANT ATTORNEY GENERAL 187 17WC 25954 GUERRERO, MIGUEL COLLINS & HERMANN, INC. 08/17/17 SCHWEICKERT & GANASSIN HOLECEK & ASSOCIATES 188 17WC 25980 RICK, AMANDA J STATE OF ILLINOIS @ 08/17/17 REESE & REESE ASSISTANT ATTY GENERAL 189 17WC 26351 YERLY, BRUCE WOZNIAK CONCRETE CONSTRUC 10/31/14 GRIVETTI, JOHN A 190 17WC 26778 TRUJILLO, TED WW TRANSPORT 06/13/17 BRIAN T MORROW, LAW OFFICE HEYL ROYSTER VOELKER & ALLEN 191 17WC 27081 SWANSON, KEVIN CARDINAL LOGISTICS 04/05/17 DAVID W OLIVERO 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 ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 192 17WC 27636 COBB, HOPE CASEY'S GENERAL STORE, IN 07/10/17 SCHWEICKERT & GANASSIN HEYL ROYSTER VOELKER & ALLEN 193 17WC 27836 GRAVER, ALICE WALMART SUPERCENTER 06/17/17 SCHWEICKERT & GANASSIN GANAN & SHAPIRO 194 17WC 28064 RADKIEWICZ, NICHOLAS ERIC'S A CUT ABOVE 10/14/16 BENNETT LAW OFFICES RUSIN & MACIOROWSKI LTD 195 17WC 28141 GARCIA, OTILIA TIMBER CREEK INN AND SUIT 03/31/17 DWORKIN AND MACIARIELLO GANAN & SHAPIRO 196 17WC 28274 SARTORI, BRANDON PRIORITY STAFFING 09/16/17 DWORKIN AND MACIARIELLO THOMAS & PORTELA 197 17WC 28383 OKUBADEJO, OMOLARA PARK POINTE HEALTHCARE RE 09/06/17 BAUM RUFFOLO & MARZAL LTD BRADY CONNOLLY & MASUDA PC 18WC017859 -C 198 17WC 29237 19B DIAZ, FRANCISCO INSALE CONTRACTING GROUP, 09/19/17 HORWITZ HORWITZ & ASSOC KLAUKE LAW GROUP LLC 199 17WC 30236 BOHLER, APRIL CLOVER TECHNOLOGIES GROUP 03/14/17 TIMOTHY CANTLIN INMAN & FITZGIBBONS 200 17WC 30594 SODARO, ERIC IDOT 06/28/17 FRANCINE B WHITE ILLINOIS ATTORNEY GENERAL 201 17WC 30758 MURPHY, LISA SANDWICH SCHOOL DIST 430 09/11/17 PORRO NIERMANN LAW GROUP INMAN & FITZGIBBONS 17WC030762 -C 202 17WC 31591 SHEVOKAS, LISA NICOR GAS CO. 08/09/17 SCHWEICKERT & GANASSIN 203 17WC 32002 BRUCE, JEFFREY VACTOR MANUFACTURING 08/23/17 PETER F FERRACUTI & ASSOCI BRADY CONNOLLY & MASUDA PC 204 17WC 32843 MORALES, ELIDA HCC, INC 05/21/15 DREW J FERRACUTI MACIOROWSKI SACKMANN & ULRIC 205 17WC 33075 RASMUSSON, GARTH KENDALL COUNTY SHERIFF'S 10/26/17 BLOCK, KLUKAS & MANZELLA P INMAN & FITZGIBBONS 206 17WC 33131 HALE, CALETHA KENDALL COUNTY SPECIAL 10/01/17 DWORKIN AND MACIARIELLO INMAN & FITZGIBBONS 207 17WC 33188 BAKER, GUY RIVERDOCKS, INC 06/28/17 SCHWEICKERT & GANASSIN THOMAS & PORTELA 208 17WC 34442 VINCENT, CINDY CASEY'S GENERAL STORE 02/08/17 O'CONNOR & NAKOS 209 17WC 35328 CONNERY, MICHAEL EURO-TECH INC 04/28/17 HORWITZ HORWITZ & ASSOC WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 13 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 210 17WC 35769 SLIKER, KAYLA HEARTHSIDE FOOD SOLUTIONS 02/28/17 WOODRUFF & JOHNSON 211 17WC 35843 STERCHI, BENJAMIN STATE OF IL @ 02/07/17 ANTHONY C RACCUGLIA & ASSO ASSISTANT ATTY GENERAL 212 17WC 35947 PAGELOF, RONALD G REPUBLIC SERVICES 07/27/17 MARKS INJURY LAW 213 17WC 36117 DEANE, RYAN EDWARD-ELMHURST HEALTH 10/12/17 TURNER & SACKETT LLC KEEFE CAMPBELL & ASSOC LLC 214 17WC 36152 LARSON, ANGELA ILLINOIS VETERAN'S HOME @ 10/23/17 SCHWEICKERT & GANASSIN STATE OF ILLINOIS 215 17WC 36287 ZILM, FREDERICK MORRIS TRANSMISSION & AUT 10/25/17 HORWITZ HORWITZ & ASSOC HENNESSY & ROACH PC 216 17WC 36869 CONROY, ADRIAN INDUSTRIAL TRANSPORT GROU 12/04/17 DWORKIN AND MACIARIELLO FRANCESCA LARSEN 217 17WC 37229 KNOP, AUSTIN S&S MIDWEST FABRICATING, 11/03/17 SCHWEICKERT & GANASSIN WOLFE & JACOBSON, LTD 218 17WC 37966 LASIK, KEVIN XPO LOGISTICS 10/23/17 SCHWEICKERT & GANASSIN RUSIN & MACIOROWSKI LTD 219 18WC 00401 LIESCHKE, JOSEPH HIGH HEELS DANCING CO, IN 12/21/17 DWORKIN AND MACIARIELLO LAWRENCE COZZI - LAW OFFICES 220 18WC 00679 SALINAS, RAUL SPARTAN TOOL, LLC 12/18/17 PERONA, PETERLIN, ANDREONI RUSIN & MACIOROWSKI LTD 221 18WC 00680 SALINAS, RAUL SPARTAN TOOL, LLC 10/14/16 PERONA, PETERLIN, ANDREONI RUSIN & MACIOROWSKI LTD 222 18WC 01349 COOPER, CHARLES BLACK BROS, CO 05/17/17 SCHWEICKERT & GANASSIN HOLECEK & ASSOCIATES 223 18WC 01541 DINKINS, BOBBY LYONDELL BASELL COMPANY 11/17/17 SCHWEICKERT & GANASSIN BRADY CONNOLLY & MASUDA PC 224 18WC 02328 REPPIN, MICHAEL LASALLE CNTY SHERIFF'S OF 12/13/17 SCHWEICKERT & GANASSIN HERBOLSHEIMER LANNON ET AL 225 18WC 02331 IRVIN, HUSTON RUAN TRANSPORTATION CORP 03/21/16 SCHWEICKERT & GANASSIN JAMES M KELLY 226 18WC 02810 NEWSOME, DANIEL A MONTEREY MUSHROOMS, INC. 12/03/16 PERONA, PETERLIN, ANDREONI BRADY CONNOLLY & MASUDA PC 227 18WC 02886 LISHER, MALLORY ENDRIZZI CONTRACTING 12/11/17 GOLDENBERG HELLER ANTOGNOL

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 14 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 228 18WC 03091 PUCKETT, TERRY LASALLE COUNTY SHERIFFS O 12/26/16 MEYERS & FLOWERS HERBOLSHEIMER LANNON ET AL 229 18WC 03267 SMITH, LORI NORTH CENTRAL BEHAVIORAL 01/07/18 SCHWEICKERT & GANASSIN HEYL ROYSTER VOELKER & ALLEN 230 18WC 03328 PRATT, JULIE M THE RESULTS COMPANIES 10/11/17 DREW J FERRACUTI 231 18WC 03390 WALGREN, BRANDON MENARDS 06/14/17 MILLON & PESKIN LTD 232 18WC 04423 HOWE, ROBERT DYNO NOBEL INC 12/27/16 GOLDBERG WEISMAN & CAIRO L SPIEGEL & CAHILL, PC 233 18WC 05593 HAUPPA, TINA MENARDS DISTRIBUTION CENT 10/20/17 MILLON & PESKIN LTD 234 18WC 05685 CARLSON, KERRY REGENEX CORP 02/14/17 SCHWEICKERT & GANASSIN 235 18WC 06019 FORBES, JEAN BO/GAR ENTERPRISES 07/13/17 CHRIS DOSCOTCH 236 18WC 06455 PETERSON, DYLAN A PRINCETON TIRE SERVICES L 08/08/17 KALEEL, DAVID M 237 18WC 06507 SOMMER, ROGER W IL DEPT OF TRANSPORTATION 01/27/17 DREW J FERRACUTI ASSISTANT ATTY GENERAL 238 18WC 06636 LEASURE, EDDIE SENECA FIRE DEPARTMENT 10/16/17 RATHBUN CSEVENYAK & KOZOL 239 18WC 06689 KOLLS, MANDY SHELL 02/11/18 MC HARGUE & JONES HEYL ROYSTER VOELKER & ALLEN 240 18WC 07281 EMM, JAMES GRASSER'S PLUMBING & HEAT 02/22/14 DAVID W OLIVERO GANAN & SHAPIRO 241 18WC 07324 ANDERSON, RICHARD JOSEPH KELLY SERVICES/PETSMART 05/26/17 SCHWEICKERT & GANASSIN NYHAN BAMBRICK KINZIE & LOWR 242 18WC 07715 BARRETT, THOMAS A YRC, INC 02/09/18 ALEKSY BELCHER HENNESSY & ROACH PC 243 18WC 07765 GIBSON, TAMARA L LCN CLOSERS 06/13/17 PETER F FERRACUTI & ASSOCI

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 15 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 244 18WC 07988 REED, DANIEL OWENS-ILLINOIS 05/17/17 DREW J FERRACUTI POWER & CRONIN LTD 245 18WC 08063 WALLS, TIMOTHY J ALLIED LOCKE INDUSTRIES 01/26/18 MERTES & MERTES PC ACCIDENT FUND HOLDINGS 18WC017031 -C 246 18WC 08093 CRAMER, RANDALL BLOCK ELECTRIC 10/16/17 PORRO NIERMANN LAW GROUP ACCIDENT FUND HOLDINGS 247 18WC 08905 SPOTTS, LORI L STATE OF ILLINOIS, @ 12/31/17 REESE & REESE ASSISTANT ATTY GENERAL 248 18WC 09069 WALTER, GERALD LASALLE PERU HS DIST 120 02/19/18 PATRICOSKI, MARK G WIEDNER & MCAULIFFE LTD 249 18WC 09587 URBINA, JUAN D BLACK HORSE CARRIERS, INC 01/24/18 THOMAS J STIBERTH LAW OFFI ROSARIO CIBELLA 250 18WC 09823 ZILM, FREDERICK MORRIS TRANSMISSION & AUT 02/15/18 HORWITZ HORWITZ & ASSOC 251 18WC 10266 GRABOWSKI, KATHY CARLIN O'BRIEN, INC 09/20/17 HORWITZ HORWITZ & ASSOC GANAN & SHAPIRO 252 18WC 10466 STEVENS, DANIEL NPL CONSTRUCTION CO 03/21/18 ANESI OZMON RODIN NOVAK KO GRANT & FANNING 253 18WC 10793 MANEGOLD, ED 47 VIDEO 10/02/17 WOODRUFF & JOHNSON JOSEPH MARCINIAK 254 18WC 11105 KOSTMAN, PATRICKJ ILLINOIS DEPT OF CORRECTI @ 03/21/18 PIGNATELLI & ASSOCIATES ASSISTANT ATTY GENERAL 255 18WC 11108 HARTY, LISA JC WHITNEY 01/09/18 SCHWEICKERT & GANASSIN BRYCE DOWNEY & LENKOV LLC 256 18WC 11114 GONZALEZ, EDGAR TOMKAT ROOFING INC 12/21/17 SCHWEICKERT & GANASSIN 257 18WC 11258 VANCIL, ANDREW SANDY CREEK LANE, LLC 03/13/18 DAVID HUNT WOLFE & JACOBSON, LTD 258 18WC 11393 BENDER, RANDY CLEARY BUILDING INC. 11/10/16 THE CANTLIN LAW FIRM HOLECEK & ASSOCIATES 259 18WC 11414 OREGON, JESUS XPO LOGISTICS 01/22/18 HANNIGAN & BOTHA, LTD 260 18WC 11531 LEMUS, ANTHONY TRENCH PLATE RENTAL CO 04/04/18 GOLDBERG WEISMAN & CAIRO L WIEDNER & MCAULIFFE LTD 261 18WC 12060 FLORES-MUNOZ, AGUSTIN EXEL INC 01/01/17 DANIEL E MURPHY

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 16 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 262 18WC 12610 BUNDY, DEAN B WAL-MART INC 01/09/18 EMMANUEL F GUYON QUINTAIROS PRIETO WOOD & BOY 263 18WC 13156 BROCK, PAUL TRUXXPRESS 03/29/18 RIDGE & DOWNES 264 18WC 13263 ZILINGER, SANDRA ILLINOIS VETERANS HOME 04/23/18 DWORKIN AND MACIARIELLO ASSISTANT ATTY GENERAL 265 18WC 13315 BALLERINI, HEIDI L OSF SAINT FRANCIS MEDICAL 04/19/18 DREW J FERRACUTI HINSHAW & CULBERTSON 266 18WC 13609 GOETZ, CRAIG W IL DEPT OF TRANSPORTATION 02/16/17 DREW J FERRACUTI ASSISTANT ATTY GENERAL 267 18WC 13681 WHALEY, RACHEL OTTAWA DENTAL LAB 04/19/18 CHRIS DOSCOTCH 268 18WC 13943 SENGSOURIYASO, MAY WRIGLEY 02/20/18 WOODRUFF & JOHNSON GAROFALO SCHREIBER STORM GRA 269 18WC 14336 CASTRO, LUIS CITY OF LASALLE 12/26/17 SCHWEICKERT & GANASSIN RODDY LAW LTD 270 18WC 14797 GARCIA OROZCO,ANDRES ALEJ YOUNGLOVE CONSTRUCTION 04/27/18 EPSTEIN, JACK R LAW OFFICE 271 18WC 15088 CORCORAN, CHRISTINA OSF ST ELIZABETH MEDICAL 04/29/17 SCHWEICKERT & GANASSIN HERBOLSHEIMER LANNON ET AL 272 18WC 15476 GODINEZ, JULIO CESAR MENARD'S DISTRIBUTION CTR 05/07/18 WOODRUFF JOHNSON RODDY LAW LTD 273 18WC 16236 HENDRIX, BILLY WILSON LANDSCAPING CO-NUR 08/15/17 STRONG LAW OFFICE GANAN & SHAPIRO 274 18WC 16885 WIGGIN, JAMES D L. W. SCHNEIDER INC 12/13/16 KATZ NOWINKSI PC 275 18WC 17080 LIGHTNER, JOHN ALLIED LOCKE INDUSTRIES 03/21/18 SCHWEICKERT & GANASSIN ACCIDENT FUND HOLDINGS 276 18WC 17638 FULLER, CARL W SR. CREST FOODS CO INC 05/09/18 MC HARGUE & JONES ACCIDENT FUND HOLDINGS 277 18WC 17706 KUEKER, JONATHAN IL STATE POLICE 05/31/18 RIDGE & DOWNES ASSISTANT ATTY GENERAL 278 18WC 17738 DURBIN, DOUGLAS PETSMART, INC 05/14/18 SCHWEICKERT & GANASSIN WIEDNER & MCAULIFFE LTD 279 18WC 17741 ALEXANDER, JOSHUA KING TIRE 04/24/18 SCHWEICKERT & GANASSIN RODDY LAW LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 17 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 280 18WC 17808 WARD, LORI B KSB HOSPITAL 09/27/17 REESE & REESE NYHAN BAMBRICK KINZIE & LOWR 281 18WC 17903 WOLFE, ROBERT A&R MECHANICAL INC 12/06/17 SCHWEICKERT & GANASSIN ACCIDENT FUND HOLDINGS 282 18WC 18299 HAMILTON, KRISTOPHER MILLER PIPELINE 05/24/18 FOOTE MIELKE CHAVEZ O'NEIL BRADY, CONNOLLY & MASUDA, PC 283 18WC 18378 COX, MATTHEW A BECKER'S LAWN CARE & LAND 06/06/18 BOSHARDY LAW OFFICE PC JOSEPH MARCINIAK 284 18WC 18408 DROUGHT, JENNIFER CREST FOODS COMPANY, INC 11/13/17 KATZ FRIEDMAN EAGLE ET AL ACCIDENT FUND HOLDINGS 285 18WC 18790 RODRIGUEZ, MAXIMINO FORTUNE METAL MIDWEST 09/15/17 SMOLER LAW OFFICE, PC 286 18WC 18850 SMITH, BRANDON OLD DOMINION FREIGHT LINE 06/02/18 PETER F FERRACUTI & ASSOCI RODDY LAW LTD 287 18WC 19194 CAMPBELL, BEN TODD CAMPBELL TRUCKING, I 09/30/17 SCHWEICKERT & GANASSIN GILDEA, COGHLAN & REGAN LTD. 288 18WC 19482 PHILLIPS, ERIC DOHRN TRANSFER CO 04/15/18 SCHWEICKERT & GANASSIN GANAN & SHAPIRO 289 18WC 19991 BRENNAN, WILLIAM DUNBAR TRANSFER 10/23/17 JEFF GREEN 290 18WC 20788 GODINEZ, EMILIO JACOBS FIELD SERVICES 06/08/18 KATZ FRIEDMAN EAGLE ET AL SPIEGEL & CAHILL, PC 291 18WC 20871 CHAPINSKI, RICH ORKIN PEST CONTROL 07/06/17 KENNETH MAHAFFEY BRADY, CONNOLLY & MASUDA, PC 292 18WC 21440 WALTER, GERALD LASALLE PERU HS DIST 120 05/16/18 PATRICOSKI, MARK G WIEDNER & MCAULIFFE LTD 293 18WC 21816 CREAGER, DEBRA HORIZON HOUSE OF IL VALLE 07/18/18 DWORKIN AND MACIARIELLO BRYCE DOWNEY & LENKOV LLC 294 18WC 22034 MCCORMICK, SUSAN L TAMARA S. THOMAS-LEONATTI 01/10/18 PERONA PETERLIN ANDREONI 295 18WC 22265 GONZALEZ, MIGUEL EUCLID BEVERAGE LLC 01/10/18 SCHWEICKERT & GANASSIN 296 18WC 22271 MANCHEN, ROBERT FRITO-LAY NORTH AMERICA, 02/19/16 SCHWEICKERT & GANASSIN GILDEA, COGHLAN & REGAN LTD. 297 18WC 22323 OLSON, REBECCA CLIVER TECHNOLOGIES 07/17/18 STRONG LAW OFFICE

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 18 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 298 18WC 22639 RICCOLO, TERRY STATE OF IL - DEPT OF TRA @ 03/09/18 MICHAEL HELLMAN ASSISTANT ATTY GENERAL 299 18WC 22663 KOVEIKIS, CHRISTOPHER M KOSAN CRISPLANT MISSOURI, 06/07/18 RUBIN LAW GROUP KEEFE CAMPBELL BIERY & ASSOC 300 18WC 22999 KELLERHUIS, BILLE L HY-VEE 05/30/18 PETER F FERRACUTI & ASSOCI QUINN JOHNSTON HENDERSON ETA 301 18WC 23042 DIAZ, MARIA E HEARTSIDE FOOD SOLUTIONS 04/24/18 JONATHAN SCHLACK 302 18WC 23336 RANKIN, JOHN MONTERREY MUSHROOM 07/27/18 DWORKIN AND MACIARIELLO BRADY CONNOLLY & MASUDA PC 303 18WC 23960 NIXON, MARK YORKVILLE SCHOOL DIST 115 06/19/18 PATRICOSKI, MARK G 304 18WC 24637 LARABEE, JUSTINE BILL WALSH CORONET 01/09/18 SCHWEICKERT & GANASSIN INMAN & FITZGIBBONS 305 18WC 24935 GRIEVES, LILLIAN M COSTCO WHOLESALE CORPORAT 03/14/18 CHRISTIAN & MANNO GANAN & SHAPIRO 306 18WC 25386 SIBRIAN, JOSE REHRIG PACIFIC COMPANY 07/17/18 SCHWEICKERT & GANASSIN BRYCE DOWNEY & LENKOV LLC 307 18WC 25389 JOHNSON, AMY ACE HARDWARE DISTRIBUTN C 05/12/18 SCHWEICKERT & GANASSIN KLAUKE LAW GROUP LLC 308 18WC 25392 BARATTA, CHRISTINE DEL MONTE FOODS, INC. 10/25/17 SCHWEICKERT & GANASSIN RODDY LAW LTD 309 18WC 25488 DREISBACH, JEFFREY ABF FREIGHT 08/13/18 KROL BONGIORNO & GIVEN LTD KEEFE CAMPBELL BIERY & ASSOC 310 18WC 25552 NOVAK, NICHOLAS G ST OF IL DEPT OF CORRECTI @ 06/28/18 REESE & REESE ASSISTANT ATTY GENERAL 311 18WC 25638 COX, KATIE STATE OF IL DOC SHERIDAN @ 07/30/18 PETER F FERRACUTI & ASSOCI ASSISTANT ATTY GENERAL 312 18WC 25715 WASILEWSKI, MICHAEL A IDOT/STATE OF ILLINOIS @ 08/21/18 DREW J FERRACUTI ASSISTANT ATTY GENERAL 313 18WC 26158 GUTIERREZ, HIRAM EXELON NUCLEAR SECURITY 06/07/18 DWORKIN AND MACIARIELLO HENNESSY & ROACH PC 314 18WC 26371 STERLING, BEATRICE M CASEYS GENERAL STORES INC 08/01/18 PERONA PETERLIN ANDREONI HEYL ROYSTER VOELKER & ALLEN 315 18WC 26791 LESKO, JUNE H&R BLOCK 08/10/17 SEIDMAN MARGULIS & FAIRMAN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 19 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 316 18WC 26903 EDMONDS, KRISTI PARK POINTE HEALTH CENTER 08/15/18 RATHBUN CSEVENYAK & KOZOL BRADY, CONNOLLY & MASUDA, PC 317 18WC 27391 ABERNATHY, ANNA CRISTAL METALS 08/15/18 PETER F FERRACUTI & ASSOCI HENNESSY & ROACH PC 318 18WC 27819 ESSL, JAMES CENTURI CONSTRUCTION GROU 07/25/18 PERONA PETERLIN ANDREONI GRANT & FANNING 319 18WC 28417 NIETO, ROSA HEARTHSIDE FOOD SOLUTIONS 06/13/17 SCHWEICKERT & GANASSIN WIEDNER & MCAULIFFE LTD 320 18WC 28421 GONAZALEZ, MARIA SEATTLE SUTTON HEALTHY EA 07/24/18 SCHWEICKERT & GANASSIN 321 18WC 28427 CATE, SHERYL CASEY'S GENERAL STORES, I 05/06/18 SCHWEICKERT & GANASSIN HEYL ROYSTER VOELKER & ALLEN 322 18WC 28552 SCHMITZ, MARGARET PARKER NURSING & 07/09/18 PETER F FERRACUTI & ASSOCI WIEDNER & MCAULIFFE LTD 323 18WC 28824 NEWELL, JEREMY COLLINS & HERMANN 08/23/18 TAXMAN POLLOCK 324 18WC 29070 HICKS, WILLIAM WAL-MART 07/17/18 LIPKIN & HIGGINS LAW OFFIC QUINTAIROS PRIETO WOOD & BOY 325 18WC 29785 BOISO-SANTANA, JULIO CESA THORNAPPLE LANDSCAPES INC 07/26/18 ARGIONIS & ASSOCIATES LLC BRYCE DOWNEY & LENKOV LLC 326 18WC 30223 HILLMAN, PATRICIA COSTCO DEPOT 08/21/18 HORWITZ HORWITZ & ASSOC GANAN & SHAPIRO 327 18WC 30629 SMITH, WALTER JR POSTAL FLEET/PEOPLELEASE 06/28/18 DREW J FERRACUTI LEAHY EISENBERG & FRAENKEL 328 18WC 31259 NEWMAN, JASON ILLINOIS CEMENT COMPANY, 08/28/18 AJESTER LAW OFFICE SPIEGEL & CAHILL, PC 329 18WC 31335 DIXON, DELLA CHICAGO PUBLIC SCHOOLS 02/23/17 MARK N LEE CHGO BOARD OF EDUCATION 330 18WC 31589 SCHUMACHER, VIVA JEAN SUPERVALU, INC 07/20/18 PERONA PETERLIN ANDREONI HEYL ROYSTER VOELKER & ALLEN 331 18WC 31618 BERNINGER, THOMAS EJ MCKERNAN CO 06/06/18 SCHWEICKERT & GANASSIN JOSEPH MARCINIAK 332 18WC 31621 MANNING, ROBERT COLOR POINT, LLC 04/26/18 SCHWEICKERT & GANASSIN GAROFALO SCHREIBER STORM GRA 333 18WC 31712 MCCULLOUGH, JO ANNE REGENEX 09/11/18 HORWITZ HORWITZ & ASSOC RODDY LAW LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 20 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 334 18WC 31805 PALKO, CHERYL A OWENS-BROCKWAY GLASS CONT 06/29/18 DREW J FERRACUTI POWER & CRONIN LTD 335 18WC 32262 GRABILL, THERESA GCA NUCLEAR FACILITY 07/06/18 SCHWEICKERT & GANASSIN 336 18WC 32567 PAVY, CLIFTON GDC ILLINOIS, INC 09/19/18 SCHWEICKERT & GANASSIN QUINN JOHNSTON HENDERSON ETA 337 18WC 32568 DUNN, SADIE ALLEGION PLC 08/10/17 SCHWEICKERT & GANASSIN HOLECEK & ASSOCIATES 338 18WC 32729 VAN BUREN, MARYBETH A OP STORAGE, LLC 10/19/18 PERONA PETERLIN ANDREONI 339 18WC 33050 GALLACHER, JAMES WELLINGTON INDUSTRIES 09/26/18 DAVID W OLIVERO HOLECEK & ASSOCIATES 340 18WC 33112 SCHOTT, GERALD A OTTAWA TOWNSHIP HIGH SCHO 07/19/18 DREW J FERRACUTI 341 18WC 33241 CROMPTON, JERRY L CF INDUSTRIES, INC 07/13/18 DREW J FERRACUTI NYHAN BAMBRICK KINZIE & LOWR 342 18WC 33442 BETTASSO, KAILEY PRESCOTT BROTHERS 07/24/18 PETER F FERRACUTI & ASSOCI RODDY LAW LTD 18WC034044 -C 343 18WC 33722 KOFFSKI, JENNIFER THE RESERVES NETWORK 10/24/18 PETER F FERRACUTI & ASSOCI WIEDNER & MCAULIFFE LTD 18WC033723 -C SIGAN AMERICA, LLC 344 18WC 34087 WHITFIELD, JEREMY VACTOR MANUFACTURING 09/30/18 PETER F FERRACUTI & ASSOCI 345 18WC 34174 MC CARDLE, BRADLEY E DIXON DIRECT, LLC 05/08/18 REESE & REESE 346 18WC 34644 NOLAN, LISA M HEELS AND HARDHATS 10/20/18 DREW J FERRACUTI RODDY LAW LTD 347 18WC 34659 GEIGER, DARRELL W ILLINOIS VALLEY COMM HOSP 07/07/17 GALLAGHER, DONALD V NYHAN BAMBRICK KINZIE & LOWR 348 18WC 34830 MILTON, JEANETTE JOLIET DSR OFFICE 08/08/18 DWORKIN AND MACIARIELLO ASSISTANT ATTY GENERAL 349 18WC 35593 CARRIER, BRIAN NUSSBAUM TRANSPORTATION 09/12/18 GOLDFINE & BOWLES RIPES NELSON BAGGOT KALOBRAT 350 18WC 36211 WILLIAMS, BRITTANY SINNISSIPPI CENTERS INC. 10/16/18 STRONG LAW OFFICE HENNESSY & ROACH PC 351 18WC 36360 GEORGEFF, NICK J MORTENSON CONSTRUCTION CO 11/15/18 ANESI OZMON RODIN NOVAK KO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 21 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 352 18WC 36750 DAVIS, TAMMI PLANO SCHOOL DISTRICT 88 08/13/18 GOLDBERG WEISMAN & CAIRO L DENNIS J NOBLE & ASSOC 353 18WC 36901 KUNTZELMAN, SHAWN A STATE OF ILLINOIS JACK MA @ 01/31/17 REESE & REESE ASSISTANT ATTY GENERAL 354 18WC 37045 VOLKER, CHRISTOPHER HEARTHSIDE FOOD SOLUTIONS 10/15/18 SCHWEICKERT & GANASSIN WIEDNER & MCAULIFFE LTD 355 18WC 37069 FORTSON, MARY J OWENS-BROCKWAY GLASS 11/18/17 PERONA PETERLIN ANDREONI POWER & CRONIN LTD 356 18WC 37669 MCEMERY, LEESA (WIDOW OF) MAYOU ROOFING & SUPPLY CO # 02/21/18 MISKELL LAW CENTER KNELL LAW LLC 357 18WC 37765 GREVE, MATTHEW J JOHN'S SALES AND SERVICE 07/27/18 DREW J FERRACUTI WIEDNER & MCAULIFFE LTD 358 18WC 38028 GAHAN, MICHAEL COVIA HOLDINGS CORP 02/22/18 SCHWEICKERT & GANASSIN 359 18WC 38085 REHTMEYER, LAURA INNOVATIVE STAFF SOLUTION 10/02/18 LAW OFFICE ALISSA GEARHART THOMAS MAMER & HAUGHEY 360 18WC 38269 BRUCE, JACOB THE RESERVE NETWORK 09/13/17 O'CONNOR & NAKOS WIEDNER & MCAULIFFE LTD 361 18WC 38416 SPAMPANATO, MICHAEL HCC, INC 11/14/18 KATZ FRIEDMAN EAGLE ET AL MACIOROWSKI SACKMANN & ULRIC 362 19WC 00122 PINNEY, THERESA OTTAWA PAVILLION 12/24/18 PETER F FERRACUTI & ASSOCI 363 19WC 00275 KASOSKI, GZIM MENARDS 03/01/18 KNELL LAW LLC GANAN & SHAPIRO 364 19WC 00359 FAIRCHILD, ROBERT A ALLIED POWER 10/29/18 ANESI OZMON RODIN NOVAK KO LAWRENCE COZZI - LAW OFFICE 365 19WC 00447 KERZISNIK, KAITLYN BIG R STORES 08/08/18 CORBOY & DEMETRIO PC 366 19WC 00674 VANCOPPENOLLE, BROOKE OSF HOME HEALTH & HOSPICE 06/04/18 PETER F FERRACUTI & ASSOCI HERBOLSHEIMER LANNON ET AL 367 19WC 01085 AYALA, FRANCISCO YORKVILLE HILL LANDSCAPIN 12/02/17 DAVID W MARTAY JOSEPH MARCINIAK 368 19WC 01175 BLUM, DANIEL L WILLET, HOFAMNN & ASSOCIA 10/17/18 MERTES & MERTES PC NYHAN BAMBRICK KINZIE & LOWR 369 19WC 01491 RAMEY, JOHN JM TRANSPORT 11/27/18 KINNALLY FLAHERTY KRENTZ WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 22 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 370 19WC 01544 CRIMMINS, TIMOTHY STANDARD FORWARDING COMPA 06/04/18 RIDGE & DOWNES HENNESSY & ROACH PC 371 19WC 01585 THOMAS, JOSEPH OWENS-BROCKWAY GLASS CONT 01/10/19 ANESI OZMON RODIN NOVAK KO POWER & CRONIN LTD 372 19WC 01712 MANAHAN, DAVID RURAL KING SUPPLY CO 10/20/18 SCHWEICKERT & GANASSIN RURAL KING 373 19WC 01897 AICHER, TIFFANY M TCB 123 LLC D/B/A ROWDY'S 07/01/18 QUINTAIROS PRIETO WOOD & BOY 374 19WC 02007 MC KEE, ROBERT VIRDEN BROADCASTING CORP 11/30/18 GOLDFINE & BOWLES 375 19WC 02083 KOLESAR, KIMBERLY OTTAWA FRIENDSHIP HOUSE 01/08/19 SCHWEICKERT & GANASSIN 376 19WC 02311 DELEON, MARIA MONTEREY MUSHROOMS INC 11/11/18 SCHWEICKERT & GANASSIN BRADY CONNOLLY & MASUDA PC 377 19WC 02543 HATMAN, ALTON MENARDS 08/02/17 ANKIN LAW OFFICE 378 19WC 02667 BRADLEY, DENISE ROWDY'S 06/05/18 DAVID W OLIVERO GANAN & SHAPIRO 379 19WC 02863 COX, LAURIE ILLINOIS VALLEY COMMUNITY 11/02/18 PETER F FERRACUTI & ASSOCI STEPHEN P. KELLY 380 19WC 03276 MOORE, ELBERT "MARK" NORTHERN PARTNERS CO-OP 09/25/17 ANTHONY C RACCUGLIA & ASSO CAPUANI, FRANK S 381 19WC 03781 WILLAMS, RANDALL L CREST FOODS 12/04/18 REESE & REESE 382 19WC 03831 MEDERO, MILKO H.B. FULLER CO 01/29/19 GOLDBERG WEISMAN & CAIRO L HENNESSY & ROACH PC 383 19WC 03904 FOLKERTS, KATHERINE IDOC/DIXON CORRECTIONAL C @ 11/27/18 PETER F FERRACUTI & ASSOCI ASSISTANT ATTY GENERAL 384 19WC 04337 FREEMAN, JESSIE DO IT BEST CORP 08/06/18 PIGNATELLI & ASSOCIATES 385 19WC 04699 WILKISON, LLOYD RESERVES NETWORK (STREATO 01/31/19 PETER F FERRACUTI & ASSOCI WIEDNER & MCAULIFFE LTD 386 19WC 04730 MARQUEZ, RAMIRO CLARK DIETRICH 08/23/18 PETER F FERRACUTI & ASSOCI 387 19WC 04966 LOCHIRCO, PHILLIP J MVP PLUMBING CORP 05/01/18 BRADY CONNOLLY & MASUDA PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 23 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 388 19WC 05059 TOMPKINS, RHONDA SAUK VALLEY COMMUNITY COL 11/13/18 REESE & REESE 389 19WC 05221 SUTTON, JESSE DIXON CORRECTIONAL CENTER @ 02/04/19 PETER F FERRACUTI & ASSOCI ASSISTANT ATTY GENERAL 390 19WC 05289 TALAVERA, WILFREDO SWIFT TRANSPORTATION 04/09/18 BOGGS & FILLENWARTH WIEDNER & MCAULIFFE LTD 391 19WC 05454 CAVANESS, JIM C RIVERVIEW ENTERPRISES, LL 12/16/16 PERONA PETERLIN ANDREONI 392 19WC 05635 SZABO, MICHAEL L RAYNOR MANUFACTURING COMP 03/20/18 REESE & REESE 393 19WC 06242 WILLIAMS, CHARLES P MENDOTA FORD, INC 05/28/18 DREW J FERRACUTI 394 19WC 06251 GERKITZ, DAVID FLINK COMPANY 03/17/17 HORWITZ HORWITZ & ASSOC RIPES NELSON BAGGOT KALOBRAT 395 19WC 06377 FEITH, JAMES ALLIED-LOCKE INDUSTRIES 11/13/18 SCHWEICKERT & GANASSIN ACCIDENT FUND HOLDINGS 396 19WC 06620 JABLONSKY, JAMES STATE OF ILLINOIS 11/15/18 REESE & REESE ASSISTANT ATTY GENERAL 397 19WC 06702 CHAVEZ, LUIS MENARDS 06/28/18 KURASCH & KLEIN, LTD 398 19WC 06768 RODRIGUE, JOYCE GEMINI MOTOR TRANSPORT, L 09/10/18 LIPKIN & HIGGINS LAW OFFIC ROSARIO CIBELLA 399 19WC 06909 WENDEL, ROBERTA ILLINOIS VALLEY COMMUNITY 08/30/17 DREW J FERRACUTI NYHAN BAMBRICK KINZIE & LOWR 400 19WC 07304 CHAVEZ, LUIS MENARD'S 09/15/17 KURASCH & KLEIN, LTD 401 19WC 07381 DANKO, ANDREW DYNO NOBEL INC. 10/31/17 SCHWEICKERT & GANASSIN BRADY, CONNOLLY & MASUDA, PC 402 19WC 07471 RUDOLPH, WILLIAM L COYNE AND SONS CONSTRUCTI 09/21/18 SPIROS LAW PC 403 19WC 07533 STEWART, BOB IL DEPT OF CORRECTIONS 10/28/18 DWORKIN AND MACIARIELLO ASSISTANT ATTY GENERAL 404 19WC 07577 NIETO, MIGUEL GARCIA MENDARDS DISTIBUTION CENT 02/10/19 WOODRUFF JOHNSON 405 19WC 07700 PARR, KATHLEEN ILLINOIS VALLEY COMMUNTIY 02/10/19 BURNETT & CARON, LTD NYHAN BAMBRICK KINZIE & LOWR

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 24 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 406 19WC 08165 WAGENKNECHT, GARY COMED 02/01/19 GESMER & REYNOLDS PC HENNESSY & ROACH PC 407 19WC 08313 YARBORO, SALLY ACE HARDWARE DIST CENTER 01/29/19 PETER F FERRACUTI & ASSOCI KLAUKE LAW GROUP LLC 408 19WC 08474 PELKA, HELEN JEAN JOHANNES BUS SERVICE INC 02/25/19 SCHWEICKERT & GANASSIN INMAN & FITZGIBBONS 409 19WC 08578 SANDOVAL, MARTIN DEL MONTE CORP. 04/07/17 ANTHONY C RACCUGLIA & ASSO 410 19WC 08639 REPPIN, KATHY WAL-MART 07/31/18 PERONA PETERLIN ANDREONI QUINTAIROS PRIETO WOOD & BOY 411 19WC 08895 BURASH, RICHARD VACTOR MANUFACTURING 02/01/18 SCHWEICKERT & GANASSIN BRADY CONNOLLY & MASUDA PC 412 19WC 09047 DURBALA, RACHEL WALMART * 02/20/19 DAVID W MARTAY WIEDNER & MCAULIFFE LTD 413 19WC 09088 DILLON, ERIC STATE OF IL - CMS @ * 01/19/19 MARK N LEE ASSISTANT ATTY GENERAL 414 19WC 09126 CHAPMAN, PATRICIA MENARD, INC * 03/13/19 SCHWEICKERT & GANASSIN 415 19WC 09184 RUGGERIO, RONALD STAFFQUICK * 03/01/19 DWORKIN AND MACIARIELLO HENNESSY & ROACH PC 416 19WC 09364 MADDOX, JOHN BEDFORD SALES * 08/16/17 FOOTE MIELKE CHAVEZ O'NEIL 417 19WC 09499 ABEL, JOSEPH KENDALL COUNTY SHERIFF * 12/12/17 MCNAMARA PHELAN MCSTEEN LL 418 19WC 09763 STINAR, ROY K TREEHOUSE FOODS * 02/26/19 REESE & REESE 419 19WC 09790 WILSON, DANIK STATE OF ILLINOIS * 02/08/19 REESE & REESE ASSISTANT ATTY GENERAL 420 19WC 09840 VEGA, WILLIAM ILLINOIS DEP OF TRANSPORT * 01/02/19 JONATHAN SCHLACK ASSISTANT ATTY GENERAL 421 19WC 09911 WIRES, MYONG-HE DONALDSON COMPANY * 02/12/19 PIGNATELLI & ASSOCIATES LEAHY EISENBERG & FRAENKEL 422 19WC 10549 DONALD, JENNIFER WALMART DISTRIBUTION CENT * 07/04/16 HORWITZ HORWITZ & ASSOC QUINTAIROS PRIETO WOOD & BOY 423 19WC 10784 GATZA, RAYMOND CITY OF LASALLE POLICE DE * 12/29/18 SEIGLER, DARRELL K LTD POWER & CRONIN LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 25 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 424 19WC 10853 KARLSSON, AMBER C STATE OF ILLINOIS JACK MA @ * 03/26/19 REESE & REESE ASSISTANT ATTY GENERAL 425 19WC 11350 LOUIS, PHILIP FLINK COMPANY * 02/12/19 PETER F FERRACUTI & ASSOCI 426 19WC 11820 DAVIS, ASHLEY MARIE DORS/IL DEPT OF REHAB SVC @ * 04/03/17 LAW OFFICE ALISSA GEARHART 427 19WC 12031 TESTA, TOMMY JAMES HARDIE BLDG PRODUCT * 03/01/19 DREW J FERRACUTI HOLECEK & ASSOCIATES 428 19WC 12127 PYSZKA, MIKE SR. ADVANCED ASPHALT CO INC * 06/07/13 ACCIDENT FUND HOLDINGS 429 19WC 12365 DAVIS, ASHLEY MARIE DORS/ILD REHAB SVCS/ILDHS @ * 04/03/17 LAW OFFICE ALISSA GEARHART 430 19WC 12665 BOSS, TYLER CIT TRUCKS LLC * 07/03/18 ROBERT WARSASKI 431 19WC 12942 ZUK, PAUL DOUBLE D EXPRESS * 02/23/18 VRDOLYAK LAW GROUP LLC 432 19WC 13131 SOTO, ALVINO VIAKABLE MANUFACTURING * 02/18/19 PETER F FERRACUTI & ASSOCI 433 19WC 13135 SCHAEFER, JAMES M STATE OF IL DEPTOF CORREC @ * 06/10/18 REESE & REESE ASSISTANT ATTY GENERAL 434 19WC 13203 PENDLETON, JEAN MORRIS HOSPITAL * 06/23/16 ANTHONY C RACCUGLIA & ASSO 435 19WC 13218 PARK, TERESA DOLLAR GENERAL * 04/24/19 DWORKIN AND MACIARIELLO LEAHY EISENBERG & FRAENKEL 436 19WC 13371 JACKSON, BRANDON AMCO MACHINE * 04/02/19 WOODRUFF JOHNSON 437 19WC 13880 HAIRAPETIAN, SUSAN FOODLINER, INC. * 12/03/18 PERONA PETERLIN ANDREONI WIEDNER & MCAULIFFE LTD 438 19WC 13942 LEWIS, WILLIAM EXELON CORPORATION * 09/13/18 KINNALLY FLAHERTY KRENTZ 439 19WC 13983 BOROWICZ, DANETTE M SENECA GULF * 01/04/19 DREW J FERRACUTI 440 19WC 14192 HELLMAN, MICHAEL ALLIED POWER HOLDINGS LLC * 03/03/19 SCHWEICKERT & GANASSIN LAWRENCE COZZI - LAW OFFICE 441 19WC 14289 LITTLE, KEVIN SYNECTICS * 12/18/18 HORWITZ HORWITZ & ASSOC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 26 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR OTTAWA 40001 ON 07/22/2019 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 442 19WC 14754 GLENN, MICHAEL J RAYNOR WORLDWIDE, INC * 11/07/18 REESE & REESE 443 19WC 15011 QUERCIAGROSSA, DAVE WHITE CONSTRUCTION, INC * 05/15/19 PETER F FERRACUTI & ASSOCI 444 19WC 15279 SVOBODA, JOAN MI HOMES * 10/27/18 TURNER & SACKETT LLC 445 19WC 15482 HOLMES, MICHAEL VILLAGE OF MARK * 09/25/18 STEPHEN P. KELLY 446 19WC 16105 THOMAS, ROBERT MENARDS * 05/27/19 ANGELINI & ORI LLC 447 19WC 16476 WOLFF, CYNTHIA J RURAL KING * 11/30/18 DREW J FERRACUTI 448 19WC 16605 PROVOST, JON J WALMART ASSOCIATES, INC * 05/01/19 PERONA PETERLIN ANDREONI 449 19WC 16845 CONNESS, ROBERT LASALLE COUNTY HIGHWAY DE * 12/19/18 TIMOTHY CANTLIN HERBOLSHEIMER LANNON ET AL 450 19WC 17051 NEWTON, JAMES P PLANO MOLDNG CO(PLANO SYN * 10/10/18 DREW J FERRACUTI 451 19WC 17238 JACKSON, BRANDON T AMCO MACHINE * 04/02/19 BERTRAND LAW OFFICE 452 19WC 17367 WARNER, TONIA ROSATI'S PIZZA * 02/15/19 WOODRUFF JOHNSON 453 19WC 17519 MARTINEZ, HERIBERTO VIAKABLE MANUFACTURING, L * 03/05/19 SCHWEICKERT & GANASSIN 454 19WC 17607 ROD, LANCE W NARVICK BROTHERS LUMBER C * 08/08/18 BRADY CONNOLLY & MASUDA PC 455 19WC 17722 GOMEZ, JOSE UTILITY CONCRETE PRODUCTS * 11/30/18 DANIEL E MURPHY 456 19WC 17759 LUCAS, KIM VISSERING CONSTRUCTION CO * 06/11/19 WILSON LAW OFFICES LLC 457 19WC 17851 MACHAJ, DANIEL LAWRENCE FICEK ELECTRIC * 02/08/19 HORWITZ HORWITZ & ASSOC 458 19WC 17993 HEAD, JAMES RMI INDUSTRIAL INC * 04/10/19 SHAY & ASSOCIATES 459 19WC 18087 CLARK, AMANDA ANN WIDOW O NATIONAL BELT SERVICE # * 05/25/19 HOWERTON, DORRIS & STONE