ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 1 C A S E H E A R I N G S Y S T E M

DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 1 00WC 63060 MURRAY, PATRICIA WIDOW AN MOTOROLA # 11/15/99 WHITNEY WOLFE ELFENBAUM EV BRADY CONNOLLY & MASUDA PC 2 01WC 04146 FELL, BERNARD T STATE OF IL/DEPT OF TRANS @ 12/13/00 DECKER LINN & CAMPE ASSISTANT ATTORNEY GENERAL 03WC016153 -C ST OF IL IL DEPT OF TRANSP 04WC033448 -C 3 01WC 26682 COLLINS, CARY BELL ENTERTAINMENT 01/19/99 MARSZALEK AND MARSZALEK SPIEGEL & CAHILL, PC 02WC054561 -C 4 02WC 12535 CRAWFORD, CYNTHIA WINCHESTER HOUSE 10/11/01 LAW OFFICES OF MICHAEL J H WOLFE & JACOBSON, LTD 02WC026043 -C 5 02WC 20690 RUTECKI, JOHN EDWARD SCOTSMAN ICE SYSTEMS 03/18/98 STEVEN J SEIDMAN LAW OFFIC COZZI & GOGGIN-WARD 6 02WC 33832 19B ROMEO, JEFF MJ ELECTRIC AND/OR 05/02/02 COLLISON & O'CONNOR LTD GAROFALO SCHREIBER STORM 08WC043619 -C BECKER ELECTRIC 7 03WC 34786 HAJRULLAHU, FERDINAZE CDW 05/28/03 HETHERINGTON KARPEL BOBBER BRYCE DOWNEY & LENKOV LLC 04WC019313 -C 04WC039980 -C 06WC048515 -C 06WC048516 -C 8 05WC 15816 VLECK, ROBERT F ST OF IL DEPARTMENT OF CE @ 03/22/05 COHN & COHN ASSISTANT ATTORNEY GENERAL 9 06WC 30316 WALTERS, PAMEILIA ST OF IL, ANN M KILEY CEN @ 07/15/04 MARKHAM M JEEP & ASSOCIATE ASSISTANT ATTORNEY GENERAL 08WC007220 -C 10WC033613 -C ANN KILEY CENTER 11WC031432 -C STATE OF ILLINOIS 12WC036680 -C 10 07WC 09652 WRIGHT, LLOYD R MEIERS OUTDOOR WORLD 09/08/04 PETER D CORTI LAW GROUP RUSIN MACIOROWSKI & FRIEDMAN 07WC018851 -C 11 07WC 14933 MARTINEZ ATKIN, SUE STATE OF ILLINOIS ANN KIL 03/12/07 CAMERON CLARK ASSISTANT ATTORNEY GENERAL 12 07WC 40157 ANDREWS, DAVID PEPPER PATH HOMES W 04/23/07 POLANSKY & CICHON CHTD 13 07WC 46850 19B LEWANDOWSKI, AMBER ALDI FOODS 07/15/07 BAUM RUFFOLO & MARZAL LTD MACIOROWSKI SACKMANN & ULRIC 14 08WC 00824 19B DETLAF, JOHN RESAM CONSUMER PLASTICS, 11/01/07 LEWIS DAVIDSON & HETHERING SPIEGEL & CAHILL, PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 2 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 15 08WC 02277 BUSTAMENTE, LUCIANA TERESITA RESTAURANT W 12/19/07 CULLEN, HASKINS, NICHOLSON 16 08WC 27768 SALYER-ROBERTS, TAMMY AUTO ZONE 04/14/08 STEVEN J SEIDMAN LAW OFFIC GILDEA & COGHLAN 11WC037755 -C 17 08WC 32702 HUCKER, KURT GPW BUILDERS 01/18/08 RICHARD D HANNIGAN, LTD BRADY CONNOLLY & MASUDA PC 18 08WC 35482 RODRIGUEZ, CELESTINO L & M CORRUGATED 05/12/08 GOLDSTEIN FISHMAN BENDER E RODDY LAW LTD 19 08WC 51751 PADILLA, JOHN MIDWEST DECK-N-DOCK INC W 09/02/08 ANKIN LAW OFFICE STANCZAK LAW OFFICES 20 08WC 53741 CHARLIER, MONICA A ST OF IL DEPT OF W 10/09/08 TAMVAKIS, GEORGE L ASSISTANT ATTORNEY GENERAL 21 08WC 56379 FREIBERG, MICHAEL G LAKE COUNTY HEALTH DEPART 05/11/07 MARKHAM M JEEP & ASSOCIATE SMITH AMUNDSEN LLC 22 09WC 02346 KESSLER, DOUG WEBMD INC 02/07/07 MURPHY & MURPHY NYHAN BAMBRICK KINZIE & LOWR 23 09WC 05102 GUZMAN, ALICIA WILLIAMS ELECTRONIC 10/10/08 O'CONNOR & NAKOS NOBLE & ASSOCIATES PC 09WC005103 -C 09WC024600 -C WMS GAMING INC 12WC032181 -C 24 09WC 06084 CAFFERATA, SUZANLEE TOWNSHIP HIGH SCHOOL 113 09/26/08 MARSZALEK AND MARSZALEK WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 3 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 25 09WC 06388 RIZZO, JOHN TRANS FORCE INC 01/05/09 KATZ FRIEDMAN EAGLE ET AL THOMAS & ASSOCIATES 26 09WC 10888 TILLMAN, CHARLES CHICAGO BEARS FOOTBALL CL 12/17/06 GORDON LAW OFFICES LTD MC ANDREWS & NORGLE LLC 09WC010889 -C 09WC010890 -C 10WC003006 -C 10WC003007 -C 14WC023001 -C 14WC023002 -C 14WC023003 -C 14WC033001 -C 27 09WC 13346 JULIAN, SOFIA COMPELETE TEMPORARY LABOR 07/18/08 MARK A MORGENSTERN KOREY LAW LLC 28 09WC 24465 19B DONNER, TERESA VISTA MEDICAL CENTER EAST 11/10/08 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 29 09WC 31988 RUYAK, CHERYL LAKE VILLAGE SCHOOL DST # 02/13/09 BAUM RUFFOLO & MARZAL LTD COZZI & GOGGIN-WARD 15WC021355 -C 30 09WC 33750 ANAGNOSTOPOULOS, EFROSINI WAVES HAIR SALON 12/19/08 DAVID W MARTAY RIPES NELSON BAGGOT KALOBRAT 31 09WC 44349 OLSEN, EARL S VITALITY FOOD SERVICES 08/26/09 DAVID W MARTAY NYHAN BAMBRICK KINZIE & LOWR 32 09WC 53121 MC GRAW, CHARLYNE J KAVO DENTAL 11/25/09 LAW OFFICE PHILIP BLOMBERG HENNESSY & ROACH PC 33 10WC 06232 GIANNI, MARILU HEWITT ASSOCIATES 10/26/09 SLAVIN & SLAVIN GRANT & FANNING 34 10WC 13999 SMITH, SCOTT W G.E.S. INC 07/05/07 LINN, CAMPE & RIZZO LTD GILDEA & COGHLAN 10WC014112 -C 35 10WC 17121 NELSON, DONNA LAKE FOREST HOSPITAL 12/05/09 CULLEN HASKINS NICHOLSON NYHAN BAMBRICK KINZIE & LOWR 36 10WC 17906 HUEBNER, DAVID STERLING ENGINEERING, INC 03/18/10 LINN, CAMPE & RIZZO LTD WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 4 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 37 10WC 20662 19B JARERO, JORGE SMURFIT STONE 03/29/10 RICHARD D HANNIGAN, LTD GAROFALO SCHREIBER STORM 38 10WC 20856 ECHEVERRIA, VIRGINIA THE PARK AT VERNON HILLS 05/07/10 FRANK A SANTILLI & ASSOC THOMAS & ASSOCIATES 10WC039177 -C 39 10WC 23616 CORDOVA, CANDIDO COMMERCIAL PLASTICS COMPA 05/24/10 SALK, STEVEN B & ASSOC LTD STONE & JOHNSON CHARTERED 10WC023617 -C 40 10WC 26448 OCHOA, JOSE WILLIAMS ELECTRONICS & GA 02/22/10 STEVEN J SEIDMAN LAW OFFIC RUSIN MACIOROWSKI & FRIEDMAN 41 10WC 47524 MALUSKY, SARAH MUNDELEIN COMMUNITY BANK 08/27/10 NEWLAND NEWLAND & NEWLAND HOLECEK & ASSOCIATES 42 10WC 47989 NELSON, DONNA LAKE FOREST HOSPITAL 11/22/10 CULLEN HASKINS NICHOLSON NYHAN BAMBRICK KINZIE & LOWR 43 10WC 49197 JULIAN, SOPHIA MOST VALUABLE PERSONNEL 07/18/08 MARK A MORGENSTERN 44 11WC 00239 DALESSANDRO, MICHAEL F TH RYAN CARTAGE 10/05/10 BOUDREAU NISIVACO LLC HINSHAW & CULBERTSON 45 11WC 01134 DIAZ, JUAN MANUEL CHARLESTON BUILDING SERV W 11/08/10 KATZ FRIEDMAN EAGLE ET AL 46 11WC 04174 WOOD, RICHARD M MICHAEL PEMBROOK; INDIVID 08/09/10 LINN, CAMPE & RIZZO LTD 47 11WC 05392 CONTA, ASHLEY BATH & BODY WORKS 12/29/10 COHN & COHN BRYCE DOWNEY & LENKOV LLC 48 11WC 09284 RIOS, DAVID KILDEER COUNTRYSIDE 05/21/10 LEE A CAMPBELL LAW OFFICE WIEDNER & MCAULIFFE LTD 49 11WC 13065 THOMAS, MARY ANN VISTA EAST MEDICAL CTR 03/25/10 HANNIGAN & BOTHA, LTD WIEDNER & MCAULIFFE LTD 50 11WC 14307 HANNAN, MARK V LAKE COUNTY FOREST 08/06/10 LEE A CAMPBELL LAW OFFICE GAROFALO SCHREIBER STORM 51 11WC 15154 JOHNSON, TERESA ADAMS TARGET STORES 10/06/10 BERNARD WYSOCKI & ASSOCIAT KEEFE CAMPBELL & ASSOC LLC 52 11WC 15870 ESPINOSA, CARMEN ADPRO HEALTH CARE SERVICE 04/08/11 LAW OFFICES OF RONALD B SK 53 11WC 19583 SHULTIS, KAREN YMCA EARLY HEAD START 04/19/11 EPSTEIN, JACK R LAW OFFICE STELLATO & SCHWARTZ 54 11WC 29140 BREWTON, CLARA BAXTER HEALTHCARE 04/23/11 DWORKIN AND MACIARIELLO MACIOROWSKI SACKMANN & ULRIC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 5 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 55 11WC 30055 POSADAS, PAULA LB ANDERSEN 07/21/11 MARKHAM M JEEP & ASSOCIATE WIEDNER & MCAULIFFE LTD 56 11WC 31522 KUEBKER, PATRICK L MEYER MATERIAL AGGREGATE 03/31/11 LINN, CAMPE & RIZZO LTD KEEFE CAMPBELL & ASSOC LLC 57 11WC 31525 HAPP, LAWRENCE J WAUKEGAN SCHOOL DISTRICT 09/07/10 LINN, CAMPE & RIZZO LTD BRADY CONNOLLY & MASUDA PC 58 11WC 31703 KEENAN, RENEE LONG GROVE FIRE 11/23/10 THOMAS W DUDA RUSIN MACIOROWSKI & FRIEDMAN 59 11WC 32054 LENOX, SHAWN P INTEGRYS ENERGY GROUP 04/04/11 PERONA, PETERLIN, ANDREONI GAROFALO SCHREIBER STORM 60 11WC 40182 SEROLA, JOHN ECOLAB, INC 07/26/10 TODD SHIVERS KEEFE CAMPBELL & ASSOC LLC 11WC040183 -C 61 11WC 41260 MADISON, ODESSA ODY WAUKEGAN PUBLIC SCHOOL DI 02/09/11 DUDLEY & LAKE LLC BRADY CONNOLLY & MASUDA PC 62 11WC 43028 PETERSON, EVELINA G UMLAU CHICAGO SEA RAY INC # 09/18/10 LINN, CAMPE & RIZZO LTD HENNESSY & ROACH PC 63 11WC 43167 TABAKA, MARIA CM PACKAGING INC 02/02/11 LEWIS & DAVIDSON, LTD HOLECEK & ASSOCIATES 64 11WC 46813 HOHS, CHARLES FINAL PHASE HOME IMPROVEM W 11/02/11 DWORKIN AND MACIARIELLO JORDAN FRANK 65 11WC 47377 CUNA, JOSE G PERFORMANCE FOOD GROUPº 09/13/11 DWORKIN AND MACIARIELLO BRYCE DOWNEY & LENKOV LLC 66 11WC 49088 WATTS, SHEVELLE STATE OF ILLINOIS @ 12/10/11 HORWITZ HORWITZ & ASSOC 12WC015723 -C ANN M KILEY CENTER 67 12WC 07522 HAYDEN, KEITH ILLINOIS TOLLWAY AUTHORIT 02/15/12 DUDLEY & LAKE LLC NYHAN BAMBRICK KINZIE & LOWR 68 12WC 08199 REICHEL, AMY N STATE OF ILLINOIS @ 02/14/12 DWORKIN AND MACIARIELLO MATTHEW LICAVOLI 69 12WC 08698 KOZLIK, JOHN ILLINOIS DEPARTMENT OF @ 08/29/11 HETHERINGTON KARPEL BOBBER MATTHEW LICAVOLI 70 12WC 09038 DOYLE, JANICE NORTHWESTERN LAKE FOREST 05/29/09 ROBERT J COZZI NYHAN BAMBRICK KINZIE & LOWR 12WC009039 -C 71 12WC 10217 CRUZ, LORENA PREFERRED MEALS SYSTEMS I 01/03/12 PATRICIA HARDIMAN LAW OFFI POWER & CRONIN LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 6 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 72 12WC 10764 CZARNECKI, DARLENE ILLINOIS DEPT OF 02/16/12 JOHN F GREGORIO & ASSOC ASSISTANT ATTORNEY GENERAL 73 12WC 10861 MISEK, JOHN JR ILLINOIS TOLLWAY AUTHORIT 03/07/12 DUDLEY & LAKE LLC NYHAN BAMBRICK KINZIE & LOWR 74 12WC 11833 ANDERSON, RICARDO WAUKEGAN TOWNSHIP 11/11/11 COHN & COHN RUSIN MACIOROWSKI & FRIEDMAN 12WC011919 -C 75 12WC 12128 ORTIZ, ISIS PAYLESS SHOE SOURCE 08/16/11 SHELDON I MINKOW & ASSOCIA 76 12WC 12990 VALLIER, BETTY ST OF IL DEPT OF HUMAN SE @ 07/09/10 LEWIS & DAVIDSON, LTD ASSISTANT ATTORNEY GENERAL 12WC012991 -C 77 12WC 13719 WEINGART, FRANCES L AMCOR FLEXIBLES 09/05/11 PARENTE & NOREM PC HOLECEK & ASSOCIATES 12WC013720 -C 12WC013721 -C 78 12WC 14731 YTURRALDE, ROBERT KENGENELK DELIVERLY SVC I 03/15/12 HANNIGAN & BOTHA, LTD NYHAN BAMBRICK KINZIE & LOWR 79 12WC 15072 SUPRUNOVICH, DMITRY DISH NETWORK LLC CORP 08/11/10 STEVEN J SEIDMAN LAW OFFIC BROWN & JAMES, PC 80 12WC 15747 MEADOWS, AMY CARSON PIRIE SCOTT II, IN 12/21/11 MARKHAM M JEEP & ASSOCIATE 13WC012320 -C 81 12WC 16307 JACOBI, MARY E LAKE COUNTY HEALTH DEPT 02/17/12 TAMVAKIS, GEORGE L BERNARD WYSOCKI & ASSOCIATES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 7 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 82 12WC 20727 MALDONADO, SALVADOR L A LANDSCAPE INC 11/01/09 CULLEN HASKINS NICHOLSON 83 12WC 21222 FLAMMINI, DONNA R VISTA MEDICAL CENTER EAST 08/27/10 MARK B PEAVEY, PC WIEDNER & MCAULIFFE LTD 12WC021223 -C 13WC018985 -C 13WC029756 -C 14WC004510 -C 14WC028449 -C 15WC014515 -C 84 12WC 25338 BELL, ROBERT ROUND LAKE POLICE DEPT 06/30/12 MARSZALEK AND MARSZALEK RUSIN MACIOROWSKI & FRIEDMAN 14WC006349 -C VILLAGE OF ROUND LAKE PD 14WC006350 -C 85 12WC 26649 NAVARRETE, MARGARITA VISUAL PACK 07/05/12 JONATHAN SCHLACK KOREY COTTER HEATHER RICHARD 86 12WC 26893 PORCAYO, NICOLAS ROSBROUGH PARTNERS 06/07/12 THE ROMAKER LAW FIRM HANSON LAW OFFICE 87 12WC 26949 DECASTANEDA, MONICA V SALVATION ARMY 04/10/12 CULLEN HASKINS NICHOLSON NYHAN BAMBRICK KINZIE & LOWR 88 12WC 30379 BLANCO, CARLOS FACILITEC CONTROL 03/01/12 AIOSSA LAW FIRM CHILTON YAMBERT PORTER LLP 89 12WC 30896 PEROTT, MARC MENARDS INC 08/20/12 PETER D CORTI LAW GROUP CHILTON YAMBERT PORTER LLP 13WC041850 -C 15WC015990 -C 90 12WC 33012 BAARTZ, BRIAN J S & L HOSPITALITY LLC 06/25/12 MAY & BUEGE COZZI & GOGGIN-WARD 91 12WC 34064 CIANGI, SALLY STATE OF ILLINOIS @ 02/16/10 KATZ FRIEDMAN EAGLE ET AL JORDAN FRANK 12WC034065 -C 92 12WC 35024 RAMIREZ, RENE ARCHITERRA INC DBA 08/13/12 JONATHAN SCHLACK 93 12WC 35125 CRUMP, WILLIAM ABBOTT LABORATORIES 03/13/12 DAVID W MARTAY HENNESSY & ROACH PC 12WC035126 -C 94 12WC 36720 ROSA, SYNDER I PARKER HAMMIFIN CORPORATI 08/07/12 MAY & BUEGE RUSIN & MACIOROWSKI LTD 95 12WC 37412 FLORES, ARTURO I CITY OF WAUKEGAN 07/13/12 LINN, CAMPE & RIZZO LTD BERNARD WYSOCKI & ASSOCIATES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 8 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 96 12WC 38282 DELGADO, ALFONSO CNS HOME SERVICE 09/25/12 JONATHAN SCHLACK COZZI & GOGGIN-WARD 97 12WC 38405 ANGELI, MIKE MIDWEST COPIER EXCHANGE 02/12/11 BRISKMAN BRISKMAN GREENBER HEYL ROYSTER VOELKER & ALLEN 98 12WC 38431 19B NAST, NICKI EYE SPECIALISTS OF CHICAG 10/11/12 SMOLER LAW OFFICE, PC NYHAN BAMBRICK KINZIE & LOWR 99 12WC 39144 COLLINS, CARY (AS EXECUTO BELL ENTERTAINMENT # 08/04/02 MARSZALEK AND MARSZALEK 100 12WC 40418 NAGEL, RAY INTERSTATE BRANDS 10/04/12 GOLDBERG WEISMAN & CAIRO L SCOPELITIS GARVIN LIGHT 12WC040419 -C 101 12WC 41543 ARTAC, JEFF NORTH SHORE GAS CO 10/04/12 ELFENBAUM EVERS & AMARILIO GAROFALO SCHREIBER STORM 102 12WC 42733 SCHERER, JACK LORIG CONSTRUCTION 12/27/11 JONATHAN SCHLACK GAROFALO SCHREIBER STORM 12WC042739 -C 103 12WC 42925 MELGOZA, HILDA Z PARKER HANNIFIN CORP 05/14/12 HANNIGAN & BOTHA, LTD RUSIN & MACIOROWSKI LTD 104 12WC 43177 SHAPE, KEVIN CITI CARE TRANSPORTATION @ W 12/11/12 STEIN & CHERNEY LTD DWORKIN AND MACIARIELLO 105 12WC 43944 GALLUP, JAMISON AT&T 09/27/12 MARKHAM M JEEP & ASSOCIATE HENNESSY & ROACH PC 106 12WC 44105 WOODMAN, TONY WAUKEGAN SD #60 11/20/12 STEVEN J SEIDMAN LAW OFFIC BRADY CONNOLLY & MASUDA PC 107 12WC 44153 HOPKINS, ROCHELE CHICAGO BREAD 09/11/12 ANKIN LAW OFFICE COZZI & GOGGIN-WARD 108 13WC 00365 TUROVITZ, BARBARA SOURCE INTERLINK 06/08/11 PETER C KOPOULOS GAROFALO SCHREIBER STORM 109 13WC 01790 RITTHALER, PETER NOLAND SALES CORP 08/24/12 HANNIGAN & BOTHA, LTD KEEFE CAMPBELL & ASSOC LLC 110 13WC 03031 TOUSI, SAEID O'HARE MIDWAY 01/04/13 CULLEN HASKINS NICHOLSON LAW OFFICES JOSEPH MARCINIAK 111 13WC 03150 PRUDHOMME, DANYELL R HAIRCUTTERY 06/24/12 LINN, CAMPE & RIZZO LTD 112 13WC 03593 MARTIN, KARIANN HCR MANOR CARE 03/08/12 DWORKIN AND MACIARIELLO BRYCE DOWNEY & LENKOV LLC 113 13WC 03654 FREEMAN, DAVID E CITY OF WAUKEGAN 03/29/10 THOMAS W DUDA NYHAN BAMBRICK KINZIE & LOWR

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 9 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 114 13WC 04243 LENOX, SHAWN INTEGRYS ENERGY GROUP 08/07/12 PERONA, PETERLIN, ANDREONI 115 13WC 05519 VILLARREAL, ALI D NORTHERN ILLINOIS MACK 05/31/12 LINN, CAMPE & RIZZO LTD HEYL ROYSTER VOELKER & ALLEN 116 13WC 05634 PARISI, MARY K THE MERIT CLUB 09/19/11 LINN, CAMPE & RIZZO LTD CASSANO & ASSOCIATES 117 13WC 05970 KOCH, JAMES P VILLAGE OF VERNON HILLS 08/29/12 LINN, CAMPE & RIZZO LTD NYHAN BAMBRICK KINZIE & LOWR 13WC005972 -C 14WC005707 -C 14WC005714 -C 15WC007039 -C 15WC007234 -C 15WC038477 -C 118 13WC 06523 SANCHEZ, HUGO F WINDRIDGE BUILDERS INC 02/15/13 ACEVES & PEREZ PC KEEFE CAMPBELL & ASSOC LLC 119 13WC 06903 19B BARNA, BRIAN BUFFALO GROVE 05/30/12 CAPRON & AVGERINOS PC RUSIN MACIOROWSKI & FRIEDMAN 120 13WC 07788 SPENCER, ARLETHA R LAKE BLUFF HOME CARE SOLU 07/12/12 ALAN A BLUM, PC KEEFE CAMPBELL & ASSOC LLC 121 13WC 07994 STOKES, ANITA A CITY OF WAUKEGAN 11/07/11 LINN, CAMPE & RIZZO LTD NYHAN BAMBRICK KINZIE & LOWR 14WC005722 -C 122 13WC 08735 HOPF, MICHAEL FEDEX EXPRESS 07/06/12 EPSTEIN, JACK R LAW OFFICE HANSON LAW OFFICE 13WC008741 -C 123 13WC 08967 KINNEY, DARRYL STACK ON PRODUCTS INC 11/02/12 VASILATOS & COTTER LLC LAW OFFICE OF PAUL O WATKISS 13WC038853 -C 13WC038854 -C 14WC013310 -C 15WC008592 -C 15WC018524 -C 16WC000649 -C 16WC000651 -C 124 13WC 09158 SHRAKE, KENNETH HOBART 01/07/13 HANNIGAN & BOTHA, LTD HENNESSY & ROACH PC 125 13WC 10050 MISICKA, LAWRENCE PAYNE & DOLAN INC 10/22/12 CAPRON & AVGERINOS PC STONE & JOHNSON CHARTERED 14WC028563 -C 126 13WC 10065 GROTH, DIANE THE THURBER COMPANY 04/20/12 NEWLAND & NEWLAND RUSIN MACIOROWSKI & FRIEDMAN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 10 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 127 13WC 11024 RIVERA, MIQUEL CDW 08/15/12 DUDLEY & LAKE LLC HENNESSY & ROACH PC 128 13WC 11403 MOORE, TARNISHA MOTOROLA MOBILITY 04/25/12 HANNIGAN & BOTHA, LTD BRADY CONNOLLY & MASUDA PC 129 13WC 11775 VELASGUEZ, JOSEFINA MOST VALUABLE PERSONNEL 05/11/12 JONATHAN SCHLACK KOREY COTTER HEATHER RICHARD 13WC011776 -C 130 13WC 11947 KORNSTEIN, RICHARD PEP BOYS 11/30/12 MARKHAM M JEEP & ASSOCIATE CHILTON YAMBERT PORTER LLP 131 13WC 12028 HELGESEN, KYLE CITY OF ZION POLICE DEPT 09/11/12 MARKHAM M JEEP & ASSOCIATE RUSIN MACIOROWSKI & FRIEDMAN 14WC011363 -C 132 13WC 12249 AVILA, MINERVA ACE LASER TEK INC 03/29/13 JOHN S. ELIASIK HANSON LAW OFFICE 133 13WC 12838 ALCALA, LETICIA CARDINAL HEALTH 01/08/13 ACEVES & PEREZ PC HENNESSY & ROACH PC 15WC024356 -C 134 13WC 13353 LAZAR, LLENE CHASE BANK 01/03/13 CULLEN HASKINS NICHOLSON NYHAN BAMBRICK KINZIE & LOWR 135 13WC 13365 MONTIEL, MIRNA QPS EMPLOYMENT GROUP 08/01/12 MARSZALEK AND MARSZALEK WOLFE & JACOBSON, LTD 136 13WC 13842 IRBY, SHARMAN ADA MCKINLEY 07/05/12 ANKIN LAW OFFICE GAROFALO SCHREIBER STORM 137 13WC 13930 SOTELO, FELIPE DOLLAR JUNCTION & MORE IN 03/22/13 DAVID W MARTAY 138 13WC 14072 PIOTROWSKI, RICHARD COSTCO WHOLESALE 03/04/12 LINN, CAMPE & RIZZO LTD GANAN & SHAPIRO 139 13WC 15047 LUDVIGSEN, KEVIN S MECHANICAL INC 03/26/13 JOHN F GREGORIO & ASSOC HOLECEK & ASSOCIATES 140 13WC 15370 SOMOZA, HELEN M COMMUNITY ACTION 05/17/12 HANNIGAN & BOTHA, LTD 141 13WC 15891 MENDOZA, RAUL LAKE COUNTY FOREST 11/29/12 LINN, CAMPE & RIZZO LTD RUSIN MACIOROWSKI & FRIEDMAN 142 13WC 16508 KASTEN, JESSIE PERSONNEL STAFFING GROUP 04/17/13 TARADASH LAW OFFICE KOREY COTTER HEATHER RICHARD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 11 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 143 13WC 17595 PICARD, SHANICE T DENTAL DREAMS 04/30/12 PAUL A COGHLAN & ASSOC LAW OFFICES OF EDWARD J. KOZ 144 13WC 20475 PHELPS, MYRON ANN KILEY 05/28/13 WOODRUFF & JOHNSON ASSISTANT ATTORNEY GENERAL 14WC027387 -C 145 13WC 20587 VEIT, DANIEL R LAKESIDE PEST CONTROL 09/04/12 LINN, CAMPE & RIZZO LTD GANAN & SHAPIRO 146 13WC 20821 DIAZ, BELEN DOUBLETREE LIBERTYVILLE 01/20/12 JONATHAN SCHLACK COZZI & GOGGIN-WARD 13WC033376 -C 147 13WC 20886 SZUBINSKI, SHARON MILAN BANQUEST 12/30/12 THERMAN LAW OFFICES LAW OFFICES JOSEPH MARCINIAK 148 13WC 21451 ULLOA, AMADO PSSI 09/11/12 MC HARGUE, JAMES P LAW OFF HEYL ROYSTER VOELKER & ALLEN 13WC021456 -C 149 13WC 22076 CAMPBELL, ZIYETTA M ST OF ILL DEPT OF HUMAN S @ 05/19/13 GALLAGHER, DONALD V MATTHEW LICAVOLI 150 13WC 22685 VELOZ, ANA RLC ENTERPRISES INC 05/28/13 FERRIS THOMPSON & ZWEIG 151 13WC 23224 MARTINEZ, MARTHA VISTA MEDICAL CENTER EAST 08/04/12 MARKS & ASSOCIATES POWER & CRONIN LTD 152 13WC 24270 GOLDEN, CHRISTINE HIGHLAND PARK HOSPITAL 06/25/13 KATZ FRIEDMAN EAGLE ET AL KEEFE CAMPBELL & ASSOC LLC 153 13WC 24462 GRUND, JONNIE R & M CONSULTING LLC 03/11/13 DWORKIN AND MACIARIELLO HOLECEK & ASSOCIATES 154 13WC 24669 BACHLER, ROBERT VILLAGE OF LAKE ZURICH 07/06/13 FIGLIOLI, DAVID RUSIN MACIOROWSKI & FRIEDMAN 155 13WC 25544 OSORIO, ENRIQUE LUDLOW MANUFACTURING 03/07/13 JONATHAN SCHLACK HEYL ROYSTER VOELKER & ALLEN 13WC040110 -C 156 13WC 26136 RODRIQUEZ, ISIDRO ECHO INC 03/01/13 FERRIS THOMPSON & ZWEIG STONE & JOHNSON CHARTERED 157 13WC 26206 CRONIN, JASON ARROW PLUMBING 10/11/12 HANNIGAN & BOTHA, LTD RIPES NELSON BAGGOT KALOBRAT

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 12 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 158 13WC 26362 FERRUSQUIA, JOSE BIMBO BAKERIES 06/27/13 DWORKIN AND MACIARIELLO 159 13WC 26388 BAHENA, SIPRIANO COLEMAN CABLE INC 02/04/13 COHN & COHN 13WC035175 -C 160 13WC 26426 MENDOZA, FRANCISCO ARAMARK 10/30/12 LEONARD LAW GROUP LLC INMAN & FITZGIBBONS 161 13WC 26537 DOTSON, JEWELL BATH AND BODY WORKS 01/02/13 COHN & COHN GALLIANNI DOELL & COZZI LTD 162 13WC 26628 BARRERA, CLARA BETTY SCHWARTZ'S 06/25/13 MARTIN L GLINK LAW OFFICE RUSIN MACIOROWSKI & FRIEDMAN 163 13WC 26745 VASQUEZ, MOISES ALAN M LANDSCAPING 03/05/13 MC HARGUE, JAMES P LAW OFF RUSIN MACIOROWSKI & FRIEDMAN 164 13WC 26920 BAIR, COURTNEY L JEWEL INC 07/19/13 LINN CAMPE & RIZZO LTD 165 13WC 27373 RANGEL, LORENA MVP STAFFING INC 07/09/13 CULLEN HASKINS NICHOLSON KOREY COTTER HEATHER RICHARD 166 13WC 29066 THOMPSON, KAITLIN ROUNDY'S SUPERMARKETS INC 07/13/13 FERRIS THOMPSON & ZWEIG BRYCE DOWNEY & LENKOV LLC 167 13WC 29343 SCHMIDT, MICHAEL D MEDLINE INDUSTRIES 12/12/12 STANCZAK LAW OFFICES GAROFALO SCHREIBER STORM 168 13WC 29472 JOZEFOWICZ, EDWARD ABBOTT 02/07/13 BAUM RUFFOLO & MARZAL LTD WIEDNER & MCAULIFFE LTD 169 13WC 29547 GIGNAC, MICHAEL E W S WELDING SUPPLY 05/15/13 FIGLIOLI, DAVID GANAN & SHAPIRO 170 13WC 29620 GARCIA, MARIA E MAID BRIGADE W 03/07/13 CULLEN HASKINS NICHOLSON 171 13WC 29932 OCHS, THOMAS J II AMN HEALTHCARE 02/07/13 O'CONNOR & NAKOS ADELSON TESTAN & BRUNDO 172 13WC 29956 GULIO, ANDREW J AMLI RESIDENTIAL 08/01/13 ATSAVES, LOUIS G LTD RIPES NELSON BAGGOT KALOBRAT

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 13 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 173 13WC 30545 RICHARDS, BRIAN STACK-ON PRODUCTS COMPANY 08/20/13 MARKHAM M JEEP & ASSOCIATE 174 13WC 30669 PEREZ, YOLANDA THE VISUAL PAK COMPANIES 08/15/13 GOLDBERG WEISMAN & CAIRO L KOREY COTTER HEATHER RICHARD 15WC001109 -C 175 13WC 31973 HANSEN, AMBER R MIRAGE DEVELOPMENT, INC 04/19/13 LINN, CAMPE & RIZZO LTD GANAN & SHAPIRO 176 13WC 32022 WILLKOMM, SARAH BAXTER HEALTHCARE CORPORA 02/15/12 DOUGLAS RALLO PC MACIOROWSKI SACKMANN & ULRIC 177 13WC 32787 PRICE, RICHARD L CAREY ELECTRIC INC 08/08/13 GOLDBERG WEISMAN & CAIRO L 178 13WC 32815 REIDY, PATRICK J CON WAY FREIGHT INC 10/19/11 KELLY & KING 179 13WC 34731 KUHNLE, PAUL HYDRAFORCE INC 08/15/11 NEWLAND & NEWLAND 180 13WC 34923 SALGADO, RAPHAEL SOUTHEAST SERVICE CORP 04/02/13 LINN, CAMPE & RIZZO LTD 181 13WC 35006 SZALAJ, GREGORY SUNSET FOODS 09/22/13 WILLIAMS, ROBERT B LAW OFF KEEFE CAMPBELL & ASSOC LLC 16WC005509 -C 182 13WC 35862 AMEZQUITA-MARTINEZ, MARIA FLEXIBLE STAFFING 05/27/13 JEROME FOREMAN & ASSOCIATE 183 13WC 36546 FRATICELLY, JOSE MATTHEWS PROFESSIONAL 08/29/13 AIOSSA LAW FIRM RUSIN & MACIOROWSKI LTD 184 13WC 36704 BACHLER, ROBERT VILLAGE OF LAKE ZURICH 03/24/11 FIGLIOLI, DAVID RUSIN MACIOROWSKI & FRIEDMAN 185 13WC 36705 BACHLER, ROBERT VILLAGE OF LAKE ZURICH 05/10/13 FIGLIOLI, DAVID RUSIN MACIOROWSKI & FRIEDMAN 186 13WC 37254 RODRIGUEZ, MARCO ADVANCE STORE CO, INC 09/03/13 KENNETH B GORE, LTD 187 13WC 37383 ORTIZ, JOSE WEST MACHINE PRODUCTS INC 10/22/13 GOLDBERG WEISMAN & CAIRO L 188 13WC 37604 HANSEN, HOWARD P HOME DEPOT 05/09/13 SLAVIN & SLAVIN MC ANDREWS & NORGLE LLC 189 13WC 38179 REYES PINTOR, DANIELA KENALL MANUFACTURING CO 04/17/13 LAW OFFICE OF DONALD SINGE NYHAN BAMBRICK KINZIE & LOWR 190 13WC 38260 LIMON, ANA MCDONALDS 2224 09/13/13 ROSS J HELFAND GANAN & SHAPIRO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 14 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 191 13WC 39188 SILVA-MORALES, GABRIEL LEIDERS PRAIRIE VIEW GARD 05/15/13 KATZ FRIEDMAN EAGLE ET AL 192 13WC 39281 IBARRA, BERNARDINO RED COAT FARM 10/31/13 LINN, CAMPE & RIZZO LTD COZZI & GOGGIN-WARD 193 13WC 39284 IBARRA, BERNARDINO RED COAT FARM 05/08/13 LINN, CAMPE & RIZZO LTD 194 13WC 39369 LEVI, NAOMI DEERFIELD ANIMAL HOSPITAL 11/06/13 ROSENBERG & ROSENBERG PC KNELL & O'CONNOR 195 13WC 39510 SUAREZ, ANGELA MARIA (WID PRECISION PARTNERS 09/04/13 BAUM RUFFOLO & MARZAL LTD HOLECEK & ASSOCIATES 15WC002919 -C 196 13WC 39519 PIERRE, RENETRICE ST OF IL DEPT OF KILEY 08/22/13 CORNFIELD & FELDMAN ASSISTANT ATTORNEY GENERAL 197 13WC 40206 SAENZ, ENRIQUE COOK ILLINOIS CORPORATION 11/07/13 FERRIS THOMPSON & ZWEIG GALLIANNI DOELL & COZZI LTD 198 13WC 40246 ZANETTI, LEONA M AON-HEWITT 10/21/13 PAUL F PETERS ADELSON TESTAN & BRUNDO 199 13WC 40735 FLOHR, HOPE (AS NEXT FRIE ACE HARDWARE # 10/16/13 HANNIGAN & BOTHA, LTD RUSIN MACIOROWSKI & FRIEDMAN 200 13WC 41809 CALLEJA, RICARDO QUALITY LABOR SERVICES 09/30/13 HORWITZ HORWITZ & ASSOC BRADY CONNOLLY & MASUDA PC 201 13WC 42402 GUTIERAREZ, ROCIO GOODWILL TALENT BRIDGEP 11/08/13 ANKIN LAW OFFICE ACCIDENT FUND HOLDINGS, INC 202 14WC 00189 19B HASKINS, ROBERT STATION IMAGING 08/09/12 LIPKIN & HIGGINS LAW OFFIC KNELL & O'CONNOR 203 14WC 00222 GREEN, LETORIA M ST OF IL DHS 10/08/13 GALLAGHER, DONALD V ASSISTANT ATTORNEY GENERAL 204 14WC 01469 POSADAS, PAULA LB ANDERSON 08/28/13 GRAHAN J. JEEP GANAN & SHAPIRO 205 14WC 01489 SANCHEZ, JUVENTINO JUAN ALEMAN 12/08/13 JONATHAN SCHLACK 206 14WC 01982 MONTEMAYOR, SYLVIA A VONCO PRODUCTS, LLC 03/12/12 COLLISON LAW OFFICES HOLECEK & ASSOCIATES 207 14WC 02096 ROSARIO, JORGE JR UNISTAFF INC 11/21/13 GRAHAN J. JEEP WIEDNER & MCAULIFFE LTD 208 14WC 02316 GARCIA, JOSE A JOHNSON TREE EXPERT 06/28/12 ACEVES & PEREZ PC BRADY CONNOLLY & MASUDA PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 15 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 209 14WC 02509 19B WALLACE, CAROLYN FEDEX GROUND 12/23/13 SEIDMAN MARGULIS & FAIRMAN SCOPELITIS GARVIN LIGHT 210 14WC 02696 ABDAGIC, NEVZETA KENALL MANUFACTURING 10/05/12 CULLEN HASKINS NICHOLSON NYHAN BAMBRICK KINZIE & LOWR 211 14WC 02896 PONCE-GARCIA, JOSE VAL'S FRESH MARKET 01/08/14 ARGIONIS & ASSOCIATES LLC BRADY CONNOLLY & MASUDA PC 212 14WC 02912 MORENO, AUGUSTINO LIGHTSCAPE INC 05/01/13 JONATHAN SCHLACK RUSIN MACIOROWSKI & FRIEDMAN 213 14WC 03180 WILDER, THOMAS ULTIMATE PAINT SHOP 08/19/13 DOUGLAS RALLO PC GANAN & SHAPIRO 214 14WC 03476 RAWLEY, SCOTT USF HOLLAND 08/08/13 ROSENBERG & ROSENBERG PC HENNESSY & ROACH PC 215 14WC 03671 SWANSON, MICHAEL J CITY OF HIGHLAND PARK 09/03/13 DOUGLAS RALLO PC 216 14WC 03882 ZAMICHE, FAHIM J.M.E. MARKETING INC 10/25/13 MEYERS & FLOWERS 217 14WC 04597 JOHNSON, YOSHIKA SAFEWAY TRANSPORATION 01/23/14 HOLECEK & ASSOCIATES 218 14WC 05710 NOVARRO, DALE J COUNTY OF LAKE 12/23/13 BAUM RUFFOLO & MARZAL LTD 219 14WC 06337 JUAREZ, REYNA C MEDLINE INDUSTRIES INC 02/07/12 JAUREGUI & ASSOCIATES 220 14WC 06564 MAIER, ANNE-MARIE MILLBURN DISTRICT 24 12/10/10 WOLFE LAW PC WIEDNER & MCAULIFFE LTD 14WC014359 -C 16WC008319 -C 221 14WC 06738 WEISS, PAUL HIGHLAND PARK FORD 12/17/13 DWORKIN AND MACIARIELLO GANAN & SHAPIRO 14WC006739 -C 222 14WC 06755 RUIZ, JOSE COYOTE CONSTRUCTION, LLC 12/06/13 LINN, CAMPE & RIZZO LTD WIEDNER & MCAULIFFE LTD 223 14WC 07070 BRCIK, MICHAEL G VASO JOVIC DBA ALEXANDRA 09/29/13 CRONIN & PETERS LAW OFFICES DEBORAH SCHAEFER 224 14WC 07366 SIEGEL, JEAN LAKE ZURICH LEXINGTON HEA 02/16/14 SOSTRIN AND SOSTRIN PC KEEFE CAMPBELL & ASSOC LLC 14WC023867 -C

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 16 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 225 14WC 07568 PARDA, GRAZYNA WOLLYS CLEANING SERVICES 01/24/14 CHEPOV & SCOTT LLC 226 14WC 07633 HENRIKSEN, HENRY FEDERAL EXPRESS 11/23/12 LINN, CAMPE & RIZZO LTD HANSON LAW OFFICE 15WC038921 -C FED EX 227 14WC 07906 PODRAZA, RADOSLAW LARSEN MANUFACTURING 02/17/14 THERMAN LAW OFFICES HOLECEK & ASSOCIATES 228 14WC 08004 THOMPSON, KAITLIN ROUNDY'S SUPERMARKETS INC 12/02/12 FERRIS THOMPSON & ZWEIG BRYCE DOWNEY & LENKOV LLC 229 14WC 08074 IRIGOYEN, URIEL PLEXUS 01/15/14 AIOSSA LAW FIRM NYHAN BAMBRICK KINZIE & LOWR 230 14WC 08147 HAHLE, JAMES P ROUNDY'S INC 12/27/11 TAMVAKIS, GEORGE L BRYCE DOWNEY & LENKOV LLC 231 14WC 08532 MIRELES-PAREDES, JOEL MC DONALD'S #7323 02/07/14 KENNETH B GORE, LTD NYHAN BAMBRICK KINZIE & LOWR 232 14WC 08554 HERNANDEZ, LUCIO SUPER FRESH MARKET 02/17/14 233 14WC 09015 ESTEBAN, CARLOS LAWN MAN SERVICE 04/26/13 CULLEN HASKINS NICHOLSON 234 14WC 09501 SMITH, CARYN SEARS 02/26/14 LEO ALT GAROFALO SCHREIBER STORM 235 14WC 09550 CLEMENS, VINCENT WAUCONDA FIRE 09/27/11 MARKHAM M JEEP & ASSOCIATE RUSIN MACIOROWSKI & FRIEDMAN 236 14WC 09715 STANLEY, ANTHONY BROOKHAVEN APT 01/21/13 HANNIGAN & BOTHA, LTD HOLECEK & ASSOCIATES 237 14WC 09813 BALDERRAMA, MAURO MVP STAFFING, INC 03/05/14 CULLEN HASKINS NICHOLSON KOREY RICHARDSON LLC 238 14WC 10423 SANCHEZ, ALEXIS PRESTAGE PROPERTY 04/29/13 ROSS J HELFAND GANAN & SHAPIRO 239 14WC 10870 VASQUEZ, LILIA BRENTWOOD NORTH HEALTHCAR 06/23/11 VASILATOS & COTTER LLC 240 14WC 11498 WASMUND, LORI PEER CHAIN CO 12/06/13 RIFFNER BARBER ROWDEN & SC HOLECEK & ASSOCIATES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 17 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 241 14WC 12236 PEREZ-WHEELER, BELINDA LAKE COUNTY HEALTH DEPT 11/01/13 CHARLES LEVY & ASSOC LTD SMITH AMUNDSEN LLC 242 14WC 12461 LOPEZ, SANTIAGO CITY OF WAUKEGAN 12/08/13 LINN, CAMPE & RIZZO LTD NYHAN BAMBRICK KINZIE & LOWR 14WC012462 -C 243 14WC 12597 RODRIGUEZ, AZUCENA HOLIDAY INN 03/11/14 244 14WC 13107 WELSLH, ALLEN R DOLLAR GENERAL STORE 05/07/12 GOLDBERG WEISMAN & CAIRO L WIEDNER & MCAULIFFE LTD 245 14WC 13523 MAXWELL, BROCK DORMA AUTOMATIC 02/18/14 HANNIGAN & BOTHA, LTD 246 14WC 13685 GOMEZ, EVERARDO PUGSLEY & LA HAIE LTD 06/30/11 MARKHAM M JEEP & ASSOCIATE RIPES NELSON BAGGOT KALOBRAT 247 14WC 14398 CLEMENS, VINCENT WAUCONDA FIRE PROTECTION 08/05/13 MARKHAM M JEEP & ASSOCIATE RUSIN MACIOROWSKI & FRIEDMAN 248 14WC 14473 RODRIQUEZ, ISIDRO ECHO, INC 04/15/14 FERRIS THOMPSON & ZWEIG 249 14WC 14556 AHUMADA, VIVIAN LABOR SOLUTIONS 11/18/13 250 14WC 14578 NASR, WAFAA COMMUNITY ACTION PARTNERS 10/03/12 DUDLEY & LAKE LLC STELLATO & SCHWARTZ 251 14WC 15358 CISNEROS, ADALBERTO JOEL KENNEDY CONSTRUCTING 02/25/14 WITTER LAW OFFICE CHILTON YAMBERT PORTER LLP 252 14WC 15795 EVANS, ASHLEY ANN KILEY DEVELOPMENTAL C 03/05/14 LAW OFFICE ANTHONY ESPOSIT ASSISTANT ATTORNEY GENERAL 253 14WC 15832 CONN, DEBRA B JEWEL FOODS 12/18/13 LINN, CAMPE & RIZZO LTD 254 14WC 16139 JOHNSON, DIVINE THE WEALSHIRE 02/11/14 DWORKIN AND MACIARIELLO 255 14WC 16163 TRASKA, DANIEL W LETECH, INC. 03/03/14 LINN, CAMPE & RIZZO LTD RUSIN MACIOROWSKI & FRIEDMAN 256 14WC 16461 BOONE, JONATHAN THE PLUMBER DOCTOR W 04/27/14 WOODRUFF & JOHNSON 257 14WC 16787 CALLAHAN, SAMUEL IMPERIAL GUARD & DETECTIV 09/22/13 HANNIGAN & BOTHA, LTD HOLECEK & ASSOCIATES 258 14WC 16942 GILES, ELENA JELLY BELLY CANDY CO 05/06/14 ANKIN LAW OFFICE COZZI & GOGGIN-WARD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 18 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 259 14WC 17121 ALVAREZ, DELIA SAM'S CLUB 03/07/14 HANNIGAN & BOTHA, LTD WIEDNER & MCAULIFFE LTD 260 14WC 17289 MORRISON, ANTIONETTE BAXTER HEALTH CARE 04/22/14 DWORKIN AND MACIARIELLO MACIOROWSKI SACKMANN & ULRIC 261 14WC 17334 DOMINQUEZ, MARTIN KEY LIME COVE 03/24/14 HORWITZ HORWITZ & ASSOC 262 14WC 17908 SCOTT, ERIC DEPARTMENT OF HUMAN SERVI @ 12/28/13 THE MACK LAW GROUP PC ASSISTANT ATTORNEY GENERAL 263 14WC 18114 CUARENTA, ALFONSO INTERNATIONAL PRECISION C 05/19/14 STROM, NEAL B LAW OFFICES JOSEPH MARCINIAK 264 14WC 18274 BERTONCINI, VINCE AMERITEMP GROUP 04/08/14 ANGELINI & ORI LLC 265 14WC 18407 RATAJCZYK, MICHAEL LAKELAND AUTOBODY INC 12/26/12 ROSS TYRRELL LAW OFFICES JOSEPH MARCINIAK 266 14WC 18796 ARROYO, FELIX CARTER HOFFMANN LLC 05/21/14 HANNIGAN & BOTHA, LTD WIEDNER & MCAULIFFE LTD 267 14WC 18942 ROBERTS, DEBRA BAXTER HEALTHCARE CO 03/19/14 BUDIN LAW OFFICES MACIOROWSKI SACKMANN & ULRIC 268 14WC 19542 GALLEGO, PEDRO VOLKSWAGEN CREDIT INC 01/11/13 ROMANEK & ROMANEK GAROFALO SCHREIBER STORM 269 14WC 19923 HOFF, JOHN JOSEPH SAFE TRAVEL 02/02/13 COHN & COHN HENNESSY & ROACH PC 270 14WC 19990 GRIMSIC, KENNETH COUNTY OF LAKE HEALTH DEP 08/30/13 MARKHAM M JEEP & ASSOCIATE WOLFE & JACOBSON, LTD 271 14WC 20132 SHIN, IK VOICE TRANS INC 05/10/14 LEO ALT 272 14WC 20490 HERNANDEZ, ROSALIA WILLIAMS ELECTRONIC GAMES 05/30/14 ILLINOIS INJURY LAWYERS RUSIN MACIOROWSKI & FRIEDMAN 14WC030899 -C 273 14WC 20673 DOMINGUEZ, DIXIANA LIZETH ELITE STAFFING INC 05/30/14 PARENTE & NOREM PC MARC CAIRO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 19 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 274 14WC 21051 TENTLER, DAVID KNAUZ MOTOR SALES INC 02/24/14 MARKHAM M JEEP & ASSOCIATE GANAN & SHAPIRO 275 14WC 21258 LOCKWOOD, CHARLES NFI INDUSTRIES 05/12/14 HORWITZ HORWITZ & ASSOC MACIOROWSKI SACKMANN & ULRIC 14WC035277 -C 276 14WC 21429 CARRENO, MARIA BEL RESOURCES, INC. 11/14/13 FERRIS THOMPSON & ZWEIG 277 14WC 22105 GUADARRAMA, JOSEFINA DUNKIN DONUTS 04/23/14 278 14WC 22237 CAZARES, JULIA ECHO INCORPORATED 03/28/14 THE ROMAKER LAW FIRM WIEDNER & MCAULIFFE LTD 279 14WC 22973 PARDO, JOSEPH MARIANO'S FRESH MARKET 12/16/11 CULLEN HASKINS NICHOLSON BRYCE DOWNEY & LENKOV LLC 280 14WC 23094 GLATZ, MARY ANN JEWEL FOOD STORES INC 09/25/12 GRAHAN J. JEEP QUINTAIROS PRIETO WOOD & BOY 14WC023095 -C 281 14WC 23173 TEASLEY, THOMAS J ZION SOLUTIONS 06/11/14 RUBIN LAW GROUP 282 14WC 23428 WONNELL, NORMAN LEE THOMAS HAMILTON ROOFING 12/02/13 LAW OFFICES TIMOTHY LAMPIN 283 14WC 23564 NASH, KURT SR CITY OF NORTH CHICAGO 12/28/11 COLLISON & O'CONNOR 284 14WC 23979 DELGADO, ELIZABETH STAFFING NETWORK LLC 02/15/14 STROM, NEAL B SLAVIN & SLAVIN 285 14WC 23999 MERCIER, PAMELA MENARDS 06/19/14 TARADASH LAW OFFICE 286 14WC 24080 LARSON, RANDY PACE 04/30/14 BRISKMAN BRISKMAN GREENBER POWER & CRONIN LTD 15WC010160 -C 287 14WC 24148 WEBB, DAVID GERBER COLLISION & GLASS 06/09/14 LAW OFFICES PETER LEKAS HOLECEK & ASSOCIATES 288 14WC 24292 REED, MICHAEL D CITY OF WAUKEGAN 06/04/14 LINN, CAMPE & RIZZO LTD NYHAN BAMBRICK KINZIE & LOWR 14WC024347 -C 289 14WC 24300 KREUSER, LUZ M CANCER TREATMENT 05/30/13 LINN, CAMPE & RIZZO LTD GAROFALO SCHREIBER STORM 290 14WC 24336 SJODIN, DONNA JONES LANG LASALLE 03/14/14 MARSZALEK AND MARSZALEK LAW OFFICES JOSEPH MARCINIAK

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 20 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 291 14WC 24349 BRISCOE, CALVIN O METALEX INC 12/23/13 LINN, CAMPE & RIZZO LTD COZZI & GOGGIN-WARD 292 14WC 24442 ALVAREZ, ISMAEL SEB SERVICES OF NEWYORK, 06/30/14 HORWITZ HORWITZ & ASSOC SCOPELITIS GARVIN LIGHT 293 14WC 24891 19B SCHMIDT, MICHELENE SENIOR SILVERADO LIVING 01/30/15 STEVEN J TENZER, LTD RUSIN & MACIOROWSKI LTD 15WC005245 -C 294 14WC 25037 ESCOBAR, JOSE DORMA AUTOMATIC 07/17/14 AIOSSA LAW FIRM 295 14WC 25166 HAGEN, JOHN MENARD INC 06/28/14 THOMAS J POPOVICH CHILTON YAMBERT PORTER LLP 296 14WC 25296 JAKUBIAK, ROMAN COST OF WISCONSIN INC 05/05/14 CUSHING LAW OFFICES 297 14WC 25425 RAMIREZ, BLANCA COUNTYARD MARIOTT 06/07/13 POSTERLI, OSCAR NYHAN BAMBRICK KINZIE & LOWR 298 14WC 25522 DIX, ANTIONETTE DOVENMUEHLE MORTGAGE 02/20/14 SMOLER LAW OFFICE, PC INMAN & FITZGIBBONS 299 14WC 25619 MARTINEZ, ERIKA A SBM SITE SERVICES LLC 05/23/14 ANKIN LAW OFFICE GILDEA & COGHLAN 300 14WC 25901 MUN, JOHN WM MEYERS & SON 05/19/14 TOPPER & WEISS LTD 301 14WC 26083 PARHAM, VICTORIA ILLINOIS CENTRAL SCHOOL B 05/12/14 SHELDON I MINKOW & ASSOCIA MACIOROWSKI SACKMANN & ULRIC 302 14WC 26211 WIETING, WILLIAM HOME DEPOT 07/11/12 GOLDBERG WEISMAN & CAIRO L ADELSON TESTAN & BRUNDO 14WC026212 -C 14WC026213 -C 303 14WC 26215 CERNE, JENNIFER S STAREX INC 10/12/12 GOLDBERG WEISMAN & CAIRO L KEEFE CAMPBELL & ASSOC LLC 304 14WC 26259 HERNANDEZ, LAURA COMFORT SUITES 11/19/13 STROM, NEAL B INMAN & FITZGIBBONS 305 14WC 26565 MELCHOR, AUGUSTIN PATRICK SCALZO INDIVIDU & 05/29/14 LINN, CAMPE & RIZZO LTD 306 14WC 27131 VASQUEZ, JAIME MANEVAL CONSTRUCTION COMP 08/04/14 HANNIGAN & BOTHA, LTD BRADY CONNOLLY & MASUDA PC 307 14WC 27304 RODRIGUEZ, MARIO LAKE FOREST HOSPITAL 04/25/14 PATRICIA HARDIMAN LAW OFFI

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 21 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 308 14WC 27479 RAMIREZ, JOSE JUAN TOBY'S TAVERN 06/15/14 309 14WC 27565 AYALA, ANDRES JB BRICKWORKS INC 11/04/13 HANNIGAN & BOTHA, LTD WIEDNER & MCAULIFFE LTD 310 14WC 27999 WOODRICH, WILLIAM SPECIAL EDUCATION DIST OF 09/12/13 RUBIN LAW GROUP NYHAN BAMBRICK KINZIE & LOWR 311 14WC 28067 MISEK, JOHN ILLINOIS TOLLWAY 06/04/14 HANNIGAN & BOTHA, LTD NYHAN BAMBRICK KINZIE & LOWR 14WC028068 -C 14WC035134 -C 312 14WC 28084 WHITTAKER, ZACKERY PAULY HONDA AND PAULY ACU 11/07/13 GANAN & SHAPIRO 313 14WC 28310 RAMIREZ, ENRIQUE SR ARO SERVICES LTD 08/19/13 BRADY CONNOLLY & MASUDA PC 314 14WC 29164 HERNANDE, LAURA COMFORT 08/02/14 FERRIS THOMPSON & ZWEIG 315 14WC 29165 CERVANTES, DAVID CDW LLC 06/11/14 FERRIS THOMPSON & ZWEIG HENNESSY & ROACH PC 316 14WC 30610 NUNEZ, NORMA A-S MEDICAL SOLUTIONS 12/12/12 THE ROMAKER LAW FIRM LAW OFFICES OF EDWARD J. KOZ 317 14WC 30701 HAUBER, JOHN K VILLAGE OF BUFFALO GROVE 01/01/01 CULLEN HASKINS NICHOLSON POWER & CRONIN LTD 318 14WC 30929 MARTINEZ, NORA JST CORP 01/27/14 LEONARD LAW GROUP LLC HENNESSY & ROACH PC 319 14WC 31006 KULP, ARTHUR J FEDEX GROUND 08/22/14 HANNIGAN & BOTHA, LTD SCOPELITIS GARVIN LIGHT 320 14WC 31010 CADETTE, STEVE GOODWILL INDUSTRIES 08/22/14 DWORKIN AND MACIARIELLO ACCIDENT FUND HOLDINGS 14WC031011 -C 321 14WC 31049 PETERMAN, LISA WINTRUST FINANCIAL CORPOR 08/16/13 NILSON STOOKAL GLEASON CAP HOLECEK & ASSOCIATES 322 14WC 31164 GALVEZ, JOSE MOST VALUABLE PERSONNEL 07/01/14 FERRIS THOMPSON & ZWEIG KOREY RICHARDSON LLC 323 14WC 31197 HOPKINS, BRENDA L J C PENNEY 04/21/14 LINN, CAMPE & RIZZO LTD QUINTAIROS PRIETO WOOD & BOY 324 14WC 31450 GROVER, ROBERT W LAKE SHORE BEVERAGE, INC 06/24/14 LINN, CAMPE & RIZZO LTD ASHER, RAYMOND L LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 22 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 325 14WC 31494 SIPOS, JUANITA STAR WELLS BLOOMFIELD 10/08/13 VRDOLYAK LAW GROUP LLC WIEDNER & MCAULIFFE LTD 326 14WC 31821 FREEMAN, CAROL IL BONE & JOINT INSTITUTE 08/02/07 GRAHAM J. JEEP LAW OFFICES OF EDWARD J. KOZ 327 14WC 31925 CONTRERAS, LUIS PETCO 01/08/14 SEIDMAN MARGULIS & FAIRMAN 328 14WC 32766 OAVON, ANA TAKEDA PHARMACEUTICAL CO 11/13/13 SMOLER LAW OFFICE, PC HENNESSY & ROACH PC 329 14WC 32782 BENES, FRANK STATE OF ILLINOIS @ 05/05/14 GOLDBERG WEISMAN & CAIRO L ASSISTANT ATTORNEY GENERAL 330 14WC 32859 ROSALES, PAOLA ACCURATE PERSONNEL LLC 09/05/14 CULLEN HASKINS NICHOLSON 331 14WC 32886 MCCARROLL, DEBRA GOODWILL INDUSTRIES 09/04/14 ANKIN LAW OFFICE ACCIDENT FUND HOLDINGS, INC 332 14WC 33080 TELLEZ, ROSENDO SEBERT LANDSCAPING INC 07/22/14 AIOSSA LAW FIRM 333 14WC 33349 GRAF, L KELLY HBS MANAGEMENT CORP 08/09/13 LINN, CAMPE & RIZZO LTD 334 14WC 33352 CASTRO, JUANA LABOR SOLUTIONS 05/12/14 LINN, CAMPE & RIZZO LTD KLAUKE LAW GROUP LLC 335 14WC 33451 19B HUERTA, ANDRES LANDSCAPE CONCEPTS 03/06/13 DAVID J. BAWCUM KNELL & O'CONNOR 336 14WC 33919 ANTONIO, CRISTOPHER DEBDOUB CLEANING SERVICES 09/16/14 337 14WC 34012 MOORE, CHARMAINE MARIANOS 09/19/14 THE ROMAKER LAW FIRM BRYCE DOWNEY & LENKOV LLC 338 14WC 34257 ESCUTIA, MARIA GRAND AVENUE DONUTS INC 09/15/14 JONATHAN SCHLACK BRYCE DOWNEY & LENKOV LLC 14WC034258 -C 339 14WC 34333 ROSEN, PHILLIP INSURANCE SERVICE CENTER 04/15/14 STROM, NEAL B NYHAN BAMBRICK KINZIE & LOWR 14WC034334 -C 340 14WC 35160 MITCHELL, KEVIN P ROE AUTOMOTIVE, INC. 07/14/14 LINN, CAMPE & RIZZO LTD 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 DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 341 14WC 35637 SPINLER, LANCE MORTON METALEX NORTH MFG 09/01/14 CAPRON & AVGERINOS PC COZZI & GOGGIN-WARD 342 14WC 35820 SIEGAL, JEFFREY TOWNSHIP DISTRICT HIGH 11/17/11 KREITER, BYCK & ASSOC LLP WIEDNER & MCAULIFFE LTD 14WC035821 -C 343 14WC 35887 OCAMPO, JUAN SCOTT BYRON & COMPANY INC 07/10/14 CULLEN HASKINS NICHOLSON NYHAN BAMBRICK KINZIE & LOWR 344 14WC 36112 POMOZY, ATTILA USA OVERSEAS WIRELESS CAB 06/12/14 NEWLAND & NEWLAND GANAN & SHAPIRO 345 14WC 36459 HILLIGOSS, ANDREY MEDICAL EXPRESS AMBULANCE 09/04/14 346 14WC 36575 CRUZ, JUAN LUIS ACCURATE PERSONNEL 07/03/14 LAW OFFICES LEONARDO MORAL GRANT & FANNING 347 14WC 37036 TALAVERA, LUIS RAMON ULINE INC 04/14/14 DEPAOLO ZADEIKIS GORE GANAN & SHAPIRO 348 14WC 37101 LIGAY, MARY FIRST STUDENT INC 02/08/14 STEIN & CHERNEY LTD WIEDNER & MCAULIFFE LTD 349 14WC 37160 KREJCI, CELIA SUNRISE SENIOR LIVING 04/22/13 ANTHONY J MAY 350 14WC 37269 ZAMORA, ARTEMIO LANDSCAPE CONCEPTS MNGMT 09/09/14 HANNIGAN & BOTHA, LTD KEEFE CAMPBELL & ASSOC LLC 351 14WC 37839 GENTZEN, JULIE A ROUND LAKE SCHOOL 09/05/14 ANESI OZMON RODIN NOVAK KO NYHAN BAMBRICK KINZIE & LOWR 352 14WC 37982 TAPIA, MARIA LORENA ECHO INC 08/09/12 AIOSSA LAW FIRM 353 14WC 38156 WEISKE, PHIL UNIVERSAL PLUMBING, INC. 08/15/14 CRAIG L MANCHIK & ASSOC. BRADY CONNOLLY & MASUDA PC 354 14WC 38905 ELLIOTT, PAMELA S ABBOTT LABORATORIES 07/01/14 LAW OFFICE ILONKA ULRICH WIEDNER & MCAULIFFE LTD 355 14WC 38952 O'DONNELL, TAMMY KAISER INSURANCE 04/01/13 ALLEN KOPET & ASSOCIATES 356 14WC 39162 MOORE, WILBERT GOODWILL INDUSTRIES 10/24/14 DWORKIN AND MACIARIELLO ACCIDENT FUND HOLDINGS, INC 357 14WC 39909 CHARO, RUBEN AMCOR FLEXIBLES 07/31/14 DWORKIN AND MACIARIELLO HOLECEK & ASSOCIATES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 24 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 358 14WC 40326 VASQUEZ, JOSEFINA ABBVIE 07/16/14 GOLDBERG WEISMAN & CAIRO L HENNESSY & ROACH PC 359 14WC 40412 BROTAN, BOBBY BUCHANAN ENERGY 08/25/14 RUBIN LAW GROUP RODDY LAW LTD 14WC041554 -C 360 14WC 41250 YOUSIF, ANDY ARAMARK 10/23/14 KALOGERAKOS & ASSOC 361 14WC 41523 PETERSON, RALPH LAMBENT TECHNOLOGIES CORP 02/27/13 362 14WC 41908 MILUTINOVIC, NIKOLA ROAD SAFE TRAFFIC SYSTEMS 10/22/13 ANGELINI & ORI LLC RUSIN & MACIOROWSKI LTD 363 14WC 42232 HUMBRACHT, ALBERT PIZZA HUT/F.M.I. W 01/15/14 RAYMOND M SIMARD, PC 364 14WC 42542 MARTINEZ, JUAN SON CROP DBA ROSATIS PIZZ 01/09/14 FERRIS THOMPSON & ZWEIG 365 14WC 42797 RYBARCZYK, GREGORY JR THE COCA COLA COMPANY INC 11/13/14 GRAHAM J. JEEP BRADY CONNOLLY & MASUDA PC 366 14WC 42829 SORBY, KELLY E BAKERS SQUARE INC 09/17/14 LINN, CAMPE & RIZZO LTD HENNESSY & ROACH PC 367 14WC 42838 MANGES, JOSEPH E VILLAGE OF GRAYSLAKE 07/11/13 LINN, CAMPE & RIZZO LTD RUSIN & MACIOROWSKI LTD 368 14WC 43279 ESPINOZA, ESTEBAN LEWIS PRODUCE MARKET 11/25/14 POSTERLI, OSCAR KOPKA, PINKUS & DOLIN, PC 369 14WC 43641 VUONG, MILAGRO STAFFING DIMENSIONS 04/09/12 FERRIS THOMPSON & ZWEIG LAW OFFICES FRANCESCA LARSEN 14WC043642 -C 14WC043643 -C 370 15WC 00152 BUTCHER, CAROL ADLAI E STEVENSON H S 10/09/14 SEIDMAN MARGULIS & FAIRMAN NYHAN BAMBRICK KINZIE & LOWR 371 15WC 00656 BROWN, CHAD FED EX 12/15/14 ANKIN LAW OFFICE SCOPELITIS GARVIN LIGHT 372 15WC 00786 ZUNIGA, ADOLFO A DIVINCI PAINTERS INC 12/23/14 GOLDSTEIN AIOSSA & GOOD 373 15WC 00878 RODRIGUEZ, KRISTINE VAL'S FRESH MARKET 11/20/14 WILLIAMS, ROBERT B LAW OFF GAROFALO SCHREIBER STORM 374 15WC 01335 JACKSON, WILLIAM L ARAMARK 12/19/14 ANKIN LAW OFFICE

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 25 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 375 15WC 01861 LARSEN, AMY THE ALLENDALE ASSOCIATION 01/01/13 MURPHY & MURPHY 376 15WC 02229 PLACENCIO, GINA MEADOWVIEW SCHOOL 01/05/15 GOLDBERG WEISMAN & CAIRO L 377 15WC 02479 NADULEK, JACK CIRCLE K, INC. 07/01/14 STORTO FINN & ROSINSKI NYHAN BAMBRICK KINZIE & LOWR 378 15WC 02640 FLORES, ADRIAN HORIZONS HOLDINGS LLC 07/07/14 DOUGLAS RALLO PC COZZI & GOGGIN-WARD 379 15WC 03162 TALAVERA, LUIS R ULINE INC 07/10/13 DEPAOLO ZADEIKIS GORE GANAN & SHAPIRO 380 15WC 03267 HARRIS, WILLIAM MID-STATE EQUIPMENT 11/13/14 DUDLEY & LAKE LLC MACIOROWSKI SACKMANN & ULRIC 381 15WC 03353 AQUINO, FELIX WALKER BROTHERS, THE ORIG 01/01/15 FERRIS THOMPSON & ZWEIG 382 15WC 03460 BUHNERKEMPER, MAURICE NORTH SHORE SANITARY DIST 08/18/14 LANNON LANNON & BARR LTD RUSIN & MACIOROWSKI LTD 383 15WC 03733 MONETTE, THOMAS MOST VALUABLE PERSONNEL 11/07/14 GRIMES, G DOUGLAS KOREY RICHARDSON LLC 384 15WC 04066 DEMAIN, DANIEL J MBA TRANSPORT LTD 10/30/14 HANNIGAN & BOTHA, LTD ALLEN KOPET & ASSOCIATES 385 15WC 04500 COLEMAN, TANISHA HELP-AT-HOME, INC 11/30/14 LEO ALT COZZI & GOGGIN-WARD 386 15WC 04640 ORTIZ-SANTIAGO, IRENE STAFFIG NETWORK 01/29/15 DEPAOLO ZADEIKIS GORE SLAVIN & SLAVIN 387 15WC 04830 BABAR, NAILA DEERFIELD MONTESSORI SCHO 01/23/15 DWORKIN AND MACIARIELLO RUSIN & MACIOROWSKI LTD 388 15WC 04861 PRICE, ANTHONY CALVIN KINGWIRE 11/24/14 COLLISON & O'CONNOR LAW OFFICES OF EDWARD J. KOZ 389 15WC 05730 PETERSON, ANTHONY VANTAGE SPECIALTY CHEMICA 01/01/15 390 15WC 05915 RAINES, LOVETTA NORTH POINTE RESOURCES 02/05/15 AIOSSA LAW FIRM RUSIN & MACIOROWSKI LTD 391 15WC 06336 MARTINEZ, ITZEL XCEL STAFFING SOLUTIONS 10/03/14 LINN, CAMPE & RIZZO LTD KOREY RICHARDSON LLC 392 15WC 06342 BROWN, MICHAEL T WALMART 07/30/13 LINN, CAMPE & RIZZO LTD QUINTAIROS PRIETO WOOD & BOY

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 26 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 393 15WC 06355 DE JESUS, HERNANDEZ VELAZ LABOR SOLUTIONS, INC. 08/25/14 LINN, CAMPE & RIZZO LTD NEWLAND & NEWLAND 394 15WC 06359 CORDOVA, DEYANIRA GRAHAM'S C-STORE 10/02/14 LINN, CAMPE & RIZZO LTD COZZI & GOGGIN-WARD 395 15WC 06378 CASTELLANOS, JESUS COLBERT PACKAGING/SYNERGY 12/02/14 LINN, CAMPE & RIZZO LTD KNELL & O'CONNOR 396 15WC 06465 BLAIR, REGINA K. SIX FLAGS GREAT AMERICA 08/07/13 DWORKIN AND MACIARIELLO 397 15WC 06774 QUEZADA, MARTIN ZION SOLUTIONS LLC 02/04/15 HORWITZ HORWITZ & ASSOC QUINTAIROS PRIETO WOOD & BOY 398 15WC 06813 CARRILLO, DOLORES AMCOR FLEXIBLES HEALTH CA 09/12/14 DWORKIN AND MACIARIELLO 399 15WC 07014 EDMONDS, JEFFREY SCHMIDT STEEL 12/12/14 ANESI OZMON RODIN NOVAK KO HENNESSY & ROACH PC 400 15WC 07041 LANGE, JAMES A VILLAGE OF GURNEE 08/21/14 LINN, CAMPE & RIZZO LTD ANCEL GLINK DIAMOND BUSH & E 401 15WC 07415 SALDANA, EDGAR LAKESIDE INSULATION LLC 05/09/14 GRAHAM J. JEEP GRANT & FANNING 402 15WC 07469 BIGGS, CHESTER AUTO EXPO DETAILING INC 02/22/15 ROBERT EDENS BRADY CONNOLLY & MASUDA PC 403 15WC 07478 LANG, JOHN WASTE MANAGEMENT 01/05/15 GOLDBERG WEISMAN & CAIRO L 404 15WC 07802 GERATY, CHRIS BEST BUY STORES 11/12/14 HANNIGAN & BOTHA, LTD 405 15WC 07893 PEREZ, ALEJANDRO OUTBACK STEAKHOUSE 01/16/15 JOEL BELL 406 15WC 07937 HOWARD, KEVIN GURNEE DODGE 02/06/15 LANNON LANNON & BARR LTD GANAN & SHAPIRO 15WC007938 -C 16WC026522 -C 407 15WC 08024 JARABA, JOHANNA MARIANI LANDSCAPE 04/28/14 MC HARGUE, JAMES P LAW OFF 408 15WC 08269 MANDUJANO, MARIA G PRESBYTERIAN HOMES 06/16/12 POSTERLI, OSCAR NYHAN BAMBRICK KINZIE & LOWR 15WC008270 -C 409 15WC 08334 CAMARGO, CASIMIRO LENO'S CERAMIC & TILE MAR W 02/19/15 MC HARGUE, JAMES P LAW OFF

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 27 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 410 15WC 08529 BETTS, DON GURNEE DODGE 02/14/15 CAPRON & AVGERINOS PC ROSARIO CIBELLA 411 15WC 08545 DALTON, SHAUN R ELITE STAFFING 02/21/15 LEE A CAMPBELL LAW OFFICE GAROFALO SCHREIBER STORM 412 15WC 09206 ESTATE OF DEGAND, RICHARD THE GROVE AT THE LAKE # 02/26/15 DAVID J. BAWCUM BRADY CONNOLLY & MASUDA PC 413 15WC 09342 ALLEN, JENNIFER DEB SHOPS, INC. 03/10/13 MARKHAM M JEEP & ASSOCIATE 414 15WC 09475 SANCHEZ, ADRIAN XCEL STAFFING SOLUTIONS 02/27/15 JONATHAN SCHLACK KOREY RICHARDSON LLC 415 15WC 09536 KAMPENDAHL, KURT E AT & T INC 02/22/15 GOLDBERG WEISMAN & CAIRO L 416 15WC 09876 HALLORAN, ROBERT JC PENNY CORP INC 01/03/15 DUDLEY & LAKE LLC ADELSON TESTAN & BRUNDO 417 15WC 10051 DELEON, CLAUDIA ANDREWS & STAFF FORCE 03/17/15 BOGUSZ & BOGUSZ LTD SLAVIN & SLAVIN 418 15WC 10262 SUNDBLOM, CHERYL FREMONT SCHOOL DISTRICT 7 03/20/15 KEATING LAW OFFICE 419 15WC 10272 JOHNSTON, DEBRA R THE GROVE AT THE LAKE 11/23/14 HANNIGAN & BOTHA, LTD BRADY CONNOLLY & MASUDA PC 420 15WC 10492 SAMSON, KELLEY SEDGEBROOK 01/16/14 WHITESIDE & GOLDBERG LTD WOLFE & JACOBSON, LTD 421 15WC 10676 CORRALES, MARIA GREAT LAKES RESOURCES 03/12/15 FERRIS THOMPSON & ZWEIG HOLECEK & ASSOCIATES 422 15WC 11112 MEDINA, SAMUEL EAGLE TRUCK WASH 03/18/15 DWORKIN AND MACIARIELLO HOLECEK & ASSOCIATES 423 15WC 11388 YU, JONATHAN PEAPOD, INC 12/16/14 CULLEN HASKINS NICHOLSON LITCHFIELD CAVO 424 15WC 11485 ARROYO, PERLA SMALLEY STEEL RING CO 03/23/15 LUIS A ACEVES & ASSOC 425 15WC 11551 LANZEROTTI, KRISTEN ANTIOCH SCHOOL DISTRICT 3 11/10/14 MARKS & ASSOCIATES ANCEL GLINK DIAMOND BUSH & E 426 15WC 12023 MC CORKHILL, SHAWN E PRAXAIR 10/21/14 LINN, CAMPE & RIZZO LTD HENNESSY & ROACH PC 427 15WC 12089 GARCIA, EMPERATRIZ ECHO INC 04/16/13 FERRIS THOMPSON & ZWEIG

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 28 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 428 15WC 12326 BARAJAS, JOSEPHINA THE CLEANING AUTHORITY 11/24/14 LAW OFFICES LEONARDO MORAL BRADY CONNOLLY & MASUDA PC 429 15WC 12435 VELASCO, JAVIER SELECT REMEDY 08/22/14 JOHN S. ELIASIK LEAHY EISENBERG & FRAENKEL 430 15WC 12540 SCHWAB, MICHAEL HAYES MACHANICAL 03/09/15 LINN, CAMPE & RIZZO LTD GAROFALO SCHREIBER STORM 431 15WC 12578 PEREZ, JUAN WILLIAMS CUSTOM CARPENTRY 03/18/15 LAW OFFICE EDWARD RUEDA 432 15WC 12817 LOCH, MICHAEL E SMALLEY STEEL RING CO 03/25/15 DIAMOND & LESUEUR PC 433 15WC 13259 ACOSTA, SANDRA LONG GROVE CONFECTIONERY 03/09/15 MC HARGUE, JAMES P LAW OFF GANAN & SHAPIRO 15WC031333 -C 434 15WC 13401 PEREZ, BERTHA ABBVIE 10/20/13 WIEDNER & MCAULIFFE LTD 435 15WC 14052 CAMPOS, KATHRYN JEWISH COMMUNITY CENTER 11/25/14 RICHARD O. GREENFIELD LAW OFFICES JOSEPH MARCINIAK 436 15WC 14119 SCALES, SAM IDOT 03/30/15 ILLINOIS ATTORNEY GENERAL 437 15WC 14250 ALVAREZ, MARIA ILLINOIS CENTRAL SCHOOL B 02/26/15 ANTHONY J MAY MACIOROWSKI SACKMANN & ULRIC 438 15WC 14319 JIMENEZ-ALVAREZ, MARIA D MVP 03/05/14 ANTHONY J MAY KOREY RICHARDSON LLC 439 15WC 14491 VELAZQUEZ, JOSE DE JESUS LABOR SOLUTIONS, LLC 03/02/15 LINN, CAMPE & RIZZO LTD 440 15WC 14528 PROCHNOW, GREGORY ILLINOIS TOLLWAY @ 03/12/15 HANNIGAN & BOTHA, LTD NYHAN BAMBRICK KINZIE & LOWR 441 15WC 14861 CLEMENS, VINCENT WAUCONDA FIRE 02/27/15 MARKHAM M JEEP & ASSOCIATE RUSIN & MACIOROWSKI LTD 442 15WC 15255 PETT, RON LAKE COUNTY SHERIFF'S OFF 02/28/14 STANCZAK LAW OFFICES SMITH AMUNDSEN LLC 443 15WC 15453 SALEK, KRZYSTOF VAL'S CONSTRUCTION INC 12/16/14 GROSZEK LAW FIRM RUSIN & MACIOROWSKI LTD 444 15WC 15869 STORMES, EARL STACK-ON 04/21/15 ANTHONY ESPOSITO HEYL ROYSTER VOELKER & ALLEN 445 15WC 16415 ALVARADO, SERGIO ACCURATE PERSONNEL 05/07/15 HANNIGAN & BOTHA, LTD GRANT & FANNING

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 29 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 446 15WC 16528 MARTINEZ, JOSE RAUL MCDONALD'S 04/01/15 CHEPOV & SCOTT LLC NYHAN BAMBRICK KINZIE & LOWR 447 15WC 16649 EASTON, CAROL SIEMENS 02/06/15 ROBERT H HANAFORD KOPKA, PINKUS & DOLIN, PC 448 15WC 16991 EARL, ANISHA TOPLINE TRANSPORATION 05/14/15 AIOSSA LAW FIRM RUSIN & MACIOROWSKI LTD 449 15WC 16995 PEAK, LUCELLA A NOSCO, INC. 12/15/14 GREG TUITE & ASSOC WOLFE & JACOBSON, LTD 15WC030173 -C 450 15WC 17023 OLEJNICZAK, JOHN WALKERS SERVICE 01/25/15 DAVID W MARTAY LAW OFFICES JOSEPH MARCINIAK 451 15WC 17169 WATSCHKE, CHRIS HIGHLAND PARK AUTOMOTIVE, 12/30/14 MARKHAM M JEEP & ASSOCIATE 452 15WC 17320 AREVALO, ROGER LA FITNESS 03/26/15 JAMES ELLIS GUMBINER & ASS COZZI & GOGGIN-WARD 453 15WC 17528 STRAMEL, DAVID M KINZIE REAL ESTATE SERVIC 03/23/15 TAMVAKIS, GEORGE L WIEDNER & MCAULIFFE LTD 454 15WC 17729 MANDELL, BOBBE EQUINOX 02/15/15 SOSTRIN AND SOSTRIN PC 455 15WC 18096 KATRALIS, IRENE CITY OF WAUKEGAN 02/03/15 DUDLEY & LAKE LLC BERNARD WYSOCKI & ASSOCIATES 456 15WC 18120 DELCUADRO, FERNANDO STATE OF IL DEPT OF 03/19/15 ANKIN LAW OFFICE ASSISTANT ATTORNEY GENERAL 457 15WC 18200 MILLER, STACY E/ WFF FACILITY SERVICES 05/14/13 ANTHONY J MAY 458 15WC 18662 RUPRECHT, ADAM P.S. DEMOLITION INC 12/26/13 CULLEN HASKINS NICHOLSON RUSIN & MACIOROWSKI LTD 459 15WC 18745 WYLEGALA, JOANNE GAP, INC/OLD NAVY 03/17/15 CAPRON & AVGERINOS PC ROBERT L. SMITH 460 15WC 18965 BOOTHE-ANDERSON, MARIE L. ENERGY SOLUTIONS, INC. 02/19/13 LINN, CAMPE & RIZZO LTD 461 15WC 19212 HERNANDEZ, ROMULO ECHO INC 10/21/14 CHEPOV & SCOTT LLC 462 15WC 19373 POWERS, TINA M BARTON OF ZION, INC. 01/28/15 LINN, CAMPE & RIZZO LTD BRADY CONNOLLY & MASUDA PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 30 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 463 15WC 19391 REINHARD, TIMOTHY ENERGY SOLUTIONS 01/26/15 GOLDBERG WEISMAN & CAIRO L QUINTAIROS PRIETO WOOD & BOY 464 15WC 19513 FOSCO, AMANDA M COUNTY OF LAKE 05/09/15 LINN, CAMPE & RIZZO LTD SMITH AMUNDSEN LLC 15WC019993 -C 465 15WC 19787 ACOSTA, ANTONIO EDDY'S TREE SERVICE 04/27/15 DAVID J. BAWCUM GANAN & SHAPIRO 466 15WC 19869 JEFFREY, BURKE LAKE COUNTY ILLINOIS 12/08/12 BAUM RUFFOLO & MARZAL LTD 467 15WC 19975 JONES, GREDEL KILEY DEVELOPMENTAL CENTE 03/27/15 DWORKIN AND MACIARIELLO ASSISTANT ATTORNEY GENERAL 468 15WC 20030 GARDANIER, RONALD IDOT @ 03/09/15 GRAHAM J. JEEP ASSISTANT ATTORNEY GENERAL 469 15WC 20109 ALVAREZ, FELIX RUPRECHT CO 04/22/15 SALK, STEVEN B & ASSOC LTD COZZI & GOGGIN-WARD 470 15WC 20362 WINKLER, GIANENA WALGREENS 01/20/14 DWORKIN AND MACIARIELLO GILDEA & COGHLAN 471 15WC 20577 SARMIENTO, ALLAN MBA BUILDING SUPPLIES 05/28/15 MARKS & ASSOCIATES HOLECEK & ASSOCIATES 472 15WC 20957 ANDERSON, MARTHA BEL RESOURCE INC. 05/19/15 BAUM RUFFOLO & MARZAL LTD 473 15WC 21002 ROSALES, PABLO KRUGEL COBBLES 05/08/14 SEIDMAN MARGULIS & FAIRMAN GAROFALO SCHREIBER STORM 474 15WC 21121 STEMEN, RYAN PETE'S AUTOMOTIVE 09/09/14 ROSS TYRRELL RUSIN & MACIOROWSKI LTD 475 15WC 21239 EISENBERG, MARK R BAXTER INTERNATIONAL INC 06/27/13 MACIOROWSKI SACKMANN & ULRIC 476 15WC 21326 GUZMAN, GEORGE STACK ON 04/01/15 MICHAEL P MCCREADY & ASSOC BRYCE DOWNEY & LENKOV LLC 477 15WC 21341 OTAHAL, JILL WAUKEGAN PUBLIC SCHOOL DI 07/16/13 LAW OFFICE OF SCOTT B SHAP BRADY CONNOLLY & MASUDA PC 478 15WC 21700 SMITH, RAYMOND COLEMAN CABLE 05/25/15 DWORKIN AND MACIARIELLO GANAN & SHAPIRO 479 15WC 21817 GONZALEZ, EVERARDO NORTHSTAR GROUP SERVICES 05/18/15 LINN, CAMPE & RIZZO LTD THOMAS & PORTELA 480 15WC 21878 DEANDA, MARIA LIBERTYVILLE MANOR 05/25/15 DWORKIN AND MACIARIELLO KEEFE CAMPBELL & ASSOC LLC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 31 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 481 15WC 22239 BRANDON, CHRISTEL E. ULTA SALON, COSMETICS 02/02/13 LEE A CAMPBELL LAW OFFICE RUSIN & MACIOROWSKI LTD 482 15WC 22439 LOPEZ, SUSANA KALLE USA INC. 05/08/15 CHEPOV & SCOTT LLC HOLECEK & ASSOCIATES 483 15WC 22571 BLANCAS, JORGE POTBELLY SANDWICH SHOP 03/11/15 LARRY FLEISCHER & ASSOCIAT COZZI & GOGGIN-WARD 484 15WC 22752 SCHMIDT, CATHERINE L MOTOROLA MOBILITY 07/29/13 GOLDBERG WEISMAN & CAIRO L BRADY CONNOLLY & MASUDA PC 485 15WC 22941 DEALMONTE-ROJO, CAIN ATR TRANSMISSION REMANUFA 06/06/15 LAW OFFICE EDWARD RUEDA ROSARIO CIBELLA 486 15WC 22983 NEWBERRY, ANTHONY ROYER ASPHALT PAVING 06/11/15 HORWITZ HORWITZ & ASSOC CASSIDAY SCHADE LLP 487 15WC 23024 DEAND, MARIA LIBERTYVILLE MANOR 05/25/15 JEROME FOREMAN & ASSOCIATE 488 15WC 23254 HACKERT, JASON SEARS 02/02/15 HANNIGAN & BOTHA, LTD GAROFALO SCHREIBER STORM 489 15WC 23366 TELLEZ, MARIBEL ZELLER PLASTIK INC 06/05/15 LANNON LANNON & BARR LTD 490 15WC 23504 QASUM, FATMEH KENTUCKY FRIED CHICKEN 07/11/15 AMBROSE BUTZEN LAW GROUP HENNESSY & ROACH PC 491 15WC 23783 FRELAS, MARZENA STAFFING DIMENSION OF 03/13/15 MICHALSKI & GUBERNAT 492 15WC 23814 ZIMMERMAN, CATHERINE E KOHLS DEPARTMENT STORE 08/12/14 HANNIGAN & BOTHA, LTD HENNESSY & ROACH PC 493 15WC 23992 MCDUFFIE, SHAWN ABBOTT LABORATORIES 02/02/15 NEWLAND & NEWLAND HENNESSY & ROACH PC 494 15WC 24077 RIVERA, LINDA GARCIA WILLIAMS ELECTRONIC GAMES 11/05/14 COLLISON & O'CONNOR 495 15WC 24189 JUAREZ, ROSARIO ANDREWS STAFFING INC 07/31/15 FERRIS THOMPSON & ZWEIG 496 15WC 24275 COLE, JERRY J.B. HUNT 07/27/15 POLLANS, LANNIE A LTD 497 15WC 24338 MIRELES, JUAN I&L CONSULTING 04/02/15 RUEDA, IVAN A LITCHFIELD CAVO 498 15WC 24382 OSORIO, GERONIMO ENRICO MOSCONI LANDSCAPE W 07/23/15 CHEPOV & SCOTT LLC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 32 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 499 15WC 24646 MCCLAY, DASHANA AON HEWITT 03/03/15 EFTEKHARI LAW OFFICES 500 15WC 25073 VARGAS, JEYDY RUPRECHT COMPANY 06/19/15 CULLEN HASKINS NICHOLSON COZZI & GOGGIN-WARD 501 15WC 25646 CARDONA, FERMIN MANFREDINI LANDSCAPING-DE 07/06/15 DWORKIN AND MACIARIELLO RODDY LAW LTD 502 15WC 25706 RODRIGUEZ, JOSEFINA AKA COMMERCIAL PLASTICS DBA X 11/04/14 JONATHAN SCHLACK ACCIDENT FUND HOLDINGS 503 15WC 25774 WATSCHKE, DIANNA CONSOLIDATED PATHOLOGY 07/07/15 MARKHAM M JEEP & ASSOCIATE 504 15WC 25849 JIMENEZ, JOSE CHIPOTLE MEXICAN GRILL 12/23/14 CULLEN HASKINS NICHOLSON HENNESSY & ROACH PC 505 15WC 25985 SALMERON, VICTOR J. RUPRECHT COMPANY 05/27/15 CULLEN HASKINS NICHOLSON COZZI & GOGGIN-WARD 506 15WC 26170 JACKSON, MARY HERITAGE WOODS OF GURNEE 06/29/15 DWORKIN AND MACIARIELLO SLAVIN & SLAVIN 507 15WC 26291 CLEGGETT, CHARMAINE TRADER JOE'S 05/28/15 DWORKIN AND MACIARIELLO MC ANDREWS & NORGLE LLC 508 15WC 26650 TORRES, MARIO ANN M. KILEY CENTER/ @ 01/15/14 LINN, CAMPE & RIZZO LTD ILLINOIS ATTORNEY GENERAL 509 15WC 26653 GUEVARA, MARIO G. SERVICEMASTER MGMT. 02/03/15 LINN, CAMPE & RIZZO LTD LAW OFFICES JOSEPH MARCINIAK 510 15WC 26662 OCHOA, MARIA G. COLEMAN CABLE - SOUTHWIRE 04/20/15 LINN, CAMPE & RIZZO LTD GANAN & SHAPIRO 511 15WC 26774 SCHLENDER, NINA STARBUCKS COFFEE COMPANY 07/08/15 LAW OFFICES PETER LEKAS BRADY CONNOLLY & MASUDA PC 512 15WC 26946 GEZZER, ROBERT J COBBLESTONE OVENS INC 12/22/14 LINN, CAMPE & RIZZO LTD COZZI & GOGGIN-WARD 513 15WC 26949 SIMS, ROY L ARAMARK INC 02/19/15 LINN, CAMPE & RIZZO LTD 514 15WC 26952 KLAUSS, RYAN M INTERPLEX INDUSTRIES INC 05/28/15 LINN, CAMPE & RIZZO LTD 515 15WC 27085 ROBLES, CESAR COLEMAN CABLE INC 08/06/15 ANKIN LAW OFFICE GANAN & SHAPIRO 516 15WC 27242 BUNCH, CHARLES W. JR. Z & L MACHINING INC 06/15/15 GOLDBERG WEISMAN & CAIRO L GANAN & SHAPIRO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 33 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 517 15WC 27400 SHERMAN PARKER, EVELYN E DYNAPAR 10/01/14 SOSTRIN AND SOSTRIN PC 518 15WC 27566 RUIVIVAR, ISMAEL A. VERITAS DOCUMENT SOLUTION 08/04/15 CULLEN HASKINS NICHOLSON BRADY CONNOLLY & MASUDA PC 519 15WC 27696 KARANTZIS, ELLEN LLOYD SIGMAN, D.D.S., LTD 03/17/15 BURNETT & CARON, LTD INMAN & FITZGIBBONS 520 15WC 27892 TAYLOR, GEORGE GOODWILL 08/19/15 AIOSSA LAW FIRM ACCIDENT FUND HOLDINGS 521 15WC 27937 HAMILTON, TNEL NOSCO 06/22/15 AIOSSA LAW FIRM 522 15WC 28391 GUZMAN, ROBERTO PACE BUS COMPANY 08/05/15 LEE, MARK N LAW OFFICE POWER & CRONIN LTD 523 15WC 28510 GIELCZYNSKI, JOANNA NORTHWESTERN LAKE 06/03/15 ARGIONIS & ASSOCIATES LLC 524 15WC 28786 STARZEC, DARIUSZ TED'S TUCKPOINTING 08/14/15 CULLEN HASKINS NICHOLSON 525 15WC 28812 JONES, CHANTOUN WAUKEGAN PARK DISTRICT 06/05/15 DUDLEY & LAKE LLC HENNESSY & ROACH PC 526 15WC 28870 ESCOBAR, CRUZANN ACCURATE PERSONNEL SERVIC 07/18/15 JOHN S. ELIASIK 527 15WC 29048 GREEN, ROBERT BRIAN PARK DISTRIC OF 03/08/13 HENNESSY & ROACH PC 528 15WC 29305 GARIBAY, JUAN PABLO G T LANDSCAPING LLC 05/19/15 CULLEN HASKINS NICHOLSON 529 15WC 29502 WHITE, RODNEY ALERIS INTERNATIONAL 08/01/15 KATZ FRIEDMAN EAGLE ET AL BRADY CONNOLLY & MASUDA PC 530 15WC 29622 ROSENDAHL, BRUCE SUPERMIX CONCRETE LLC 07/20/15 LANCASTER, DEBORAH 531 15WC 29707 SANCHEZ, MARLEN COUNTY OF LAKE 06/26/15 DOUGLAS RALLO PC WOLFE & JACOBSON, LTD 15WC029708 -C

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 34 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 532 15WC 29777 ALEJO, ALVARO POUL'S LANDSCAPING & NURS 07/17/15 JONATHAN SCHLACK HENNESSY & ROACH PC 533 15WC 29874 CASTILLO, ROSIBEL MEDLINE INDUSTRIES, INC 06/15/15 JOHN S. ELIASIK GAROFALO SCHREIBER STORM 15WC029875 -C 534 15WC 30017 BRINGER, JEFFREY REX ELECTRIC & 12/10/14 CAPRON & AVGERINOS PC INMAN & FITZGIBBONS 535 15WC 30257 AREVALO, RONY HN PRECISION 08/20/15 POLANSKY & CICHON CHTD 536 15WC 30432 DUCHITANGA, JUAN BRADLEY MARSHALL ROOFING 07/24/15 COSTA IVONE LLC 537 15WC 30516 GONZALEZ, ANA CARELIA A L HANSEN MANUFACTURING 01/27/15 JONATHAN SCHLACK RUSIN & MACIOROWSKI LTD 538 15WC 30577 GARCIA, LUIS SULLIVAN'S STEAKHOUSE 07/27/15 DWORKIN AND MACIARIELLO 539 15WC 30662 SARANTOPOULOS, CARLA WALGREENS 08/30/15 DUDLEY & LAKE LLC GILDEA & COGHLAN 540 15WC 30796 SARANTOPOULOS, CARLA WALGREENS 08/12/15 DUDLEY & LAKE LLC GILDEA & COGHLAN 541 15WC 30965 AYALA, FERNANDO QUALITY LABOR SERVICES 08/02/15 COSTA IVONE LLC KOREY RICHARDSON LLC 542 15WC 30992 CERVANTES, OMAR THE WEALSHIRE 04/18/15 STROM, NEAL B BRADY CONNOLLY & MASUDA PC 543 15WC 31141 GARCIA, CARLOS TARGET 08/29/15 LAW OFFICES OF ANSELMO DUR KEEFE CAMPBELL & ASSOC LLC 544 15WC 31296 COMBS, JAMES ROTO ROOTER 08/15/15 HERRERA LAW CENTER WIEDNER & MCAULIFFE LTD 545 15WC 31597 DAVIS, MARY EMCO CHEMICAL DISTRIBUTOR 03/11/15 ANKIN LAW OFFICE 15WC031600 -C 546 15WC 31655 CASTILLO, PETER J RUNDY'S/MARIANO'S 09/14/15 GOLDBERG WEISMAN & CAIRO L BRYCE DOWNEY & LENKOV LLC 547 15WC 31823 MACALALAD, ISAGANI STAPLES, INC. 07/09/15 STEVEN M SELAN HENNESSY & ROACH PC 548 15WC 32035 FINE, VICKI NORTHSHORE SCHOOL DIST 11 03/02/15 KARCHMAR & STONE WIEDNER & MCAULIFFE LTD 549 15WC 32168 RADDATZ, FRED W. FAMILY DOLLAR 05/07/15 SCOTT BARBER

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 35 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 550 15WC 32341 MALDONADO, JOHN THE HOME DEPOT USA INC 03/11/15 GOLDBERG WEISMAN & CAIRO L ADELSON TESTAN & BRUNDO 551 15WC 32509 JUAREZ, YVONNE JST CORPORATION 11/19/14 COSTA IVONE LLC 552 15WC 32672 RODRIGUEZ, MARIA CATERINA FOODS 09/30/15 JONATHAN SCHLACK LAW OFFICES JOSEPH MARCINIAK 553 15WC 32766 JEWEL, MICHAEL VACATION VILLAGE ASSO 08/06/15 NYHAN BAMBRICK KINZIE & LOWR 554 15WC 32870 KARP, SUSAN ABBOTT LABORATORIES 03/18/15 CORBOY & DEMETRIO PC HENNESSY & ROACH PC 555 15WC 33094 GUTIERREZ, GERARDO PERSONNEL STAFFING GROUP 08/14/15 DWORKIN AND MACIARIELLO 556 15WC 33277 PATTEN, MICHAEL J DEERFIELD/BANNOCKBURN 05/04/13 LINN, CAMPE & RIZZO LTD RUSIN & MACIOROWSKI LTD 557 15WC 33489 PERSCHNICK, JACOB JDM CONSTRUCTION 09/20/15 WHITESIDE & GOLDBERG LTD 558 15WC 33571 WRIGHT, ETHANIEL RUPRECHT CO 09/22/15 DWORKIN AND MACIARIELLO COZZI & GOGGIN-WARD 559 15WC 33632 HANSEN, TONI A JEWEL, INC./ 05/19/15 LINN, CAMPE & RIZZO LTD 560 15WC 33710 OWEN, TIFFANY SELECT STAFFING 06/23/15 MARKHAM M JEEP & ASSOCIATE LEAHY EISENBERG & FRAENKEL 561 15WC 33868 BELLINO, DOMINICK J CITY OF LAKE FOREST 05/24/15 LINN, CAMPE & RIZZO LTD 562 15WC 33891 LARSON, LISA A. UNITED AIRLINES 05/15/14 LINN, CAMPE & RIZZO LTD 563 15WC 33894 WOLFE, JUSTIN L. VILLAGE OF LINCOLNWOOD 10/03/14 LINN, CAMPE & RIZZO LTD RIPES NELSON BAGGOT KALOBRAT 564 15WC 34027 GALVAN, ANA MARIA STEINHAFELS, INC. 05/13/15 FERRIS THOMPSON & ZWEIG 565 15WC 34228 RIZVI, SHAHINA ZEBRA TECHNOLOGIES CORP 03/03/15 GRAHAM J. JEEP POLSINELLI PC 566 15WC 34245 BERNARD, THOMAS A & H CONSTRUCTION, LLC 10/06/15 GOLDBERG WEISMAN & CAIRO L 567 15WC 34659 BROWN, BONNIE J OAK GROVE SCHOOL DISTRICT 07/27/14 COLLISON & O'CONNOR NYHAN BAMBRICK KINZIE & LOWR

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 36 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 568 15WC 34866 MORRIS, SANDRA MOST VALUABLE PERSONNEL 10/15/15 AIOSSA LAW FIRM KOREY RICHARDSON LLC 569 15WC 35129 SANDBERG, DOUGLAS ABBOTT LABORATORIES 09/16/14 DOUGLAS RALLO PC WIEDNER & MCAULIFFE LTD 570 15WC 35150 RUDNIK, DIANA DURHAM SCHOOL SERVICES 10/20/15 SEIDMAN MARGULIS & FAIRMAN 571 15WC 35362 LEVITT, TOBEY JEWISH COUNCIL YOUTH SERV 03/02/15 CAPRON & AVGERINOS PC RUSIN & MACIOROWSKI LTD 572 15WC 35480 MELTON, HENRY CHICAGO BEARS FOOTBALL 11/04/12 WOLFE LAW PC MC ANDREWS & NORGLE LLC 15WC035481 -C 573 15WC 35544 HOFF, KAREN L WASTE MANAGEMENT 06/10/15 LINN, CAMPE & RIZZO LTD 574 15WC 35610 SORAPARU, WARREN A FEDERAL EXPRESS CORP 09/22/14 LAW OFFICE DAVID W CLARK HANSON LAW OFFICE 575 15WC 35647 JACKSON, GEORGE CORNFIELDS, INC. 09/24/15 TAMVAKIS, GEORGE L 576 15WC 35695 RAMOS DE GAONO, MIGDALIA CHICAGO MARRIOTT 10/10/15 ACEVES & PEREZ PC 577 15WC 35774 CARTER, BEN FOX LAKE FIRE FROT DIST 10/23/14 SCOTT BARBER 578 15WC 35801 JUAREZ, YVONNE JST CORPORATION 03/04/14 DOUGLAS RALLO PC 579 15WC 35889 HAKE, SANDRA PREGIS CORPORATION 01/05/15 MILLON & PESKIN LTD COZZI & GOGGIN-WARD 580 15WC 36038 BAIN, TIMOTHY CLASSIC WINDOWS INC 10/06/15 HORWITZ HORWITZ & ASSOC RUSIN & MACIOROWSKI LTD 581 15WC 36117 GUZMAN, RAFAEL BRANDONISIO & CO 08/14/15 RUSSO & RUSSO LTD 582 15WC 36752 RAMIREZ, GREGORIO TERMAX, CO. 06/24/15 MC HARGUE, JAMES P LAW OFF HOLECEK & ASSOCIATES 583 15WC 36810 HOWE, CHARLES INSTALLATION SPEICALISTS, 08/11/15 GALLIANI DOELL & COZZI LTD 584 15WC 36822 RUIZ, HUGO PUGSLEY & LAHAIE 11/04/15 STROM, NEAL B WIEDNER & MCAULIFFE LTD 585 15WC 36979 DUBIENSKI, SEBASTIAN TOP LINE CONSTRUCTION COR 11/04/15 MICHALSKI & GUBERNAT HEYL ROYSTER VOELKER & ALLEN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 37 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 586 15WC 37104 MARRS, JEANETTE ABOVE THE MESS 11/02/15 DAPRATO, DENNIS BERNARD WYSOCKI & ASSOCIATES 587 15WC 37150 BABNIK, SCOTT LAKE COUNTY 06/30/15 FOOTE MIELKE CHAVEZ & O'NE WOLFE & JACOBSON, LTD 588 15WC 37231 LANDA, JUAN J DC TRICORE, INC 10/05/15 DEPAOLO ZADEIKIS GORE HENNESSY & ROACH PC 15WC037232 -C 15WC037233 -C 589 15WC 37277 HARRIS-WRIGHT, MARVA MVP 09/04/13 LEONARD LAW GROUP LLC KOREY RICHARDSON LLC 590 15WC 37429 BLAZE, SHEILA ABBVIE INC 08/27/14 OSVALDO RODRIGUEZ PC 591 15WC 37532 CARMONA, ERNESTO GUSTAVO GUARDA LANDSCAPING W 09/14/15 MC HARGUE, JAMES P LAW OFF 592 15WC 37628 TAMAYO, IRMA MEDLINE INDUSTRIES 06/20/15 SOSTRIN AND SOSTRIN PC GAROFALO SCHREIBER STORM 593 15WC 37658 TODOROVA, OLGA RELIABLE HOME CARE PROVID 06/06/15 MINKOW DOMIN 594 15WC 37739 COULMAN, PETER UNITED CANVAS INC 08/20/15 BRISKMAN BRISKMAN GREENBER 595 15WC 37772 CASTRO, EVER QUALITY LABOR SERVICES 09/24/15 COSTA IVONE LLC KOREY RICHARDSON LLC 596 15WC 38033 CLAPHAM, BRUCE ABBVIE INC 05/01/15 NEWLAND & NEWLAND WIEDNER & MCAULIFFE LTD 597 15WC 38141 MUNOZ, YESENIA CRACKER BARREL OLD COUNTR 01/27/15 BAUM RUFFOLO & MARZAL LTD 598 15WC 38412 VALADEZ, MARGARITA BROWN PAPER GOODS CO 09/29/15 POSTERLI, OSCAR 599 15WC 38687 DUGARD, JOSHUA FED EX FREIGHT 03/10/15 JAMES P. TUTAJ QUINTAIROS PRIETO WOOD & BOY 600 15WC 38787 PORCAYO, NICOMEDES MOST VALUABLE PERSONNEL 04/27/15 POSTERLI, OSCAR KOREY RICHARDSON LLC 601 15WC 38897 EVANS, ASHLEY ANN KILEY CTR 04/26/15 ANTHONY ESPOSITO ILLINOIS ATTORNEY GENERAL 602 15WC 38917 FOHLMEISTER, MICHELLE K NATIONAL HOME HEALTH 04/14/14 LINN, CAMPE & RIZZO LTD KEEFE CAMPBELL & ASSOC LLC 603 15WC 38920 FOHLMEISTER, MICHELLE K GLEN HEALTH & HOME MGMT 08/26/15 LINN, CAMPE & RIZZO LTD LAW OFFICES FRANCESCA LARSEN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 38 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 604 15WC 38929 POUNDS, ROBERT W CITY OF NORTH CHICAGO 09/27/15 LINN, CAMPE & RIZZO LTD 605 15WC 38932 WOOD, TERRY B FREEMONT PUBLIC LIBRARY 12/11/13 LINN, CAMPE & RIZZO LTD GILDEA & COGHLAN 606 15WC 38935 BOSTIC, BILLY J VILLAGE OF FOX LAKE 08/09/15 LINN, CAMPE & RIZZO LTD INMAN & FITZGIBBONS 607 15WC 39047 REYES, ALBERTO TERMAX CORPORATION 11/13/15 JAMES ELLIS GUMBINER & ASS 608 15WC 39072 GUERRERO, JOSE L. RETANA CONTRACTORS 11/13/15 ARGIONIS & ASSOCIATES LLC COZZI & GOGGIN-WARD 609 15WC 39170 LOMAX, SYLVIA ADVOCATE CONDELL 11/24/15 HANNIGAN & BOTHA, LTD NYHAN BAMBRICK KINZIE & LOWR 610 15WC 39420 ONOFRE-LAZARO, ROGELIO CATERING BY MICHAEL'S INC 10/04/15 EFTEKHARI LAW OFFICES 611 15WC 39519 ARIAS, SERGIO MEDLINE INSDUSTRIES 03/20/15 SOSTRIN AND SOSTRIN PC 612 15WC 39631 DEBOSSCHERE, ROSEMARIE JEWEL FOOD STORES, INC. 04/01/15 COMPTON LAW GROUP 613 15WC 39698 THREAT, ERIC J ALLENDALE ASSOC 06/15/15 LINN, CAMPE & RIZZO LTD 614 15WC 39716 VALESCO, RAFAEL GLENBROOK GROUP INC 10/17/15 GOLDBERG WEISMAN & CAIRO L LAW OFFICES OF EDWARD J. KOZ 615 15WC 39763 GANDHI, VALMIK SHREE SINATH ENTERPRISE I 10/29/15 LEONARD LAW GROUP LLC 616 15WC 39955 CARDONA, ALEJANDRO VILLAGE OF LIBERTYVILLE 09/18/13 FOOTE MIELKE CHAVEZ & O'NE RUSIN & MACIOROWSKI LTD 617 15WC 39956 CARDONA, ALEJANDRO VILLAGE OF LIBERTYVILLE 10/05/15 FOOTE MIELKE CHAVEZ & O'NE RUSIN & MACIOROWSKI LTD 618 15WC 39984 TERMINI, MARGARET AON HEWITT NAVIGATORS INS 11/22/14 GORDON LAW OFFICES LTD 619 15WC 41128 BARRIOS, JORGE ACCURATE PERSONNEL 10/21/15 DEPAOLO ZADEIKIS GORE MC ANDREWS & NORGLE LLC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 39 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 620 15WC 41274 MCCLENDON, DORIS ALICE'S DISCOVERY CENTER/ 01/29/15 ROSS TYRRELL LAW OFFICES JOSEPH MARCINIAK 621 15WC 41489 LUCIO, SANDRA LAKE CTY CLERK OF CIRCUIT 06/24/15 STELZMAN, RUTH 15WC041490 -C 622 15WC 41544 LENHARDT, EILEEN AMERICAN FAMILY INSURANCE 01/07/13 BOGUSZ & BOGUSZ LTD 623 15WC 41557 JERINIC-WYDRA, ERIC MCDONALD'S 01/14/15 TARADASH LAW OFFICE 624 15WC 42084 CALLESE, ROGER E VILLAGE OF ROUND LAKE BEA 10/30/15 LINN, CAMPE & RIZZO LTD 625 15WC 42181 PELLACK, CINDY WIFE & NEX PRESBYTERIAN HOMES-LAKE F 11/24/15 TARADASH LAW OFFICE NYHAN BAMBRICK KINZIE & LOWR 626 15WC 42318 GIL, RAMON DON FLORE CO 06/19/15 DOUGLAS RALLO PC 627 15WC 42378 GARCIA, CECILIO MILIEU DESIGN LLC 10/20/14 DAVID J. BAWCUM QUINTAIROS PRIETO WOOD & BOY 628 15WC 42537 CABRERA, CHRISTINE THE THERAPY TREE, LLC. 12/14/15 HANNIGAN & BOTHA, LTD INMAN & FITZGIBBONS 629 16WC 00086 HOHNSON, DYLAN J DISCOUNT TIRE 11/20/15 ANTHONY ESPOSITO 630 16WC 00122 LOBO, ALEJANDRO DUBLE TREE - MUNDELEIN 11/04/15 SALK, STEVEN B & ASSOC LTD COZZI & GOGGIN-WARD 16WC000166 -C DOUBLE TREE MUNDELEIN 631 16WC 00133 ZEMAN, DOUGLAS SMALLEY STEEL RING COMPAN 11/24/14 MARKHAM M JEEP & ASSOCIATE 632 16WC 00192 RICE, PAUL A CITY OF WAUKEGAN 12/08/15 GOLDBERG WEISMAN & CAIRO L BERNARD WYSOCKI & ASSOCIATES 633 16WC 00311 HORN, CHRISTINE C LA QUINTA INN & SUITES 12/08/15 FOLEY LAW GROUP LLC WHITT LAW LLC 634 16WC 00559 CABRAL, CARLOS EXPRESS PERSONNEL PROS IN 08/10/15 LINN, CAMPE & RIZZO LTD 635 16WC 00864 SOTELO, LAUREN GLENKIRK 10/15/15 HANNIGAN & BOTHA, LTD 636 16WC 00904 PALENCIA, SOFIA ADVANCED CLEANING SYSTEMS 12/14/15 COSTA IVONE LLC 637 16WC 01084 TWOREK, COLLETTE HOME DEPOT 10/16/14 DANIEL PERIASWAMY ADELSON TESTAN & BRUNDO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 40 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 638 16WC 01218 CARRASCO, JOSE R AMB ROOFING 12/04/15 TAMVAKIS, GEORGE L KEEFE CAMPBELL & ASSOC LLC 639 16WC 01255 PITTS, ROBERT A ABBVIE 11/23/15 DOUGLAS RALLO PC HENNESSY & ROACH PC 640 16WC 01349 CARREON, JOSE BIG BOULDER PARTNERS LLC 01/07/16 COVEN LAW GROUP 641 16WC 01390 SALGADO, CELESTINO ABBOTT LABS 07/30/15 TOPPER & WEISS LTD WIEDNER & MCAULIFFE LTD 642 16WC 01488 HERNANDEZ-MARTINEZ, OCTAV POST & PICKETT LLC 12/07/15 DUDLEY & LAKE LLC RUSIN & MACIOROWSKI LTD 643 16WC 01743 JONES, CARNELL NYPRO 01/18/13 GRIMES, G DOUGLAS RUSIN & MACIOROWSKI LTD 644 16WC 01770 WILSON, MELANIE KIDDIE KOTTAGE CHILD CARE 04/22/13 BRUCE RAFALSON LTD LAW OFFICES JOSEPH MARCINIAK 645 16WC 01797 CRUZ, ABRAHAM N XPO LOGISTICS 10/21/15 LINN, CAMPE & RIZZO LTD 646 16WC 01867 YADANZA, PAMELA NORTH SHORE HOSPITAL 11/03/14 DWORKIN AND MACIARIELLO KEEFE CAMPBELL & ASSOC LLC 647 16WC 02134 TROPPLE, ROBERT MUNDELEIN SCHOOL DISTRICT 08/11/15 DUDLEY & LAKE LLC ANCEL GLINK DIAMOND BUSH & E 648 16WC 02271 KETCHERSID, TERRY MIDWEST PRINTED CIRCUITS 11/24/15 ROBERT EDENS BRADY CONNOLLY & MASUDA PC 649 16WC 02280 REDDEN, KATIE SCARAMOUCHE ENTERPRISES L 01/16/16 MURPHY & MURPHY 650 16WC 02482 SIWEK, MAGDALENA ANIAS POLISH DELI 08/07/15 RICHARD E ALEKSY ROSARIO CIBELLA 651 16WC 02723 VASQUEZ-GARCIA, MARIA EUS SURESTAFF, INC 01/14/16 SALK, STEVEN B & ASSOC LTD KEEFE CAMPBELL & ASSOC LLC 652 16WC 02934 NEE, MARTY ERIC WINOGRAD 01/25/16 653 16WC 02958 HAMANN, TIMOTHY VILLAGE OF GURNEE 01/07/15 DUDLEY & LAKE LLC ANCEL GLINK DIAMOND BUSH & E 654 16WC 03033 SCIFO, MARTHA KINDERCARE 08/21/15 ROM LAW HENNESSY & ROACH PC 655 16WC 03117 DOMERCHIE, ADAM LAKE COUNTY SHERIFF 10/20/15 MARSZALEK AND MARSZALEK SMITH AMUNDSEN LLC

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ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 42 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 673 16WC 04849 LOPEZ, ADRIAN J.P. GRAHAM TRANSPORT INC 07/16/15 CHEPOV & SCOTT LLC MCANANY VANCLEVE & PHILLIPS 674 16WC 04966 HENRY, IRIS ZION ELEMENTARY SCHOOL 10/27/15 ROM LAW NYHAN BAMBRICK KINZIE & LOWR 16WC005941 -C 675 16WC 04999 MEZA, YANET ECHO INC 01/15/16 VRDOLYAK LAW GROUP LLC WIEDNER & MCAULIFFE LTD 676 16WC 05064 BERENI, ROLAND ABBOTT LABORATORIES 12/10/12 DWORKIN AND MACIARIELLO HENNESSY & ROACH PC 677 16WC 05175 RAMIREZ, WILBUR I PHOENIX LOCAL MOVERS 07/13/15 DEPAOLO ZADEIKIS GORE LAW OFFICES JOSEPH MARCINIAK 678 16WC 05208 ALVARDO, JOSE AVERUS FIRE PROTECTION 01/30/16 MARKS & ASSOCIATES RUSIN & MACIOROWSKI LTD 679 16WC 05217 LARA, SANDRA ANDREWS STAFFING 01/29/16 FERRIS THOMPSON & ZWEIG SLAVIN & SLAVIN 680 16WC 05497 SOSNOSKI, MELISSA COUNTRY FIRE PROTECTION D 10/04/14 DUDLEY & LAKE LLC RUSIN & MACIOROWSKI LTD 681 16WC 05607 MEDINA, ALEJANDRA BURGER KING 01/14/16 HART & DAVID LLP 682 16WC 05824 GWINN, LA ANGEL SILVERADO HIGHLAND PARK 01/26/16 DWORKIN AND MACIARIELLO 683 16WC 05940 STRONG, ARTHUR B CITY OF NORTH CHICAGO 10/25/15 LINN, CAMPE & RIZZO LTD HENNESSY & ROACH PC 684 16WC 05943 ZERVAS, DEAN V NEMERA, INC 11/21/15 LINN, CAMPE & RIZZO LTD 685 16WC 06003 BABCOCK, FRANK CLARENCE DAVIDS & CO. 08/12/14 STEVEN M SELAN MC ANDREWS & NORGLE LLC 686 16WC 06061 HEINY, MARK R LAKE COUNTY SHERIFF'S OFF 01/11/16 FOOTE MIELKE CHAVEZ & O'NE WOLFE & JACOBSON, LTD 687 16WC 06405 RAMOS, DIEGO EGG HARBOR CAFE 04/12/15 LARRY FLEISCHER & ASSOCIAT GANAN & SHAPIRO 688 16WC 06517 ROEDL, GLORIA GRANT COMMUNITY HS 12/11/13 LEO ALT NYHAN BAMBRICK KINZIE & LOWR 689 16WC 06569 DICKSON, PETER C. COUNTY OF LAKE 10/07/15 LINN, CAMPE & RIZZO LTD WOLFE & JACOBSON, LTD 690 16WC 06572 RICE, MATTHEW T. COUNTY OF LAKE 12/26/15 LINN, CAMPE & RIZZO LTD SMITH AMUNDSEN LLC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 43 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 691 16WC 06575 BARRIENTOS, SANTIAGO R. GOODWILL INDUSTRIES OF 04/08/14 LINN, CAMPE & RIZZO LTD ACCIDENT FUND HOLDINGS 692 16WC 06578 GARDUNO, REBECCA L COUNTY OF LAKE 11/02/15 LINN, CAMPE & RIZZO LTD WOLFE & JACOBSON, LTD 693 16WC 06581 BUCKLEY, RODNEY A GRAYSLAKE FIRE PROTCTION 08/31/15 LINN, CAMPE & RIZZO LTD RUSIN & MACIOROWSKI LTD 694 16WC 06824 ALVAREZ, JOSE M. KARL KNAUZ MOTORS, INC. 12/07/15 BAUM RUFFOLO & MARZAL LTD MC ANDREWS & NORGLE LLC 695 16WC 06866 ZASLAVSKIY, YEFIM WHELAN SECURITY OF IL,INC 01/15/16 LAW OFFICES YEVGENIY VAYSM HENNESSY & ROACH PC 696 16WC 07002 NEGRON, MARTA CARDINAL HEALTH 09/17/14 COHN & COHN 697 16WC 07261 GUZMAN, YOLANDA NEMERA 10/16/15 JONATHAN SCHLACK HENNESSY & ROACH PC 698 16WC 07345 SILVA, ROSA E PEOPLE LINK STAFFING 02/03/16 THOMAS J STIBERTH LAW OFFI WOLF LAW LTD 699 16WC 07417 VERDAGUER, LEOPOLDO YASKAWA AMERICA, INC 01/04/16 ROBERT EDENS 700 16WC 07642 FLETCHER, LISA WALGREENS 01/26/16 GOLDSTEIN BENDER & ROMANOF 701 16WC 07670 MORENO, DANIEL UPS 09/04/15 LEONARD LAW GROUP LLC NYHAN BAMBRICK KINZIE & LOWR 702 16WC 07686 RUSSELL, MAESHAA ADVOCATE CONDELL HOSPITAL 12/03/15 BRISKMAN BRISKMAN GREENBER NYHAN BAMBRICK KINZIE & LOWR 703 16WC 07699 GIANNAKOPOULOS, JOHN WALGREENS 06/10/15 DWORKIN AND MACIARIELLO 704 16WC 07777 GALVAN, MARIBEL LAKE FOREST PL PRESBYTERI 02/23/16 JONATHAN SCHLACK NYHAN BAMBRICK KINZIE & LOWR 705 16WC 08022 WILLIAMS, NANCY ROLLING HILLS MANOR 02/24/16 DOUGLAS RALLO PC 706 16WC 08082 LAYBURN, JAMES TOSHIBA BUSINESS SOLUTION 12/11/15 COLLISON & O'CONNOR 707 16WC 08181 TATE, SHELIA FOSS PARK DISTRICT 02/26/16 BRISKMAN BRISKMAN GREENBER RUSIN & MACIOROWSKI LTD 708 16WC 08247 YERUSHALMI, RAYMOND PLEXUS CORP 11/23/15 LINN, CAMPE & RIZZO LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 44 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 709 16WC 08261 GLINIEWICZ, MICHAEL VILLAGE OF ANTIOCH 07/04/15 LINN, CAMPE & RIZZO LTD RUSIN & MACIOROWSKI LTD 710 16WC 08282 BURNS, KEVIN L NEW ALBERTSON'S INC/JEWEL 09/03/14 LINN, CAMPE & RIZZO LTD BRADY CONNOLLY & MASUDA PC 711 16WC 08298 LUNA, NORMA GEREMARIE CORP 02/25/15 712 16WC 08403 BEARD, MOLLI IL BONE & JOINT INSTITUTE 09/04/15 BRILL & FISHEL LAW OFFICES OF EDWARD J. KOZ 713 16WC 08451 SCHREINER, ROBERT NEWPORT TWNSHP FIRE DIST 03/22/15 MEYERS & FLOWERS RUSIN & MACIOROWSKI LTD 714 16WC 08480 VICE, MARK II LAKE COUNTY SHERIFF'S 01/13/16 HANNIGAN & BOTHA, LTD WOLFE & JACOBSON, LTD 715 16WC 08746 ROQUE, MARIO JR ADVOCATE CONDELL MEDICAL 05/28/13 BAUM RUFFOLO & MARZAL LTD NYHAN BAMBRICK KINZIE & LOWR 716 16WC 08800 TERRAULT, JACQUES JR WOODLAND FOODS, LTD 06/25/14 BRILL & FISHEL 717 16WC 08917 RUTHER, GEOFFREY VLGE OF DEERFIELD POLICE 11/19/15 CORBOY & DEMETRIO PC 718 16WC 09061 GOODNETTER, MICHELLE HIGHLAND PARK PARK DISTRI 05/13/15 ASHER, RAYMOND L LTD HENNESSY & ROACH PC 719 16WC 09173 MATA-GUZMAN, MARTA CANCER TREATMENT CENTERS 02/10/16 POLANSKY & CICHON CHTD 720 16WC 09214 ROMERO, SAMANTHA LINDENHURST ANIMAL HOSPIT 01/27/16 MARKS & ASSOCIATES COZZI & GOGGIN-WARD 721 16WC 09355 ROQUE, MARIO JR ADVOCATE CONDELL 12/28/13 BAUM RUFFOLO & MARZAL LTD NYHAN BAMBRICK KINZIE & LOWR 722 16WC 09415 JUSTUS, GARY N ADVANCED VEHICLE TECH 08/15/14 HANNIGAN & BOTHA, LTD WIEDNER & MCAULIFFE LTD 723 16WC 09416 SNUFFER, DAN DOERING LANDSCAPE COMPANY 02/02/16 HANNIGAN & BOTHA, LTD RODDY LAW LTD 724 16WC 09497 MANGIONI, PATRICIA BAKER'S SQUARE 03/04/16 MEYERS & FLOWERS BRYCE DOWNEY & LENKOV LLC 725 16WC 09617 MCDERMOTT, JAMES M LTD COMMODITIES INC 11/09/15 LINN, CAMPE & RIZZO LTD 726 16WC 09790 WILLIAMS, GABORIS QPS, INC. 02/22/16 LINN, CAMPE & RIZZO LTD WOLFE & JACOBSON, LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 45 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 727 16WC 09863 BOMBACINO, PATRICIA WAL-MART 03/19/16 SEIDMAN MARGULIS & FAIRMAN QUINTAIROS PRIETO WOOD & BOY 728 16WC 09905 WILSON, DUANE A-MOBILE, INC. 10/29/14 LAW OFFICE OF SCOTT B SHAP 729 16WC 10036 WOODS, TAMARA ENOVA FINANCIAL 11/03/15 DWORKIN AND MACIARIELLO 730 16WC 10047 LOPEZ, ALFREDO THE XCEL GROUP 03/09/16 HART & DAVID LLP 731 16WC 10133 PERNICE, DEBORAH J PRO SOURCE WHOLESALE FLOO 01/30/15 LANZILLOTTI GRIBBEN & MARC COZZI & GOGGIN-WARD 732 16WC 10174 EVANS, JASON M BW CONSTRUCTION & HOME 08/11/15 LAW OFFICE PHILIP BLOMBERG RUSIN & MACIOROWSKI LTD 733 16WC 10448 BJORN, DENNIS E. AUTO PARTS CITY 01/28/16 TAMVAKIS, GEORGE L 734 16WC 10531 STEPHENS, BENJAMIN PERFECTION CUSTOM CLOSETS 10/10/14 DWORKIN AND MACIARIELLO LAW OFFICES JOSEPH MARCINIAK 735 16WC 10569 MARKS, JAMES AB SPECIALTY SILICONES 01/28/16 JEROME FOREMAN & ASSOCIATE 736 16WC 10671 PITA, JUANA L OLD REPUBLIC INS. CO 06/20/15 DEPAOLO ZADEIKIS GORE 737 16WC 10692 MEDINA, JOSE INDUSTRIAL PERSONNEL, LTD 02/18/16 DAVID J. BAWCUM 738 16WC 10721 HARAMIS, GEORGE ATR TRANSMISSION REMANF, 01/20/16 PARENTE & NOREM PC GANAN & SHAPIRO 739 16WC 10819 SONETZ, LOUIS GREAT LAKES ELECTRICAL 01/26/15 O'CONNOR & NAKOS LAW OFFICES JOSEPH MARCINIAK 16WC010820 -C 740 16WC 10925 RIVAS, JORGE AUTO PARTS CITY 02/25/16 DISPARTI LAW GROUP PA WOLFE & JACOBSON, LTD 741 16WC 10946 HOSKINS, WILLIAM CULLIGAN INTERNATIONAL CO 10/20/15 DUDLEY & LAKE LLC 742 16WC 10961 BARR, MICHAEL ROUND LAKE BEACH POLICE D 06/07/15 DUDLEY & LAKE LLC ROBERT L. SMITH 743 16WC 11222 DANIEL, CAITLYN SUPERCUTS 02/19/16 DUDLEY & LAKE LLC GILDEA & COGHLAN 744 16WC 11231 RUELLI, DONNA NORTHERN SUBURBAN SPECIAL 09/17/15 POSTERLI, OSCAR NYHAN BAMBRICK KINZIE & LOWR

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 46 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 745 16WC 11450 LEWANDOWSKI, THOMAS TURANO BAKERY 07/05/15 WILLIAMS, ROBERT B LAW OFF NOBLE & ASSOCIATES PC 746 16WC 11525 VANLIER, TIMOTHY L. OMNIREPS, LLC. 12/10/15 ANKIN LAW OFFICE GANAN & SHAPIRO 747 16WC 11584 PENA, KAREN M MARTHA'S DAYCARE 03/11/16 FERRIS THOMPSON & ZWEIG 748 16WC 11798 SALGADO, JOSE A HYDRAFORCE INC 02/20/15 MARSZALEK AND MARSZALEK 749 16WC 12023 RACANELLI-DEADWILER, KIMB GOODWILL INDUSTRIES INC 03/09/16 LINN, CAMPE & RIZZO LTD 750 16WC 12027 MARTINEZ, CARLOS L ACACIA SPICE COMPANY 02/15/16 LINN, CAMPE & RIZZO LTD INMAN & FITZGIBBONS 751 16WC 12030 PETERSON, JERRY D VILLAGE OF GURNEE 07/20/15 LINN, CAMPE & RIZZO LTD ANCEL GLINK DIAMOND BUSH & E 752 16WC 12033 REVELLE, JANICE A UNDERWRITERS LABORATORIES 12/04/13 LINN, CAMPE & RIZZO LTD 753 16WC 12060 LEITER, ANDREW BAXTER 08/14/15 AIOSSA LAW FIRM MACIOROWSKI SACKMANN & ULRIC 754 16WC 12128 PEREZ, RICARDO LANDSCAPE CONCEPTS MANAGE 09/08/15 SEIDMAN MARGULIS & FAIRMAN KNELL & O'CONNOR 755 16WC 12248 RATLIFF, JEREMIAH CHICAGO BEARS FOOTBALL 09/14/14 WOLFE LAW PC MC ANDREWS & NORGLE LLC 756 16WC 12251 RATLIFF, JEREMIAH CHICAGO BEARS FOOTBALL 10/18/15 WOLFE LAW PC MC ANDREWS & NORGLE LLC 757 16WC 12272 PALOMINO, HILDA LABOR SOLUTION 03/13/15 CHEPOV & SCOTT LLC 758 16WC 12350 LANZ, JADE SAM'S CLUB 01/16/16 TARADASH LAW OFFICE QUINTAIROS PRIETO WOOD & BOY 759 16WC 12451 PLETZ, SONIA FEDEX GROUND 06/20/13 TARADASH LAW OFFICE SCOPELITIS GARVIN LIGHT 760 16WC 12570 BARRIOS, VERONICA WINCHESTER HOUSE 03/05/16 SPENCER LAW OFFICES 761 16WC 12675 NIETO, LIDIA ECHO, INC 04/13/16 MC HARGUE, JAMES P LAW OFF 762 16WC 12715 GARCIA, JOSE P MUDDY BOOTS LANDSCAPING 07/24/14 LINN, CAMPE & RIZZO LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 47 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 763 16WC 12756 TAYLOR, DENISE GRAHAM-C STORES COMPANY 02/22/16 RANDALL A. WOLFF & ASSOC 764 16WC 12762 CRAMER, RYAN GRAYSLAKE FIRE 10/06/15 MARKHAM M JEEP & ASSOCIATE RUSIN & MACIOROWSKI LTD 765 16WC 12879 DENSON, ROMONA COLLEGE OF LAKE COUNTY 12/16/15 DUDLEY & LAKE LLC GAROFALO SCHREIBER STORM 766 16WC 13027 SLIVKA, GREGORY S VILLAGE OF VERNON HILLS 11/20/15 LINN, CAMPE & RIZZO LTD NYHAN BAMBRICK KINZIE & LOWR 767 16WC 13139 GILHOOLEY, MARK MORAINE TOWNSHIP 05/20/11 STANCZAK LAW OFFICES JAMES M KELLY 768 16WC 13213 ELDER, ROBERT J JR QUESTLINER, INC. 06/19/15 COLLISON & O'CONNOR HOLECEK & ASSOCIATES 769 16WC 13365 BROWN, CLEVELAND GOODWILL 04/19/16 AIOSSA LAW FIRM HOLECEK & ASSOCIATES 770 16WC 13411 WEBER, BRENDA WALMART 02/14/16 ROBERT EDENS QUINTAIROS PRIETO WOOD & BOY 771 16WC 13468 ANTUNEZ, ARMANDO ELAN LANDSCAPE DEVELOPMEN 05/27/15 CULLEN HASKINS NICHOLSON BRADY CONNOLLY & MASUDA PC 772 16WC 13553 LIPPERT, MICHAEL J STATE OF ILLINOIS 03/25/16 LINN, CAMPE & RIZZO LTD ILLINOIS ATTORNEY GENERAL 773 16WC 13598 POOLE, MARLENE E. JEWEL FOOD STORES, INC. 03/06/15 GOLDBERG WEISMAN & CAIRO L WIEDNER & MCAULIFFE LTD 16WC013599 -C 774 16WC 13797 RIVERA, SUNY ELITE STAFFING 03/01/16 CHEPOV & SCOTT LLC 775 16WC 13866 QUINN, PETER T RUNDY'S SUPERMARKET 09/15/15 TAMVAKIS, GEORGE L BRYCE DOWNEY & LENKOV LLC 776 16WC 13931 DRAKE, BRETT T MACGYVER DEVELOPMENT, INC 11/21/14 ANKIN LAW OFFICE STANCZAK LAW OFFICES 777 16WC 14150 MIRANDA, MARTIN GEORGE CARDENAS 07/15/15 CULLEN HASKINS NICHOLSON 778 16WC 14151 SCHWARTZ, BETH NORTHERN SUBURBAN SPECIAL 02/29/16 CULLEN HASKINS NICHOLSON 779 16WC 14208 GARCIA, ROCIO ANN KILEY CENTER @ 04/18/16 ANTHONY ESPOSITO ILLINOIS ATTORNEY GENERAL 780 16WC 14313 WARD, HEATHER NORTHERN SUBURBAN SPECIAL 12/10/15 MARKS & ASSOCIATES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 48 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 781 16WC 14401 WRIGHT, JOHNATHON MASTER TRUCK & TRAILER, L 02/26/16 GRAHAM J. JEEP RUSIN & MACIOROWSKI LTD 782 16WC 14551 DIAZ, FRUTOSO COMMERCIAL PLASTICS 11/27/15 COSTA IVONE LLC 783 16WC 14572 LIPARI, SUSAN STATE OF ILLINOIS @ 06/03/15 FRANCIS J DISCIPIO LAW OFF ILLINOIS ATTORNEY GENERAL 784 16WC 14607 HAYES, WILBERT MEGABUS 02/21/16 BIZZIERI LAW OFFICES POULOS & DIBENEDETTO LAW 785 16WC 14758 OCAMPO-BRITO, ALEJANDRO MIDWEST PRINTED 02/16/16 MARKS & ASSOCIATES 786 16WC 15062 DIEDRICH, SETH JDK SERVICES 08/17/15 GANAN & SHAPIRO 787 16WC 15291 RIOS, MARIA G ARAMARK 11/16/15 FERRIS THOMPSON & ZWEIG 788 16WC 15541 KELLEY, LISA BED, BATH & BEYOND 01/22/16 VOGG, MARK J LAW OFFICE KOPKA, PINKUS & DOLIN, PC 789 16WC 15679 PORTNOY, STACIE LETTUCE ENTERTAIN YOU 10/19/15 HANNIGAN & BOTHA, LTD NOBLE & ASSOCIATES PC 790 16WC 15726 PAGE, KEITH CAPITOL PLUMBING, INC 02/18/16 KOSIN LAW OFFICE LTD 791 16WC 15739 HOOTSELL, JEARLEAN ACCURATE 05/07/16 RUBENS AND KRESS RODDY LAW LTD 792 16WC 15891 GARCIA, OFELIA ARVATO 02/15/16 MARSZALEK AND MARSZALEK WIEDNER & MCAULIFFE LTD 793 16WC 15969 JOHANNES, CARL R PRAIRIE MATERIAL 08/14/15 GOLDBERG WEISMAN & CAIRO L GAROFALO SCHREIBER STORM 794 16WC 16001 DE LA PAZ, JOSE F FIBERTEX NONWOVENS, LLC 12/03/15 MC HARGUE, JAMES P LAW OFF 795 16WC 16084 BELTRAN, TERESA ELITE STAFFING 01/27/16 AIOSSA LAW FIRM STANCZAK LAW OFFICES 796 16WC 16151 SOSA, DANIEL STELLAR PRODUCTIONS, INC. 05/08/16 GOLDBERG WEISMAN & CAIRO L BRADY CONNOLLY & MASUDA PC 797 16WC 16330 GARCIA, EDITH CRUZ ZION DONUTS INC. D/B/A DU 10/08/15 FERRIS THOMPSON & ZWEIG 798 16WC 16426 REBAGO, LUZ HYDRO FORCE INC 05/04/16 DWORKIN AND MACIARIELLO HOLECEK & ASSOCIATES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 49 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 799 16WC 16450 RAMIREZ, SANTIAGO LABOR SOLUTIONS LLC 12/03/15 MARKS & ASSOCIATES 800 16WC 16485 VILLARRELA, MATHEW ADVANCED TREE CARE 05/09/16 ALEX Y KAPLAN 801 16WC 16636 PANKIEWICZ, BRIAN J WAUKEGAN SCHOOL DISTRICT 03/09/16 ANTHONY J MAY BRADY CONNOLLY & MASUDA PC 802 16WC 16670 POPE, RENALDO INTERNATIONAL PRECISION 07/07/15 DAVID W MARTAY 803 16WC 16713 PRYOR, CECELIA ARAMARK 03/10/16 MC HARGUE, JAMES P LAW OFF 804 16WC 16770 DONNENWIRTH, MICHAEL LAKE COUNTY CORONER 05/14/14 EVAN A HUGHES LAW OFFICE SMITH AMUNDSEN LLC 805 16WC 16974 ROBINSON, COREY AEROTEK STAFFING 12/01/15 BRISKMAN BRISKMAN GREENBER HEYL ROYSTER VOELKER & ALLEN 806 16WC 16998 FLAX, CINDY THE BON TON STORES, INC 04/26/16 EPSTEIN, JACK R LAW OFFICE BRADY CONNOLLY & MASUDA PC 807 16WC 17026 LINDOM, STEVE VILLAGE OF ANTIOCH 07/26/13 ROSS TYRRELL 808 16WC 17501 VIDAL, CARMEN FRESH THYME FARMERS MARKE 04/22/16 LOCASCIO, MARK A LTD COZZI & GOGGIN-WARD 809 16WC 17524 DAVIS, GEORGIA C ACCURATE PERSONNEL 03/12/16 LINN, CAMPE & RIZZO LTD MC ANDREWS & NORGLE LLC 810 16WC 17777 GUTIERREZ, PABLO ALVAREZ WORLD WIDE FITTINGS 02/12/16 RUBERRY STALWACK & GARVEY 811 16WC 17918 ALVAREZ, EDGAR I HINES BUILDING SUPPLY 04/07/16 JEROME FOREMAN & ASSOCIATE 812 16WC 18126 MARTINEZ, JESSICA CLEANE CLINIC AUTHORITY 11/16/15 BAUM RUFFOLO & MARZAL LTD 813 16WC 18178 CATTOUSE, SEAN CHICAGO BEARS FOOTBALL 05/27/14 WOLFE LAW PC MC ANDREWS & NORGLE LLC 16WC018179 -C 814 16WC 18493 ANTUNEZ, JAIME WOODLAND FOODS 11/17/15 DISPARTI LAW GROUP PA 815 16WC 18513 ALVAREZ, JUAN THE XCEL GROUP 01/13/16 DOUGLAS RALLO PC KOREY RICHARDSON LLC 816 16WC 18550 SANFORD, BARBARA NORTHERN ILLINOIS UNIVERS @ 07/12/15 FRANKS, GERKIN & MCKENNA P ILLINOIS ATTORNEY GENERAL

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 50 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 817 16WC 18577 FREMAUX, SHIRLEY SODEXO 02/22/16 KROL BONGIORNO & GIVEN LTD 818 16WC 18745 ARMSTRONG, KIMBERLY SGS LIFE SCIENCES 06/10/16 GORDON & CENTRACCHIO LLC BRADY CONNOLLY & MASUDA PC 819 16WC 18761 LUCAS, MICHAEL R. ABBOTT LABORATORIES 12/07/15 CULLEN HASKINS NICHOLSON WIEDNER & MCAULIFFE LTD 820 16WC 18792 PAWLOWSKI, GLENN A. MILLERS AREA HEATING 08/26/15 ANESI OZMON RODIN NOVAK KO 821 16WC 18844 ARMENDARIZ, ARMANDO ROUNDY'S ILLINOIS LLC 04/24/16 BERG & BERG 822 16WC 18902 TORRES, FRANCISCO LANDARCH SYSTEMS INC 07/28/15 THE ROMAKER LAW FIRM GAROFALO SCHREIBER STORM 823 16WC 19021 RUIZ, SARA LITTLE LADY FOODS 08/18/15 LINN, CAMPE & RIZZO LTD 824 16WC 19060 SCHUETTENBERG, CAROLYN A EMMONS GRADE SCHOOL DIST 05/28/14 LINN, CAMPE & RIZZO LTD 825 16WC 19063 ADAMS, REBECCA JEWEL, INC 03/20/16 LINN, CAMPE & RIZZO LTD BRADY CONNOLLY & MASUDA PC 826 16WC 19066 GUZMAN, LUIS WEST ROCK 04/01/16 LINN, CAMPE & RIZZO LTD 827 16WC 19069 RUIZ, JOSE NU ARRA, INC 09/10/15 LINN, CAMPE & RIZZO LTD BRYCE DOWNEY & LENKOV LLC 828 16WC 19077 HOLMES, TERESA A TRANSITIONAL CARE OF LAKE 02/24/16 LINN, CAMPE & RIZZO LTD 829 16WC 19174 LEE, CHRISTOPHER D. VETERANS DISTRIBUTION 05/31/16 INMAN & FITZGIBBONS 830 16WC 19239 HANZELIN, KENNETH FEDEX GROUND EXPRESS 04/26/16 BURNETT & CARON, LTD 831 16WC 19248 TORRES, VICTORIA BRITO ELITE STAFFING 04/01/16 ANTHONY ESPOSITO 832 16WC 19301 AMBROCIO, YNEZ C. SALAS MVP STAFFING 10/21/15 ANTHONY ESPOSITO 833 16WC 19379 SHARP, BILLY J. HOLLISTER INCORPORATED 07/09/15 ANKIN LAW OFFICE 834 16WC 19395 PIGNOTTI, MARY ESTELLA BRIGHT HORIZONS FAMILY 04/25/16 DOUGLAS RALLO PC HOLECEK & ASSOCIATES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 51 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 835 16WC 19434 TOMPKINS, MINNIE ARAMARK 10/05/15 BARRY A KETTER 836 16WC 19484 TREVINO, EDWARD DMS INC. 12/17/15 FRANCIS J DISCIPIO LAW OFF 837 16WC 19515 RASMUSSAN, BRYAN JEWEL 01/05/15 LINN, CAMPE & RIZZO LTD WIEDNER & MCAULIFFE LTD 838 16WC 19518 VAUGHN, SCOTT D PUBLIC SAFETY SERVICES IN 10/21/14 LINN, CAMPE & RIZZO LTD INMAN & FITZGIBBONS 839 16WC 19521 HORN, KEITH E ASPLUNDH 02/04/16 LINN, CAMPE & RIZZO LTD 840 16WC 19524 GARCIA, LUCILA CATERINA FOODS LLC 04/21/16 LINN, CAMPE & RIZZO LTD 841 16WC 19529 MONTOYA, AGUSTIN OLSSON ROOFING CO INC 05/06/16 LAW OFFICES OF ANSELMO DUR INMAN & FITZGIBBONS 842 16WC 19691 JONES, DARRYL GOODWILL INDUSTRIES OF SE 03/22/15 RUBIN MACHADO ROSENBLUM 843 16WC 19894 TRUJULLO, BLANCA ECHO INC 02/17/16 DAVID J. BAWCUM WIEDNER & MCAULIFFE LTD 844 16WC 19952 FALCO, ALPHONSE S VILLAGE OF ROUND LAKE PAR 08/11/15 GOLDBERG WEISMAN & CAIRO L RUSIN & MACIOROWSKI LTD 845 16WC 20154 BUTTLIERE, CARLA JEWEL OSCO 05/10/16 GOLDBERG WEISMAN & CAIRO L 846 16WC 20232 TUPA, RONALD WARREN TOWNSHIP HIGH 11/25/14 MARKS & ASSOCIATES 847 16WC 20289 RUVIRA, MARIO AVTAVIS INC 04/21/16 BOTTO GILBERT 848 16WC 20401 MALONE, MARK UPS 06/10/16 JOHN E LUSAK NYHAN BAMBRICK KINZIE & LOWR 849 16WC 20481 GUERRERO, CARMELA ANDREWS STAFFING 05/04/16 MC HARGUE, JAMES P LAW OFF SLAVIN & SLAVIN 850 16WC 20522 RAVEN, JEFFREY A SUPER MIX 10/26/15 HANNIGAN & BOTHA, LTD 851 16WC 20645 GONZALEZ-SANCHEZ, SILVIA MOST VALUABLE PERSONNEL 10/28/15 AIOSSA LAW FIRM KOREY RICHARDSON LLC 852 16WC 20668 GROSSMAN, SASHA PEAPOD 02/23/16 BRUCE RAFALSON LTD LITCHFIELD CAVO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 52 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 853 16WC 20732 LECKIE, KATARINA T DAVE & BUSTERS 05/06/16 LINN, CAMPE & RIZZO LTD 854 16WC 20815 FORSHAW, RONALD SIGNATURE FLIGHT SUPPORT 05/13/16 ANKIN LAW OFFICE WIEDNER & MCAULIFFE LTD 855 16WC 20996 GARCIA, CONSUELO ARAMARK @ 04/26/16 POSTERLI, OSCAR 856 16WC 21018 ADAMS, JACQUELINE AQUENT STAFFING 06/28/16 STEWART C ORZOFF LAW OFFICES OF EDWARD J. KOZ 857 16WC 21142 MENDOZA, BRENDA THE DELI SOURCE INC 07/05/16 AIOSSA LAW FIRM 858 16WC 21151 GOLD, KATHLEEN ST OF ILLINOIS DEPT OF @ 05/29/16 DUDLEY & LAKE LLC ILLINOIS ATTORNEY GENERAL 859 16WC 21191 UPTON, JOHN J LAKE COUNTY SHERIFF'S DEP 10/10/15 ANKIN LAW OFFICE SMITH AMUNDSEN LLC 860 16WC 21276 RAMIREZ, JOSE MENARDS 05/18/16 TAMVAKIS, GEORGE L 861 16WC 21336 ALVAREZ, SANTIAGO BG STAFFING 05/20/16 MC HARGUE, JAMES P LAW OFF 862 16WC 21558 RYBA, MARY CATHERINE LIBERTY MANOR EXTENDED CA 06/09/16 COHN & COHN KEEFE CAMPBELL & ASSOC LLC 863 16WC 21583 GALEANO, ERLIN GUY SCOPELLITI LANDSCAPIN 06/07/16 DAVID J. BAWCUM 864 16WC 21691 LOE, NICHOLAS J WACHS, E.H. 10/13/15 THOMAS M. PARIS NYHAN BAMBRICK KINZIE & LOWR 865 16WC 21777 LINVILLE, SUSAN M JEWEL FOOD STORE 10/16/15 GOLDBERG WEISMAN & CAIRO L 866 16WC 21965 FAHLSING, ROBERT C ELITE STAFFING 11/24/15 LINN, CAMPE & RIZZO LTD 867 16WC 22080 MYERS, PORSHA BAXTER HEALTH CARE 07/12/16 DWORKIN AND MACIARIELLO MACIOROWSKI SACKMANN & ULRIC 868 16WC 22110 PAULUS, MICHAEL VILLAGE OF LAKE ZURICH 04/23/16 VOGG, MARK J LAW OFFICE 869 16WC 22132 NASR, WAFAA COMMUNITY ACTION PARTNERS 11/16/15 DUDLEY & LAKE LLC RUSIN & MACIOROWSKI LTD 870 16WC 22133 VARNO, ELIZABETH LINCOLNSHIRE SCHOOL DIST. 06/16/16 DUDLEY & LAKE LLC NYHAN BAMBRICK KINZIE & LOWR

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 53 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 871 16WC 22193 JAUREZ, SANDRA MVP WORKFORCE LLC 06/17/16 HANNIGAN & BOTHA, LTD KOREY RICHARDSON LLC 872 16WC 22299 TABAKA, MARIA CM PACKAGING, INC.C/O NAT 07/30/13 LEWIS & DAVIDSON, LTD 873 16WC 22341 CASTRO, AURORA THE DELI SOURCE INC 03/30/16 AIOSSA LAW FIRM 874 16WC 22514 WILFONG, CHANTELLE MEIJER 05/16/16 ZANCK COEN WRIGHT & SALADI NYHAN BAMBRICK KINZIE & LOWR 875 16WC 22715 DAVIS, GWEN SENIOR HELPERS 07/03/16 CHEPOV & SCOTT LLC 876 16WC 22962 BIZIOR, JAROSLAW CRYSTAL MANAGEMENT & 06/18/16 BRUSTIN & LUNDBLAD LTD 877 16WC 22981 EBERT, NORMAN J COMMUNICATION TECH SERVIC 07/06/16 BURNES & LIBMAN 878 16WC 23172 CASTILLO, ROSALINO CHASERS SPORTS BAR 03/01/16 HART & DAVID LLP 879 16WC 23176 HAQQUI, SALEEM FRESENIUS MED CARE OF 04/20/16 BAUM RUFFOLO & MARZAL LTD HENNESSY & ROACH PC 880 16WC 23191 POWELL, SUSAN DOLLAR GENERAL CORP 05/23/14 ROBERT EDENS LEAHY EISENBERG & FRAENKEL 881 16WC 23280 GUTIERREZ, GUADALUPE SILVERADO SENIOR LIVING M 04/19/16 GRAVLIN, MICHAEL J LLC 882 16WC 23295 RODRIGUEZ, JOSEFINA GURNEE PARK DISTRICT 08/08/15 FERRIS THOMPSON & ZWEIG 883 16WC 23413 CRAENENBROECK, EDWARD VAN LAKESIDE GLASS & MIRROR, 05/24/16 LINN, CAMPE & RIZZO LTD 884 16WC 23534 INMAN, JEFFREY THE AUDI EXCHANGE 06/19/14 VOGG, MARK J LAW OFFICE 885 16WC 23602 RHOTON, LEE ANN ACCRETIVE SOLUTIONS CORP. 04/15/16 BRILL & FISHEL LAW OFFICES JOSEPH MARCINIAK 886 16WC 23650 BLUTHARDT, MELISSA S. ADVOCATE LUTHERN 12/01/15 LINN, CAMPE & RIZZO LTD NYHAN BAMBRICK KINZIE & LOWR 887 16WC 23668 BERNARDI, JOSEPH SUNSET FOOD MART, INC 09/13/13 STAVINS & ASSOCIATES 888 16WC 23978 GATICA, ROSALINDA EXMOOR COUNTRY CLUB 02/12/16 FERRIS THOMPSON & ZWEIG

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 54 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 889 16WC 24035 KNUTH, TIMOTHY BUTLER CORING 01/22/16 MARKS & ASSOCIATES BRADY CONNOLLY & MASUDA PC 890 16WC 24178 GOMEZ, MARIA CHASE PROFESSIONALS 05/26/16 RUEDA, IVAN A 891 16WC 24181 SABASTIANO, VICTOR ROUGHNECK CONCRETE DRILLI 06/30/16 O'CONNOR LAW GROUP LLC 892 16WC 24235 CARTER, LINCOLN ADOR CP. INC. 07/20/16 BRAD J. BALKE, PC RUSIN & MACIOROWSKI LTD 893 16WC 24320 MONREAL, SERGIO EBBEN MASONRY 07/27/16 DWORKIN AND MACIARIELLO ACCIDENT FUND HOLDINGS 894 16WC 24497 CRAMER, RYAN GRAYSLAKE FIRE PROTECTION 07/26/16 MARKHAM M JEEP & ASSOCIATE 895 16WC 24499 CRAMER, RYAN GRAYSLAKE FIRE 04/06/15 MARKHAM M JEEP & ASSOCIATE 896 16WC 24507 JACKSON, RHONDA US SECURITY ASSOCIATES 02/02/15 BRISKMAN BRISKMAN GREENBER COZZI & GOGGIN-WARD 897 16WC 24530 SCHUTTE, NICOLE SUPERIOR AMBULANCE 12/28/15 MARKS & ASSOCIATES 898 16WC 24569 BROWN, MICHAEL E GORDON FOOD SERVICE 05/06/16 MAY & BUEGE HENNESSY & ROACH PC 899 16WC 24608 GRACA, DANIEL PEAK SUPPLY INC. 07/28/16 KATZ FRIEDMAN EAGLE ET AL HENNESSY & ROACH PC 900 16WC 24673 SIMS, VANESSA PACE SUBURBAN TRANSIT 03/11/16 COHN & COHN POWER & CRONIN LTD 901 16WC 24740 RITCHIE, SAM VILLAGE OF LAKE ZURICH 06/28/16 FOHRMAN, DONALD W & ASSOCS 902 16WC 24887 MADRO, JAMES GUY SCOPELLITI LANDSCAPE 08/03/16 DWORKIN AND MACIARIELLO 903 16WC 24931 SELEGA, KAROL (KARL) PAULY MOTORS, INC 05/10/16 MARKHAM M JEEP & ASSOCIATE WOLFE & JACOBSON, LTD 904 16WC 25004 LEMONS, LANA LAKE COUNTY SHERIFF'S DEP 12/02/15 DUDLEY & LAKE LLC WOLFE & JACOBSON, LTD 905 16WC 25101 VELIZ, MANUELA WINCHESTER HOUSE 06/23/16 SPENCER LAW OFFICES 906 16WC 25132 YARBROUGH, SHIRLEY LAKESIDE TRANSPORTATION 09/01/15 DWORKIN AND MACIARIELLO GALLIANI DOELL & COZZI LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 55 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 907 16WC 25152 BELL, GARY GOLD STAR SOLUTIONS, INC. 07/15/16 TAMVAKIS, GEORGE L 908 16WC 25173 WORLEY, DAEVON ADVANCED DISPOSAL 05/23/16 ROBERT EDENS INMAN & FITZGIBBONS 909 16WC 25202 RODRIGUES, CONCEPCION EXTENDED STAY AMERICA 06/03/16 FRANKS, GERKIN & MCKENNA P 910 16WC 25333 ELIZAIDE, GUILLERMO JACKSON LANDSCAPING 06/07/16 CUSHING LAW OFFICES 911 16WC 25350 PADILLA, JUAN WINDWARD ROOFING 06/16/16 DAVID W MARTAY 912 16WC 25481 FLORES, RICARDO E GE RIDDIFORD CO 06/13/16 DEPAOLO ZADEIKIS GORE GAROFALO SCHREIBER STORM 913 16WC 25667 POPE, JAMES E. JEWEL FOOD STORES, INC. 07/03/16 LINN, CAMPE & RIZZO LTD 914 16WC 25670 ROJAS, ZAIDA BAYSIDE TERRACE 06/29/16 LINN, CAMPE & RIZZO LTD 915 16WC 25745 MALDONADO, FAUSTO MBA BUILDING SERVICES 07/20/16 SKLARE LAW GROUP 916 16WC 25758 STEMO, DENISE PORTILLO'S 07/24/16 DUDLEY & LAKE LLC 917 16WC 25933 PEREZ, MARIO LUCAS LANDSCAPING 06/16/16 ANGELINI & ORI LLC 918 16WC 25997 HERMANSEN, HOWARD ROSE CUSTOMS & CABINETS 06/20/16 GOLDBERG WEISMAN & CAIRO L 919 16WC 26159 SANCHEZ, ELIA UNISTAFF PRO 06/28/16 CUSHING LAW OFFICES 920 16WC 26521 KUEHN, STEVEN SIEMANS 07/06/16 LANNON LANNON & BARR LTD 921 16WC 26583 MOLLER, BRIAN MACLEAN-FOGG COMPANY 05/26/16 GOLDBERG WEISMAN & CAIRO L 922 16WC 26663 MENDEZ, CELIO BALLARO 08/25/16 MC HARGUE, JAMES P LAW OFF 923 16WC 26684 GARCIA, OSCAR STAFFING DIMENSIONS 07/06/15 TARADASH LAW OFFICE 924 16WC 26725 MERAZ, PERLA 7 HILLS HEALTHCARE CTR, P 08/08/16 ANKIN LAW OFFICE

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 56 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 925 16WC 26812 SMITH, ANGELA FOSS PARK DISTRICT 08/05/16 JOSEPH G HAFFNER LAW OFFIC RUSIN & MACIOROWSKI LTD 926 16WC 26933 ZAVALA PIZANO, MARTIN ONWENTSIA CLUB 08/08/16 HUGHES SOCOL PIERS RESNICK 927 16WC 26948 BAKER, DONALD THE MAIL BOX & FLAG COMPA 08/09/16 ANKIN LAW OFFICE RUSIN & MACIOROWSKI LTD 928 16WC 27176 PALMER, RAYMOND GDI SERVICES 06/27/16 VRDOLYAK LAW GROUP LLC COZZI & GOGGIN-WARD 929 16WC 27198 LIMON, YESENIA MCDONALD'S 06/13/16 CUSHING LAW OFFICES 930 16WC 27256 TALLOO, APARNA DISCOVER FINANCIAL 11/05/15 COZZI & GOGGIN-WARD 931 16WC 27333 GUZMAN, SERJIO FED EX 07/13/15 DUDLEY & LAKE LLC SCOPELITIS GARVIN LIGHT 932 16WC 27380 GARCIA, MARCO QUALITY LABOR SERVICES * 06/24/16 DAVID J. BAWCUM GRANT & FANNING 933 16WC 27505 DELANEY, AMY WOODLAND SCHOOL DISTRICT 09/02/16 KROL BONGIORNO & GIVEN LTD 934 16WC 27528 KOLB, LEE ALLAN LABRAK, INDIVIDUALL 09/01/16 LAW OFFICE OF SCOTT B SHAP 935 16WC 27608 MEENTS, HALEY LAKE COUNTY 01/20/16 POWELL & PISMAN 936 16WC 27640 ALEXANDER, TWALIA ARAMARK * 08/26/16 AIOSSA LAW FIRM 937 16WC 27906 QUINTERO, SALVADOR SHIP INPAX, LLC 07/18/16 MEYERS & FLOWERS 938 16WC 27921 MUNOZ, MARTIN RICK'S AUTO CARE & COLLIS 10/23/13 CHEPOV & SCOTT LLC 939 16WC 27961 BLANCO, JOAQUIN MEDLINE INDUSTRIES INC 06/14/16 JONATHAN SCHLACK GAROFALO SCHREIBER STORM 940 16WC 28075 MALDONADO, NELSON NORTHFIELD BLOCK COMPANY 05/10/16 HART & DAVID LLP COZZI & GOGGIN-WARD 941 16WC 28126 ZAVALA, JARVIN PAGUADA RICARDO 07/25/16 MARKS & ASSOCIATES 942 16WC 28383 UMANZOR ROJAS, SANDRY M RUPRECHT COMPANY 07/26/16 FERRIS THOMPSON & ZWEIG

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 57 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 943 16WC 28435 WALKER, ANTOINETTE THE TERRACE 09/07/16 DWORKIN AND MACIARIELLO 944 16WC 28463 GOLWITZER, GARY A WASTE MANAGEMENT, INC 03/09/15 LINN, CAMPE & RIZZO LTD 945 16WC 28466 AMANN, PATRICIA J SPEEDWAY, INC 03/13/16 LINN, CAMPE & RIZZO LTD KEEFE CAMPBELL & ASSOC LLC 946 16WC 28471 BENIGNO, VITO NEW ALBERTSON'S, INC 07/11/16 LINN, CAMPE & RIZZO LTD 947 16WC 28587 KNIGHTEN, LAWRENCE A FEDERAL EXPRESS, INC 12/01/15 LINN, CAMPE & RIZZO LTD 948 16WC 28590 SANDACZ, STEVEN M VILLAGE OF ROUND LAKE BEA 05/22/16 LINN, CAMPE & RIZZO LTD 949 16WC 28668 JONES, NORMA AURORA PAC, LLC DBA AVANT 09/04/15 RUSSO & RUSSO LTD 950 16WC 28801 GOODWIN, TIMOTHY R VILLAGE OF ROUND LAKE BEA 07/13/16 LINN, CAMPE & RIZZO LTD 951 16WC 28804 RICHEL, KAREN E 1800FLOWERS.COM INC 03/11/16 LINN, CAMPE & RIZZO LTD 952 16WC 28821 JIMENEZ-TELLEZ, ANTONIA WALMART 03/07/16 LINN, CAMPE & RIZZO LTD QUINTAIROS PRIETO WOOD & BOY 953 16WC 28846 ROCHON, RICHARD A SELECT COMFORT CORPORATIO * 02/21/14 SOSTRIN AND SOSTRIN PC 954 16WC 28915 AUGUST, JOSEPH B LOOMIS ARMORED * 08/24/16 BOWMAN & CORDAY 955 16WC 29044 GUIFARRO, VANESSA XCEL PERSONNEL * 08/30/16 SALVATO & O'TOOLE GILDEA & COGHLAN 956 16WC 29079 BALENTINE, COREY CDW * 05/15/16 JOHN M BORCIA LAW OFFICE HENNESSY & ROACH PC 957 16WC 29194 KLINE, M. SCOTT COPENHAVER CONSTRUCTION I * 08/17/16 CAPRON & AVGERINOS PC LAW OFFICES OF EDWARD J. KOZ 958 16WC 29227 POKORNEY, MARK DICKOW CYZAK TILE * 07/21/15 GREGORIO & MARCO RUSIN & MACIOROWSKI LTD 959 16WC 29309 DAUGHERTY, JOLYN ACI WORLDWIDE INC * 09/23/14 ANKIN LAW OFFICE 960 16WC 29340 BROWN, DEBRA BASS PRO SHOP * 06/17/16 STANCZAK LAW OFFICES BRYCE DOWNEY & LENKOV LLC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 58 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 961 16WC 29422 PATEL, RAJESH YASKAWA ELECTRIC AMERICA * 03/16/16 MC HARGUE, JAMES P LAW OFF HENNESSY & ROACH PC 962 16WC 29760 ORLANDO JOSEPH SYNNEX CORP * 09/11/15 SCOTT BARBER 963 16WC 29831 ANTMAN, STEVEN H TOP DRIVER * 03/08/16 DAVID M SPADA 964 16WC 29851 MARTINEZ, PAULINA UNISTAFF * 09/01/16 CHEPOV & SCOTT LLC 965 16WC 29874 KOFOED, MELISSA LINCOLNSHIRE SENIOR CARE * 08/18/16 FRED J BEER LAW OFFICES HENNESSY & ROACH PC 966 16WC 29898 FLEMING, JOANN STATE OF ILLINOIS @ * 04/06/16 CORNFIELD & FELDMAN ILLINOIS ATTORNEY GENERAL 967 16WC 30062 WILHELM, MICHAEL P THE CHICAGO PROFESSIONAL * 10/05/13 SALVATO & O'TOOLE HENNESSY & ROACH PC 968 16WC 30089 MARTINEZ, MARTA L ZEBRA TECHNOLOGIES * 08/11/15 HANNIGAN & BOTHA, LTD 969 16WC 30208 BECERRIL, CARMEN QUALITY LABOR SERVICES * 06/21/16 CUSHING LAW OFFICES KOREY RICHARDSON LLC 970 16WC 30285 MCGHEE, PATRICIA ILLINOIS TOOL WORKS, INC. * 09/20/16 ANKIN LAW OFFICE HENNESSY & ROACH PC 971 16WC 30370 ZAVALA, JAVIER ADVOCATE CONDELL MED CTR * 03/19/16 STANCZAK LAW OFFICES NYHAN BAMBRICK KINZIE & LOWR 972 16WC 30405 GARCIA, MARIA TEMPS NOW * 05/12/16 BAUM RUFFOLO & MARZAL LTD 973 16WC 30452 ARROYO, SEVERO SCOTT BYRON & CO, INC * 07/28/16 LINN, CAMPE & RIZZO LTD 974 16WC 30464 CIMINO, DIANE JEWEL OSCO * 01/26/16 GOLDBERG WEISMAN & CAIRO L 975 16WC 30594 LUTZOW, JODI COVENTRY * 08/15/16 TURNER & SACKETT LLC 976 16WC 30617 KILPATRICK, GLENDA APERION CARE HIGHWOOD * 08/29/16 DWORKIN AND MACIARIELLO 977 16WC 30714 ORTEGA, JOSE MARIANI LANDSCAPE * 09/01/16 DWORKIN AND MACIARIELLO 978 16WC 30753 JOHNSON, LUWANDA MORAN TRANSPORTATION CORP * 08/14/16 RUBIN MACHADO ROSENBLUM

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 59 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 979 16WC 30835 MUNOZ, TERESA ADA S MCKINLEY COMMUNITY * 01/27/16 HECTOR ESPITIA 980 16WC 30874 JACKSON, DERRICK CARDINAL HEALTH * 09/15/16 KREITER, BYCK & ASSOC LLP HENNESSY & ROACH PC 981 16WC 30902 GUTIERREZ, LUIS GUY SCOPELLITI ORIGINAL * 09/28/16 JONATHAN SCHLACK 982 16WC 30905 JONES, HERBERT DORMA- KABA REVOLVING DOO * 09/27/16 DUDLEY & LAKE LLC COZZI & GOGGIN-WARD 983 16WC 31057 LIRA, CLAUDIA ZELLER PLASTIK, INC * 12/19/15 GRAHAM J. JEEP 984 16WC 31118 WALLACE, KEVIN KEYTH SECURITY SYSTEMS, I * 02/19/16 ACCIDENT FUND HOLDINGS 985 16WC 31296 MENDOZA, MARIA IPCC * 07/08/14 POSTERLI, OSCAR 986 16WC 31360 FOSTER, RANDY CORNFIELDS INC * 09/22/16 HANNIGAN & BOTHA, LTD 987 16WC 31416 RIOS, GUADALUPE ECHO * 09/08/16 DAVID J. BAWCUM 988 16WC 31519 O'NEIL, JUSTIN JGS MARINE LLC DBA MASTER * 02/11/16 GRAHAM J. JEEP WOLF LAW LTD 989 16WC 31548 WIGDZINSKI, ADAM FIBERTEX CO * 09/26/16 TAMVAKIS, GEORGE L 990 16WC 31657 COLLINS, JUDY WALMART * 07/15/16 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 991 16WC 31842 EDMUNDS, JENNIFER THE BON TON STORES * 09/23/16 STEIN & CHERNEY LTD 992 16WC 31943 HANDYSIDE, JOEAN WALGREENS * 01/16/15 BERNARD WYSOCKI & ASSOCIAT 993 16WC 31966 BRAGE, CRYSTAL ALDI * 06/21/16 GESMER LAW OFFICES, PC 994 16WC 32020 NASH, CORNELL AEROTEK, INC * 11/16/15 DISPARTI LAW GROUP PA 995 16WC 32047 POST, CELENE ARAMARK EDUCATION, INC * 05/19/16 LINN, CAMPE & RIZZO LTD 996 16WC 32050 GRAHAM, JUSTIN J GURNEE FIRE PROT DISTRICT * 08/22/16 LINN, CAMPE & RIZZO LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 60 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 997 16WC 32094 VEGA, GASPAR TRIALTA CONSTRUCTION, INC * 11/06/14 LAW OFFICE OF SCOTT B SHAP 998 16WC 32186 PENA, GLORIA ACCURATE PERSONNEL LLC * 08/09/16 FIORETTI & DESJARDINS LTD 999 16WC 32292 RODRIGUEZ, MAURICIO D HORIZON CARTAGE, INC * 10/03/16 MARKHAM M JEEP & ASSOCIATE INMAN & FITZGIBBONS 1000 16WC 32336 SALGADO, LINO B NUWAVE, LLC * 11/24/15 CULLEN HASKINS NICHOLSON 1001 16WC 32444 RUSSELL, WILLIAM WELL CADILLAC * 01/19/16 CAPRON & AVGERINOS PC 1002 16WC 32485 TRUJILLO, VICTORIA BRIGHTSTAR US * 07/12/16 ARGIONIS & ASSOCIATES LLC 1003 16WC 32539 FLYNN, DALE IDOT @ * 05/19/16 WOODRUFF & JOHNSON 1004 16WC 32711 HALL, JOHN JONES LANG LASALLE * 10/10/16 NEWLAND & NEWLAND 1005 16WC 32794 PRZYWARA, MARIA NEMERA BUFFALO GROVE, LLC * 07/28/16 ANKIN LAW OFFICE 1006 16WC 32829 GOLDMAN, PETER J VILLAGE OF OAKWOOD HILLS * 10/14/16 FIGLIOLI, DAVID 1007 16WC 32903 BAKER, CAROL LAKE COUNTY HEALTH DEPT * 09/12/15 JOHN M BORCIA LAW OFFICE WOLFE & JACOBSON, LTD 1008 16WC 32959 TAUBERY, DEREK THE HILL GROUP * 10/12/16 WHITESIDE & GOLDBERG LTD BRADY CONNOLLY & MASUDA PC 1009 16WC 33050 SANTANA, ROBERTO LIQUID CONTROL, INC * 04/16/15 ROMANUCCI & BLANDIN COZZI & GOGGIN-WARD 1010 16WC 33070 BUCK, LYNN AMERICAN AIRLINES * 10/03/16 RUBENS AND KRESS 1011 16WC 33336 MEDLEY, BRENDA ELITE STAFFING * 10/05/16 BRILL & FISHEL 1012 16WC 33356 POWELL, SUSAN DOLLAR GENERAL CORPORATIO * 11/20/13 ROBERT EDENS LEAHY EISENBERG & FRAENKEL 1013 16WC 33457 DE LEON, EMELDA SEDGEBROOK RETIREMENT * 09/06/16 DAVID W MARTAY HENNESSY & ROACH PC 1014 16WC 33493 COLEMAN, FALON AEROTEK, INC * 07/23/16 MARKHAM M JEEP & ASSOCIATE HENNESSY & ROACH PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 61 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 1015 16WC 33541 JONES, TONESE JEWEL OSCO * 10/08/16 DEUTSCHMAN, JEFFREY S 1016 16WC 33613 BARRERA, EDUARDO DEERFIELD SCHOOL DIST 109 * 10/17/16 STROM, NEAL B 1017 16WC 33637 YONIN, KRISTO G HEALTH SOURCE OF NORTHSHO * 10/24/16 BARGANSKA LAW 1018 16WC 33672 BLANCAS, LUCIA KERRY AMERICAS * 03/10/16 AIOSSA LAW FIRM 1019 16WC 33729 YOUNG, DEE DISCOVER CARD FINANCIAL S * 06/10/16 DWORKIN AND MACIARIELLO 1020 16WC 33787 PEREZ, TERESA MEDINA LANDSCAPING * 10/31/14 MEYERS & FLOWERS GANAN & SHAPIRO 1021 16WC 33839 WILSON, RICKY COLEMAN CABLE CO/SOUTHWIR * 02/15/16 COHN & COHN GANAN & SHAPIRO 1022 16WC 33948 GONZALEZ, MARIA G ACCURATE PERSONNEL * 08/05/16 CUSHING LAW OFFICES 1023 16WC 34147 SELANDER, GINA HAWTHORN SCHOOL DISTRICT * 08/04/16 STEVEN J MALMAN & ASSOCIAT 1024 16WC 34241 RIVERA, NORMA PTO SERVICES, INC A/K/A * 07/25/16 VOGG, MARK J LAW OFFICE 1025 16WC 34410 HOLLAND, SCOTT THE PIT SHOP GARAGE * 09/28/16 DUDLEY & LAKE LLC 1026 16WC 34524 DONATI, ANTHONY R JEWEL FOOD STORES * 03/31/16 RICHARD O. GREENFIELD 1027 16WC 34568 JOHNSON, SHANEQUIA SIX FLAGS GREAT AMERICA * 10/31/16 DAVID W MARTAY 1028 16WC 34600 BRYANT, DAVID G AT & T * 08/05/15 LINN, CAMPE & RIZZO LTD 1029 16WC 34655 KENT, STEVEN R FINISHMASTER, INC * 08/09/16 ANKIN LAW OFFICE HENNESSY & ROACH PC 1030 16WC 34804 CARBONELL, LUIS KELLER TRUCKING COMPANY * 12/30/15 WIEDNER & MCAULIFFE LTD 1031 16WC 34855 FRY, LACIE COSTCO WHOLESALE * 12/17/15 GANAN & SHAPIRO 1032 16WC 34876 MURRILLO, NORMA KENALL * 06/10/16 FERRIS THOMPSON & ZWEIG

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 62 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 1033 16WC 34991 RAMOS-RUIZ, JOSEFINA HAFEEZ ENTERPRISES, INC * 09/12/16 ALBERT R. PINO LAW OFFICE 1034 16WC 35034 ECKEL, CARL AMERIT FLEET SOLUTIONS IN * 02/14/16 MATTHIAS D. GILL 1035 16WC 35160 HORAK, BOGDAN SHERMAN MECHANICAL, INC * 08/19/16 NEWLAND & NEWLAND ACCIDENT FUND HOLDINGS 1036 16WC 35274 VILLA, NOEL SWEET TOMATOES * 11/27/15 LINN, CAMPE & RIZZO LTD 1037 16WC 35303 ANTUNEZ, JAMIE WOODLAND FOODS, LTD * 09/15/16 DISPARTI LAW GROUP PA 1038 16WC 35334 MILLER, JUANITA GOODWILL STORES * 10/27/16 CULLEN HASKINS NICHOLSON 1039 16WC 35371 MUNOZ, FRANCISCA HUGHES ENTERP INC DBA BLU * 07/05/16 LINN, CAMPE & RIZZO LTD 1040 16WC 35374 VEGA, MARIA LABOR SOLUTIONS * 02/24/16 LINN, CAMPE & RIZZO LTD 1041 16WC 35377 GUTIERREZ-REMIREZ, FLOREN ANDREWS STAFFING * 09/02/16 LINN, CAMPE & RIZZO LTD 1042 16WC 35397 POLANCO, MARISOL CUBESMART * 10/03/16 MILLON & PESKIN LTD 1043 16WC 35481 MARTIN, RYAN DOMINOS PIZZA * 10/08/16 ARGIONIS & ASSOCIATES LLC 1044 16WC 35560 UPHOFF, CARL GRANT COMMUNITY HIGH SCHO * 11/10/16 DUDLEY & LAKE LLC 1045 16WC 35587 PATTERSON, LEONARD COUNTY OF LAKE * 01/10/16 LINN, CAMPE & RIZZO LTD 1046 16WC 35652 VEGA, MARIA LABOR SOLUTIONS * 04/15/16 LINN, CAMPE & RIZZO LTD 1047 16WC 35789 ADKINS, DENNIS B WASTE MANAGEMENT, INC * 11/02/16 LINN, CAMPE & RIZZO LTD 1048 16WC 35800 SALGADO, JAVIER LABOR SOLUTIONS PRO * 04/10/16 STAVINS & ASSOCIATES 1049 16WC 35859 PIERSON, PHILLIP PRECISION ROOFING OF LAKE * 12/10/15 WOLF LAW LTD 1050 16WC 35971 OLIVER, ANGELA M APEX3 SECURITY * 09/06/16 STAVINS & ASSOCIATES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 63 C A S E H E A R I N G S Y S T E M DOLLISON, GREGORY 095 ARBITRATION CALL FOR WAUKEGAN 50001 ON 01/20/2017 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 1051 16WC 36045 GOLDMAN, SHERI THE GAP INC, C/O CT CORP * 11/12/16 PAUL W GRAUER & ASSOC 1052 16WC 36156 NANI, KATHRYN GOLD STANDARD ENTERPRISES * 09/29/16 CAPRON & AVGERINOS PC 1053 16WC 36237 FICKENSHER, LAURA INSIGHT GLOBAL/MEDLINE * 11/05/16 DUDLEY & LAKE LLC 1054 16WC 36268 CHUNG HONG KIM, RICHARD LAKE CITY CLEANERS * 08/05/16 WOLFE LAW PC 1055 16WC 36320 VENTURA, MARTHA CHANNER CORP * 08/26/16 MARKS & ASSOCIATES 1056 16WC 36391 CARVALLIDO, MARGARITO ABC CLEANERS * 06/24/15 HOLECEK & ASSOCIATES 1057 16WC 36446 VANTREESE, MICHAEL MEINEKE CAR CARE CENTER * 11/17/16 DWORKIN AND MACIARIELLO 1058 16WC 36587 GAROLIS, CYNTHIA ABBOTT LABORATORIES * 10/25/16 MC HARGUE, JAMES P LAW OFF 1059 16WC 36615 PANDO, ALLEN E FEDEX * 11/14/16 FRANKS & RECKENBERG 1060 16WC 36684 TOW, CONSTANCE CLUB DEMONSTRATION SERVIC * 06/17/15 DWORKIN AND MACIARIELLO 1061 16WC 36762 NERHEIM, JAY STEFFEN WAUKEGAN TIRE & SUPPLY * 10/19/16 LINN, CAMPE & RIZZO LTD 1062 16WC 36790 VEGA, BALOMERO WALMART * 01/02/16 MAURICE E DUSKY PC 1063 16WC 36838 BROCK, JEFFREY PAPA JOHN'S * 10/12/16 WOODRUFF & JOHNSON 1064 16WC 36873 ZWICKE, GARY ZION BENTON HS DISTRICT # * 02/04/16 NYHAN BAMBRICK KINZIE & LOWR 1065 16WC 36948 RIOS, MARCOS ROCCO FIORE & SONS, INC * 09/01/16 CULLEN HASKINS NICHOLSON 1066 16WC 37029 HAMIL, SHERRI WALMART * 09/05/16 MILLON & PESKIN LTD 1067 16WC 37205 GONZALEZ, ANTONIO THERMASEAL/LAKESIDE INSUL * 07/25/16 HANNIGAN & BOTHA, LTD 1068 16WC 37262 SALAZAR, JUAN QUALITY LABOR STAFFING * 08/19/16 DOUGLAS RALLO PC