ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 1 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 1 06WC 32768 HORSMAN, MATTHEW B POWELL CONSTRUCTION 08/30/03 HOPKINS & HUEBNER PC 2 07WC 38226 LOPEZ, MANUEL CAMPOS MUFFLER & BRAKE 01/11/07 3 09WC 27572 MARTINEZ DE NEVAREZ, GUAD TYSON FOODS 02/25/09 HOPKINS & HUEBNER PC GANAN & SHAPIRO 4 10WC 25114 MARTINEZ, JERONIMO MCLAUGHLIN BODY CO 06/22/09 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 10WC025115 -C 5 10WC 27034 JONES, JEREMY LUMEA STAFFING W 07/19/09 BLACK & JONES 6 10WC 28412 KINTZ, NIKKI DAN KOSTH D/B/A SPORTRONS 07/16/10 MALVIK, JOHN 7 10WC 38222 MCINTIRE, DENNIS J JOHN DEERE HARVESTER 03/26/08 AMES LAW OFFICES CALIFF & HARPER PC 8 10WC 39371 ESCAMILLA, ISRAEL THE BEDDING GROUP 02/02/09 HOPKINS & HUEBNER PC 9 11WC 09233 LANGE, JEREMY WURTH SERVICE SUPPLY 03/13/08 BARRICK SWITZER LONG ET AL KEEFE CAMPBELL & ASSOC LLC 10 11WC 22354 METTLER, JEANNINE STATE OF ILLINOIS @ 02/26/10 JAMES M RIDGE & ASSOC PC ASSISTANT ATTORNEY GENERAL 11 11WC 25338 SCHONE, RONALD IDOT DISTRICT 2 @ 02/02/11 JAMES M RIDGE & ASSOC PC ASSISTANT ATTORNEY GENERAL 11WC047515 -C 14WC027442 -C DEPARTMENT OF TRANSPORTATI 14WC033397 -C 15WC022871 -C DEPARTMENT OF TRANSPORTATI 12 11WC 28604 MARTINEZ DE NEVAREZ, GUAD TYSON FOODS 09/04/09 HOPKINS & HUEBNER PC GANAN & SHAPIRO 13 11WC 35982 MILBY, ELIZABETH E CJ SCOTTS INC DBA 12/03/10 AMES LAW OFFICES LAW OFFICES JOSEPH MARCINIAK 11WC040569 -C C.J. SCOTTS D/B/A DAIRY QU 14 11WC 39181 SMALL, GWENDOLYN HOPE CREEK 09/08/11 GOLDSTEIN BENDER & ROMANOF STATES ATTY OF ROCK ISLAND 11WC043250 -C 12WC029382 -C 15 11WC 45513 SABIEL, AMKALSOUM TYSON FRESH MEATS INC 03/15/11 LEADERS LAW CENTER LLC GANAN & SHAPIRO 16 12WC 11097 GREENO, MICHAL W STERLING RAIL SERVICE 10/12/11 MERTES & MERTES PC BRADY, CONNOLLY & MASUDA, PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 2 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 17 12WC 18370 CASEY, LAWRENCE J COLONY BRANDS INC 11/01/11 THOMAS R LICHTEN WOLFE & JACOBSON, LTD 18 12WC 21707 TASSIKE, ABALA KOMA TYSON FRESH MEATS INC 07/13/11 LEADERS LAW CENTER LLC GANAN & SHAPIRO 19 12WC 22579 BEESON, MARK KINSETH HOTEL CORP 05/10/12 KATZ HUNTOON & FIEWEGER P HOLECEK & ASSOCIATES 12WC022580 -C 20 12WC 23610 GORDON, JIM HOLM INDUSTRIES INC 04/19/12 LAW OFFICE DAVID HUNT WIEDNER & MCAULIFFE LTD 12WC023611 -C 21 12WC 27062 PUSKAR, JOHN M JENSEN CONSTRUCTION 05/18/12 STEPHENS FIDDES MCGILL ASS 22 12WC 27763 DEAN, ROBERT E EXPORT PACKAGING CO, INC 05/30/12 KATZ HUNTOON & FIEWEGER P RUSIN & MACIOROWSKI LTD 23 12WC 29912 BRODY, MATTHEW P AG FAB LLC W 10/19/11 JAMES M RIDGE & ASSOC PC ASSISTANT ATTORNEY GENERAL 12WC029913 -C 24 12WC 40583 JENNINGS, CHADWICK JOHN DEERE HARVESTER 01/24/12 BELCHER LAW OFFICE CALIFF & HARPER PC 12WC040663 -C 25 13WC 03467 FLORES, JOSE XPAC 07/09/12 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 26 13WC 08393 ALI, PAMELA MCLAUGHLIN BODY CO 01/14/13 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 27 13WC 09536 19B WILDERMUTH, BRADLEY T ABF FREIGHT SYSTEMS INC 01/09/12 AMES LAW OFFICES KEEFE CAMPBELL & ASSOC LLC 28 13WC 10656 HALEY, DANIEL EAST MOLINE FIRE DEPT 04/01/10 THOMAS W DUDA MCCARTHY, CALLAS & FEENEY PC 29 13WC 10811 HALEY, DANIEL EAST MOLINE FIRE DEPARTME 04/02/10 THOMAS W DUDA MCCARTHY, CALLAS & FEENEY PC 30 13WC 11688 ADAMS, DANIEL ROCK ISLAND SCHOOL DIST 10/06/11 WINSTEIN KAVENSKY & WALLAC INMAN & FITZGIBBONS 13WC012074 -C 31 13WC 14499 HOLLANDER, VICKI M ARAMARK CORP 02/25/13 KATZ HUNTOON & FIEWEGER P STONE & JOHNSON CHARTERED 32 13WC 17314 SEGNERI, ALFRED UNITED ELECTRIC 01/24/12 TURNER & SACKETT LLC NYHAN BAMBRICK KINZIE & LOWR 33 13WC 18979 MANSARAY, WANDA A SAL FAMILY & COMMUNITY SV 11/01/12 KATZ HUNTOON & FIEWEGER P

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 3 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 34 13WC 19079 19B JONES, RHONDA SBM BUSINESS EQUIPMENT 12/21/12 WOLFE LAW PC HEYL ROYSTER VOELKER & ALLEN 35 13WC 28127 WEST, PAULA A WALMART DISTRIBUTING CENT 08/15/09 RIDGE & DOWNES LLC QUINTAIROS PRIETO WOOD & BOY 36 13WC 29165 SHELDON, DEBBIE JOHN DEERE 09/10/10 MARSZALEK AND MARSZALEK CALIFF & HARPER PC 37 13WC 30265 BARDONER, JENNIFER JOHN DEERE CYLINDER AND 12/15/12 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 13WC030266 -C 14WC021668 -C 15WC023198 -C 38 13WC 31416 MEYER, AMY E CITY OF STERLING/STERLING 07/27/13 MERTES & MERTES PC ANCEL GLINK DIAMOND BUSH & E 39 13WC 31582 MEYER, AMY E CITY OF STERLING/STERLING 02/19/11 MERTES & MERTES PC ANCEL GLINK DIAMOND BUSH & E 40 13WC 33168 SHOWALTER, SCOTT JOHN DEERE HARVESTER WORK 05/02/12 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 13WC037262 -C 13WC037263 -C 41 13WC 35502 MARTINEZ, JERONIMO MCLAUGHLIN BODY COMPANY 07/13/13 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 42 13WC 38029 FETTERER, SAMANTHA TRIANGLE INN 12/27/12 HOPKINS & HUEBNER PC RUSIN & MACIOROWSKI LTD 43 13WC 39049 LANE, TIMOTHY ILLINOIS YOUTH CENTER KEW @ 04/11/13 RIDGE & DOWNES LLC ASSISTANT ATTORNEY GENERAL 44 14WC 05481 ALEXANDER, STEVE J MAZEL & CO 01/02/14 MERTES & MERTES PC BRADY, CONNOLLY & MASUDA, PC 45 14WC 16746 WILKEN, KATHLEEN STATE OF IL @ 02/19/14 HAUSER LAW LLC ASSISTANT ATTORNEY GENERAL 46 14WC 18134 DOMINGUEZ, NATASHA UNITY POINT TRINITY 03/14/14 WARNER & ZIMMERLE CALIFF & HARPER PC 47 14WC 18444 PASSNO, AMANDA TYSON FRESH MEATS INC 08/13/13 ELFENBAUM EVERS & AMARILIO BRYCE DOWNEY & LENKOV LLC 48 14WC 18819 THOMPSON, CAROL WAL-MART ASSOCIATES INC 02/07/14 KATZ HUNTOON & FIEWEGER P 49 14WC 18857 FITZSIMMONS, ROB HARTLAND CONTROLS 01/24/14 BLACK & JONES RUSIN & MACIOROWSKI LTD 50 14WC 19188 EWING, WILLIAM MCLAUGHLIN BODY COMPANY 02/28/14 RIDGE & DOWNES RUSIN & MACIOROWSKI LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 4 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 51 14WC 20418 MEERDINK, KARIA SMITHFIELD FOODS, INC. 03/19/14 WINSTEIN KAVENSKY & WALLAC STEPHEN P. KELLY 52 14WC 21105 AVALOS, JOSE TYSON FRESH MEATS INC 01/15/14 ELFENBAUM EVERS & AMARILIO GANAN & SHAPIRO 53 14WC 22195 BOGGS, HERMAN E JR COUNTY WASTE SYSTEMS, INC W 03/02/14 KATZ HUNTOON & FIEWEGER P 14WC022196 -C JAMES L WATTS DBA 14WC022197 -C 14WC022198 -C JAMES L WATTS DBA 54 14WC 23044 BLACK, JIMMY JOHN DEERE HARVESTER 06/05/13 ANKIN LAW OFFICE BOZEMAN NEIGHBOUR PATTON & N 14WC041179 -C 14WC041180 -C 55 14WC 31835 RUSSELL, DONNA MANPOWER 08/12/14 BLACK & JONES GOLDBERG SEGALLA LLC 56 14WC 35241 BURKE, AUSTIN INPRO SEAL 08/13/14 WINSTEIN KAVENSKY & WALLAC COZZI & GOGGIN-WARD 57 14WC 35917 RAUSCH, CANDY L WALMART STORES INC 08/15/14 KATZ HUNTOON & FIEWEGER P 58 14WC 38383 ARNOLDUSSEN, JOHN OLD BLUE ILLINOIS, INC. 09/20/14 REHN LAW LLC HEYL ROYSTER VOELKER & ALLEN 59 14WC 40813 BROWNFIELD, MATT BOLDT MECHANICAL 11/13/14 WILLIAMS & SWEE RUSIN & MACIOROWSKI LTD 60 14WC 42454 MAXWELL, DIANE UNIVERSITY OF ILLINOIS 07/14/14 LAW OFFICE OF CHRIS DOSCOT GANAN & SHAPIRO 61 15WC 00311 BELEIN, SAWSAN T TYSON FOODS INC 08/28/13 BUDIN LAW OFFICES GANAN & SHAPIRO 62 15WC 00369 MAY, DAVID E PEOPLELINK STAFFING SOLUT 06/18/14 MARSZALEK AND MARSZALEK LAW OFFICES FRANCESCA LARSEN 63 15WC 00926 REED, LISA ST OF IL DEPT OF ILLINOIS @ 11/18/14 RIDGE & DOWNES LLC ASSISTANT ATTORNEY GENERAL 64 15WC 01286 WILKINSON, APRIL ACHIEVEMENT UNLIMITED INC 08/26/14 REHN LAW LLC GANAN & SHAPIRO 65 15WC 02822 EDWARDS, RAYMOND JOHN DEERE HARVESTER 08/12/13 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 66 15WC 03286 KOUE-ADJA, AKOSSIWA TYSON FRESH MEATS 04/08/14 CROWLEY & PRILL GANAN & SHAPIRO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 5 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 67 15WC 06301 JOHNSTON, BRUCE XPAC 02/03/15 DWORKIN AND MACIARIELLO RUSIN & MACIOROWSKI LTD 68 15WC 06818 EL-MAJDOUBI, AHMED XPAC 02/26/14 WARNER & ZIMMERLE RUSIN & MACIOROWSKI LTD 15WC038241 -C 69 15WC 07624 TEMPLETON, HOLLYWOOD WALTER BRAUD, CHIEF JUDGE 03/21/12 KATZ HUNTOON & FIEWEGER P 70 15WC 08485 SEDAM, FRANNIE VALSPAR CORPORATION 11/24/14 HOPKINS & HUEBNER PC RUSIN & MACIOROWSKI LTD 15WC017842 -C THE VALSPAR CORPORATION 71 15WC 09160 PEREZ, ANTONIO D JR RELATED MANAGEMENT CO DBA 11/21/14 JOHN LESAGANICH RIPES NELSON BAGGOT KALOBRAT 15WC009325 -C 72 15WC 09733 DELOOSE, GERALD JOHN DEERE CYLINDER 04/17/14 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 73 15WC 10123 SEKAZ, MICHAEL QUICKWAY DISTRIBUTION SER 12/20/12 GLASS & KOREIN GRANT & FANNING 74 15WC 10335 MILLER, RICKY J. PRECISION LASER ALIGNMENT 11/26/12 HOPKINS & HUEBNER PC LAW OFFICE PATRICK JENNETTEN 75 15WC 10693 VEGA, MARIO FARMLAND FOODS INC 02/06/15 HOPKINS & HUEBNER PC 76 15WC 10889 BUSHMAN, DAVID A STERLING RAIL SERVICES LL 07/28/14 REESE & REESE RODDY LAW LTD 16WC036618 -C 77 15WC 13643 APPENZELLER, TIMOTHY UPM RAFLATAC 04/23/12 HORWITZ HORWITZ & ASSOC WOLFE & JACOBSON, LTD 78 15WC 14421 TRANSOU, JASON ILLINOIS YOUTH CTR - KEWA @ 02/20/15 RIDGE & DOWNES ASSISTANT ATTORNEY GENERAL 79 15WC 16488 PEREZ, APOLONIA FARMLAND FOODS 08/06/14 VANDERGINST LAW PC STEPHEN P. KELLY 80 15WC 17117 WAGLER, BLAINE CON WAY FEIGHT 04/15/15 WINSTEIN KAVENSKY & WALLAC GAROFALO SCHREIBER STORM 81 15WC 18293 SMALL, GWENDOLYN HOPE CREEK CARE CENTER 06/11/14 GOLDSTEIN BENDER & ROMANOF BROOKS LAW FIRM 82 15WC 18409 SWANSON, KEN IFH GROUP 04/01/15 DWORKIN AND MACIARIELLO 83 15WC 18999 D'AGOSTIN, SPENCER MJ ELECTRIC LLC 03/13/15 HEDEEN, MICHAEL J PC RUSIN & MACIOROWSKI LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 6 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 84 15WC 20379 WHEELER, MICHAEL DEERE HARVESTER 12/14/10 VANDERGINST LAW PC BOZEMAN NEIGHBOUR PATTON & N 85 15WC 21271 MOTZ, KRISTIN XPAC PACKAGING 04/15/15 SAUNDERS CONDON & KENNY RUSIN & MACIOROWSKI LTD 86 15WC 21374 WOOD, ADAM JOHN DEERE HARVESTER WORK 02/13/15 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 87 15WC 21433 CRAWFORD, MICHELLE A IOWA PHYSICIANS CLINIC 01/10/14 KATZ HUNTOON & FIEWEGER P BETTY NEUMAN & MCMAHON 88 15WC 22086 COOK, AMBER HEIRLOOM CAFE 05/23/15 PIGNATELLI & ASSOCIATES RUSIN & MACIOROWSKI LTD 89 15WC 22740 PUGA, JAIME TYSON FRESH MEATSINC 03/23/15 GANAN & SHAPIRO 90 15WC 25654 CHAVEZ, JUAN STERLING RAIL SERVICES 08/19/13 REESE & REESE RODDY LAW LTD 91 15WC 26370 FOSTER, YAKISHA (GUARDIAN KFC 07/14/15 KEYS LAW OFFICES COZZI & GOGGIN-WARD 92 15WC 27525 ALI, PAMELA MCLAUGHLIN BODY CO 06/30/15 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 93 15WC 28416 ALLEN, ERIC ILLINOIS YOUTH CENTER KEW @ 08/23/15 RIDGE & DOWNES ASSISTANT ATTORNEY GENERAL 94 15WC 28524 ADAMS, ROBERT JOHN DEERE PARTS 01/01/15 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 16WC011812 -C 95 15WC 30056 KLINGAMAN, JEREMY DOHRN TRANSFER CO. 06/17/15 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 96 15WC 30203 DAVIS, TERRY L FARMLAND FOODS 10/15/14 REHN LAW LLC STEPHEN P. KELLY 97 15WC 30305 HARTMAN, JAMES K EXELON NUCLEAR SECURITY, 08/19/14 KATZ HUNTOON & FIEWEGER P HENNESSY & ROACH PC 18WC008637 -C 98 15WC 31110 HARPER, FRANCISCO JETCO INC 06/16/13 O'CONNOR & NAKOS 99 15WC 33446 MC GEE, STACEY R ILLINOIS YOUTH CENTER KEW @ 08/29/15 RIDGE & DOWNES ASSISTANT ATTORNEY GENERAL 100 15WC 33822 DOMINGUEZ, JOEL TYSON FOODS, INC 11/09/12 HOPKINS & HUEBNER PC BRYCE DOWNEY & LENKOV LLC 101 15WC 34580 MARISCAL, ANTONIO METO KOTE CORP 01/16/15 KNELL LAW LLC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 7 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 102 15WC 34818 FLYNN, AMANDA XPAC 09/04/16 DWORKIN AND MACIARIELLO RUSIN & MACIOROWSKI LTD 103 15WC 34879 CERVANTES, JORGE MICRO INDUSTRIES 10/13/15 PIGNATELLI & ASSOCIATES HENNESSY & ROACH PC 104 15WC 35720 MASSAROLO, ANGELA WAL-MART STORES, INC 10/04/15 WINSTEIN KAVENSKY & WALLAC QUINTAIROS PRIETO WOOD & BOY 105 15WC 35806 MATHRE, RICHARD IL DEPT OF AGRICULTURE @ 03/17/15 LEE, MARK N LAW OFFICE 106 15WC 37670 BOLIO, WILLIAM JOHN DEERE SEEDING GROUP 10/12/15 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 107 15WC 38478 WARD, PATRICIA A DIDOUGH'S PRETZEL 01/31/15 MERTES & MERTES PC NYHAN BAMBRICK KINZIE & LOWR 108 15WC 38497 COVEMAKER, MICHAEL DEERE & COMPANY - JOHN DE 04/01/93 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 109 15WC 38600 ANDERSON, WES LEGGETT & PLATT 08/31/15 CAPRON & AVGERINOS PC RUSIN & MACIOROWSKI LTD 110 15WC 39841 SWARTS, DARREL W TYSON FRESH MEATS INC 09/15/15 KATZ HUNTOON & FIEWEGER P GANAN & SHAPIRO 111 15WC 39888 MEDHURST F/K/A MAGEE, KER ROSEWOOD ADMINISTRATIVE 04/19/15 REHN LAW LLC RUSIN & MACIOROWSKI LTD 16WC006417 -C 112 15WC 42090 MARTINEZ, JOSE JIM GIESE COMMERCIAL RFG 08/26/15 HOPKINS & HUEBNER PC KNELL & O'CONNOR 113 16WC 01785 YOSAIF, ZAYNAB TYSON FOODS INC 06/26/13 GOLDSTEIN BENDER & ROMANOF GANAN & SHAPIRO 16WC001786 -C 114 16WC 01945 MUNTHER, PAULA JOHNSONS OIL INC 10/17/14 STRONG LAW OFFICE CAPUANI, FRANK S 115 16WC 02081 HAJOSTEK, JERRILYN GATES CORPORATION 08/01/15 BROOKS LAW FIRM QUINTAIROS PRIETO WOOD & BOY 116 16WC 02116 MARTH, MICHAEL COLONY BRANDS INC 12/10/15 HORWITZ HORWITZ & ASSOC WOLFE & JACOBSON, LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 8 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 117 16WC 02309 HAAN, DARREN JOHN DEERE HARVESTER 01/17/13 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 118 16WC 04479 MAYES, DAVID REPUBLIC SERVICES INC 08/15/14 RIDGE & DOWNES GILDEA & COGHLAN 16WC004480 -C 16WC004481 -C 119 16WC 05097 WENDELL, JEFFREY TYSON FOODS INC 08/19/15 GOLDBERG WEISMAN & CAIRO L BRYCE DOWNEY & LENKOV LLC 120 16WC 05291 LEWIS, KEITH APPELL EQUIPMENT SALES & 12/19/15 LEFANTE LAW OFFICES COZZI & GOGGIN-WARD 121 16WC 05384 HERMEYER, KIRBY OSCAR J. BOLDT 02/03/14 MEYERS & FLOWERS RUSIN & MACIOROWSKI LTD 122 16WC 05744 LAMANTIA-MC FARLAND, KARE ALDI 03/06/14 WINSTEIN KAVENSKY & WALLAC BRADY, CONNOLLY & MASUDA, PC 16WC005745 -C 123 16WC 06426 DESCHEPPER, LISA GALESBURG COTTAGE HOSPITA 08/15/15 GOLDBERG WEISMAN & CAIRO L WIEDNER & MCAULIFFE LTD 16WC006427 -C 124 16WC 06598 HAHN, DAN DEERE & COMPANY INC/JOHN 01/28/16 SCHWEICKERT & GANASSIN LANE & WATERMAN 125 16WC 07043 JORDAN, SUSAN ARAMAK UNIFORM SERVICES 01/13/16 WINSTEIN KAVENSKY & WALLAC INMAN & FITZGIBBONS 126 16WC 07119 DURAN, ROSA ST OF IL DEPT OF CORRECTI @ 01/14/16 PIGNATELLI & ASSOCIATES KRISTINA D DION 127 16WC 07741 MEDRANO, JUAN RG CONSTRUCTION SERVICES 11/24/15 GOLDBERG WEISMAN & CAIRO L MACIOROWSKI SACKMANN & ULRIC 128 16WC 08101 MILLER, JAMES R ROCK ISLAND COUNTY 02/24/16 RIDGE & DOWNES BROOKS LAW FIRM 129 16WC 08257 AMOUZOU, AMIVI FARMLAND FOODS 12/23/15 WINSTEIN KAVENSKY & WALLAC STEPHEN P. KELLY 130 16WC 08373 HAAN, DARREN JOHN DEEREHARVESTER 08/03/15 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 131 16WC 08376 HAAN, DARREN JOHN DEERE HARVESTER 11/05/15 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 132 16WC 08557 LEAL, RALPH A ROCK RIVER CARTHAGE, INC 04/10/15 MERTES & MERTES PC RUSIN & MACIOROWSKI LTD 133 16WC 08564 WHITELY, BRAD J STERLING CHEVROLET 11/12/15 MERTES & MERTES PC INMAN & FITZGIBBONS

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 9 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 134 16WC 08915 HASTINGS, GAIL MCLAUGHLIN BODY 10/14/15 CAPRON & AVGERINOS PC RUSIN & MACIOROWSKI LTD 135 16WC 09408 MESSER, EARL LEON COOKS QUICK LUBE & AUTO R W 03/03/16 WOODRUFF & JOHNSON WARD MURRAY PACE & JOHNSON P 136 16WC 09665 DECRANE KAHA, SAMANTHA L. HYVEE, INC. 07/21/13 VANDERGINST LAW PC HOPKINS & HUEBNER PC 137 16WC 09811 HELLE, ROBYN KNOX COUNTY NURSING HOME 10/20/15 REHN & SKINNER LLC BUSH MOTTO CREEN KOURY 138 16WC 10657 ROCKWELL, SHELLEY JOHN DEERE HARVESTER 07/20/15 MARSZALEK AND MARSZALEK CALIFF & HARPER PC 139 16WC 10729 MILES, CASSANDRA M ROCK ISLAND COUNTY 12/31/14 VANDERGINST LAW PC BROOKS LAW FIRM 140 16WC 11353 CEDENO, RAMIRO JOHN DEERE HARVESTER 06/03/15 DWORKIN AND MACIARIELLO CALIFF & HARPER PC 141 16WC 12073 PUGA, JAIME TYSON FRESH MEATS, INC. 03/23/15 GANAN & SHAPIRO 142 16WC 12236 LIBERG, MATTHEW T RESCAR 02/01/16 THOMAS R LICHTEN INMAN & FITZGIBBONS 143 16WC 12322 FATAH, ABDI TYSON FRESH MEATS, INC 09/05/14 GANAN & SHAPIRO 144 16WC 12489 JENKINS, CORY MCLAUGHLIN BODY COMPANY 02/29/16 WINSTEIN KAVENSKY & WALLAC RUSIN & MACIOROWSKI LTD 145 16WC 12868 EDWARDS, TERRY JOHN DEERE 11/25/15 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 146 16WC 12892 CASEY, THOMAS F III CF INDUSTRIES 02/20/14 KATZ HUNTOON & FIEWEGER P NYHAN BAMBRICK KINZIE & LOWR 16WC012893 -C 147 16WC 13384 ALLISON, CHRISTINA JOHN DEERE HARVESTER WORK 03/06/13 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 148 16WC 13960 WEST, ANDREW W CITY OF ROCK ISLAND 11/04/15 THOMAS W DUDA BETTY NEUMAN & MCMAHON 149 16WC 14405 REID, AMANDA L. C.R. ENGLAND, INC. 12/17/15 MERTES & MERTES PC SPIEGEL & CAHILL, PC 150 16WC 14612 KOVE-ADJA, AKOSSIWA TYSON FRESH MEATS INC 08/11/14 CROWLEY & PRILL GANAN & SHAPIRO 151 16WC 15922 HASSAN, HALIMA TYSON FOODS, INC. 05/02/12 WINSTEIN KAVENSKY & WALLAC BRYCE DOWNEY & LENKOV LLC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 10 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 152 16WC 15947 DAVIS, JOSHUA ILLINOIS DEPT OF CORRECTI @ 04/02/16 REHN & SKINNER LLC KRISTINA D DION 153 16WC 16541 SEGAR, KARLA JOHN DEERE HARVESTER 09/09/15 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 154 16WC 16560 FAMUTIMI, IDA TYSON FOODS, INC 06/11/15 WINSTEIN KAVENSKY & WALLAC BRYCE DOWNEY & LENKOV LLC 155 16WC 17063 THOMPSON, CINDY GENESIS MEDICQAL CENTER A 03/25/16 WINSTEIN KAVENSKY & WALLAC HOPKINS & HUEBNER PC 156 16WC 17759 VALDEZ, TEOFILO K&M EQUIPMENT, INC 01/24/11 BROOKS LAW FIRM GRANT & FANNING 157 16WC 17854 DEWITH, ENYO CITY OF ROCK ISLAND 06/23/13 THOMAS W DUDA 158 16WC 18905 DETMERS, PAUL FARMLAND FOODS 04/07/15 SIMPSON PETERSON STEPHEN P. KELLY 159 16WC 19639 DI KANDA, HENRY FARMLAND FOODS, INC 12/18/13 WOODRUFF & JOHNSON STEPHEN P. KELLY 160 16WC 20735 MCKENNA, TERRY A MALCOLM DRILLING CO INC 05/25/16 REESE & REESE COZZI & GOGGIN-WARD 161 16WC 20994 CLARK, KENNETH E WAL-MART DIST CENTER 11/07/15 MERTES & MERTES PC QUINTAIROS PRIETO WOOD & BOY 162 16WC 21827 MONTIEL, ALEXANDER WAHL CLIPPER 03/01/16 BLACK & JONES HEYL ROYSTER VOELKER & ALLEN 163 16WC 21881 FRANK, DALE JOHN DEERE HARVESTER 12/15/15 MARSZALEK AND MARSZALEK BOZEMAN NEIGHBOUR PATTON & N 164 16WC 22495 BECK, PAMELA WAHL CLIPPER CORPORATION 02/03/16 HORWITZ HORWITZ & ASSOC HEYL ROYSTER VOELKER & ALLEN 165 16WC 23146 MINI, AARON CHICAGO BRIDGE & IRON CO 03/14/16 SCHWEICKERT & GANASSIN RIPES NELSON BAGGOT KALOBRAT 166 16WC 23757 JOHNSON, DANNY K SMITHFIELD FOODS INC 01/02/15 JOHN LESAGANICH 167 16WC 24195 PATEL, JIM DLZ CONSTRUCTION 07/22/16 SEIDMAN MARGULIS & FAIRMAN 168 16WC 24572 BUCKINGHAM, LISA WAL-MART DISTRIBUTION CEN 04/08/16 MARTIN V KUGIA QUINTAIROS PRIETO WOOD & BOY 169 16WC 24621 DRAPER, JAYME BUILDERS SALES & SERVICE 02/16/16 PATRICK JENNETTEN

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 11 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 170 16WC 25134 ROBERTS, ZACHARY ANTON BAYER MILLWRIGHT 08/10/16 DWORKIN AND MACIARIELLO LOSS & PAVONE 171 16WC 25359 THARP, KENNETH I. JR. KENNY THARP MASONRY 11/06/15 BUSH MOTTO CREEN KOURY BRADY CONNOLLY & MASUDA PC 172 16WC 25619 BEAL, JOSEPHINE GOOD SAMARITAN NURSING HO 04/23/16 CAPRON & AVGERINOS PC GAROFALO SCHREIBER STORM 173 16WC 26431 FASSIG, MATTHEW AREA MECHANICAL INC. 08/05/16 LEE, MARK N LAW OFFICE WIEDNER & MCAULIFFE LTD 174 16WC 27760 STOLL, LESLIE ICW GROUP HOLDINGS, INC 04/01/15 CLARK FROST HOLTKAMP LIESE ET AL 175 16WC 28103 DAY, THADDEUS ELITE STAFFING 06/16/16 DWORKIN AND MACIARIELLO 176 16WC 28169 FERGUSON, ANGELA JOHN DEERE HARVESTER WORK 03/09/15 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 177 16WC 28658 WHITE, BRIAN J COCA COLA REFRESHMENTS, I 01/07/15 VANDERGINST LAW PC BRADY, CONNOLLY & MASUDA, PC 178 16WC 29061 NACHE, MICHAEL SR EBY-BROWN CO 05/08/15 BOSHARDY LAW OFFICE PC COZZI & GOGGIN-WARD 179 16WC 29087 PORSCHKE, CORRINA APERION CARE INC 06/25/16 VANDERGINST LAW PC 16WC029228 -C 180 16WC 29142 KONEN, GARY R DABNEY TRUCKING, INC 04/05/16 THOMSON & WEINTRAUB NYHAN BAMBRICK KINZIE & LOWR 181 16WC 29155 TAFLINGER, BRAD JOHN DEERE 06/24/14 STEPHEN P. KELLY CALIFF & HARPER PC 182 16WC 29918 KAGEE, RANDY JOHN DEERE SEEDING GROUP 09/16/16 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 183 16WC 29981 HILL, JAMES VERN'S FARM SUPPLY 04/14/16 CRONAUER, CHARLES E RODDY LAW LTD 184 16WC 30122 NEULEIB, LADONNA JOHN DEERE 08/18/16 MARSZALEK AND MARSZALEK CALIFF & HARPER PC 185 16WC 30151 HUSSEIN, TAREQ JUMER'S CASINO & HOTEL 05/21/16 WARREN E DANZ, PC HOLECEK & ASSOCIATES 186 16WC 30171 STACH, STUART XPAC 09/09/16 HARVEY & STUCKEL RUSIN & MACIOROWSKI LTD 187 16WC 30317 ROBINSON, CARLOS TYSON FRESH MEATS 09/15/16 DWORKIN AND MACIARIELLO GANAN & SHAPIRO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 12 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 188 16WC 30560 HAMM, LENDON J LKQ CORP D/B/A KEYSTONE 06/06/16 KATZ HUNTOON & FIEWEGER P BRYCE DOWNEY & LENKOV LLC 189 16WC 31566 MORRIS, PHILLIP DICK BLICK ART MATERIALS 05/13/16 JAY H JANSSEN LAW OFFICES JOSEPH MARCINIAK 190 16WC 31720 QAMHI, NAWAL TYSON FOODS INC 09/26/13 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 16WC031724 -C 16WC031725 -C 17WC012473 -C 191 16WC 32330 SEXTON, ANDREW JACK'S BRAKE & ALIGNMENT 03/18/16 RODDY LAW LTD 192 16WC 32422 BRANDT, MEREDITH EAST MOLINE SCHOOL 09/26/16 KATZ FRIEDMAN EAGLE ET AL 193 16WC 32751 CHAVEZ, LINDA XPAC 06/19/14 VANDERGINST LAW PC RUSIN & MACIOROWSKI LTD 16WC032754 -C 194 16WC 32911 CAMPEN, DEREK J CORPORATE SERVICES, INC 08/16/16 195 16WC 33408 BUCKINGHAM, LISA WALMART DISTRIBUTION CTR 04/08/16 MARTIN V KUGIA QUINTAIROS PRIETO WOOD & BOY 196 16WC 34488 ALFREDM EDELYN NAVIGATION INC 09/17/16 BRISKMAN BRISKMAN GREENBER 197 16WC 35763 ROSALES, LIZBETH GREAT DANE TRAILERS 12/09/15 SPIEGEL & CAHILL, PC 198 16WC 37093 SMITH, CLARISSA WALMART DC 11/01/16 BLACK & JONES QUINTAIROS PRIETO WOOD & BOY 199 16WC 37247 PARKS, LARRY JOHN DEERE HARVESTER 01/16/14 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 200 16WC 37828 OLSON, JACKLYN K WEST CENTRAL CUSD #235 08/31/16 THOMAS E CADY MACIOROWSKI SACKMANN & ULRIC 201 16WC 38642 MORRISSEY, WAYNE ANTHONY EUCLID BEVERAGE LLC 01/05/16 REHN LAW LLC ROBERT L. SMITH 202 16WC 38812 CURTIS, NEIL ILLINOIS DEPARTMENT OF IL 12/12/16 DWORKIN AND MACIARIELLO 203 17WC 01386 EASLEY, KIMBERLY WINNIGN WHEELS INC 01/13/17 DWORKIN AND MACIARIELLO 204 17WC 01529 19B BABERS, BEVERLY S ALDI INC 07/07/16 THOMAS E CADY BRADY, CONNOLLY & MASUDA, PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 13 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 205 17WC 01670 CASTANEDA-VALDEZ, ANGEL LA LEASING, INC DBA 09/23/16 THOMAS E CADY BETTY NEUMAN & MCMAHON 206 17WC 01930 VAN VOLTENBURG, DEANNA MILLER CONTAINER CORPORAT 11/30/16 WARNER & ZIMMERLE 207 17WC 02008 PETERSON, SHAWN STATE OF ILLINOIS - IDOT @ 10/28/14 JOHN LESAGANICH 208 17WC 02107 KLASSEN, CRAIG WEST ROCK 10/24/16 CROWLEY & PRILL SPIEGEL & CAHILL, PC 209 17WC 02120 19B SCOTT, CYNTHIA ANNAWAN SD UNIT 226 02/24/15 CAPRON & AVGERINOS PC ROSARIO CIBELLA 210 17WC 02379 CARDER, THOMAS A GATES CORPORATION 01/09/17 SIMPSON PETERSON 211 17WC 02963 LOHF, AMYRELIS TYSON FOODS, INC 06/06/16 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 212 17WC 03007 JOHNSON, JOHN JOHN DEERE HARVESTER 03/10/14 CAPRON & AVGERINOS PC CALIFF & HARPER PC 213 17WC 03053 ROYSE, JEFFREY JOHN DEERE HARVESTER WORK 01/19/16 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 214 17WC 03085 RUSSELL, TYLER MARTIN ENGINEERING 10/17/16 HORWITZ HORWITZ & ASSOC INMAN & FITZGIBBONS 215 17WC 03285 MILLER, RICKY J PRECISION LASER ALIGNMENT 12/01/15 HOPKINS & HUEBNER PC 216 17WC 03430 ADAMS, PATRICIA WALMART SUPERCENTER #2231 11/09/16 RIDGE & DOWNES QUINTAIROS PRIETO WOOD & BOY 217 17WC 03615 MATTHEWS, TAQUANA JOHN DEERE HARVESTER 02/01/14 DONOVAN ROBERTSON CALIFF & HARPER PC 218 17WC 04475 MELTON, JAMES W WHITESIDE COUNTY 12/12/16 MERTES & MERTES PC HEYL ROYSTER VOELKER & ALLEN 219 17WC 04917 PAGE, JOHN F&W TRANSPORT 11/16/16 GALANTI LAW OFFICES 220 17WC 05609 EDWARDS, TERRY JOHN DEERE HARVESTER WORK 08/01/16 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 221 17WC 05748 FOX, JOSEPH EAST MOLINE CORRECTIONAL 11/15/16 PETER F FERRACUTI & ASSOCI ASSISTANT ATTORNEY GENERAL 222 17WC 06032 SAMPSON, JIM O CGH MEDICAL CENTER 01/16/17 MERTES & MERTES PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 14 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 223 17WC 06099 STAHLER, JON KURT HAWKEYE BUILDING DISTRIBU 11/12/15 BUSH MOTTO CREEN KOURY INMAN & FITZGIBBONS 224 17WC 06525 MCDANEL, MICHAEL JOHN DEERE HARVESTER 02/02/17 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 225 17WC 06707 HILL, PEGGY L THE SALVATION ARMY 07/26/16 THOMAS E CADY RODDY LAW LTD 226 17WC 06989 AKPLA, AMA TYSON FOODS INC 07/09/16 STRONG LAW OFFICE GANAN & SHAPIRO 227 17WC 07019 OGOUBI, AFI TYSON FRESH MEATS INC 02/28/17 LEADERS LAW CENTER LLC 228 17WC 07185 BENT, RHONDA FAIRFIELD INN & SUITES 02/10/17 GOLDFINE & BOWLES COZZI & GOGGIN-WARD 229 17WC 07392 COOK, MICHAEL WAYNE STOHL & SONS PLASTE 07/21/16 STENGEL BAILEY ROBERTSON RODDY LAW LTD 230 17WC 07487 STEWART, ANGELA JOHN DEERE HARVESTER 06/01/16 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 231 17WC 07500 STEWART, ANGELA JOHN DEERE HARVESTER 05/02/14 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 232 17WC 07526 POLK, RUEBEN TYSON FRESH MEATS, INC. 10/03/16 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 233 17WC 07835 HUSKEY, RANDAL ROCK ISLAND MILAN 03/23/16 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 234 17WC 08973 ROOS, STEPHANIE FBG SERVICE CORPORATION 11/02/16 WINSTEIN KAVENSKY & WALLAC HOLECEK & ASSOCIATES 235 17WC 09091 BONNER, MARUISA GENESIS HEALTH SYSTEM 08/05/16 THOMAS E CADY HOPKINS & HUEBNER PC 236 17WC 09833 TUTTLE, KENNETH O'REILLY AUTO PARTS 11/29/16 CAPRON & AVGERINOS PC HENNESSY & ROACH 237 17WC 10247 GALINDO-VAZQUEZ, BEATRIZ FARMLAND FOODS 03/01/17 LAW OFFICE DAVID HUNT STEPHEN P. KELLY 238 17WC 10458 CHEZEM, NICHOLAS WALMART DISTRIBUTION CENT 12/05/16 LAWFIRST QUINTAIROS PRIETO WOOD & BOY 239 17WC 10574 MAES, DEBRA CHS 11/01/16 WINSTEIN KAVENSKY & WALLAC BETTY NEUMAN & MCMAHON 240 17WC 10644 MORALES FLORES, VICTOR FE PERFORMANCE FOOD GROUPS 08/25/16 WOODRUFF & JOHNSON BRYCE DOWNEY & LENKOV LLC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 15 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 241 17WC 11318 GLOVER, WILLIAM ESSG 03/18/17 LAW OFFICE DAVID HUNT WIEDNER & MCAULIFFE LTD 242 17WC 11375 FREDERICK, JENNIFER APERION CARE 03/08/17 DWORKIN AND MACIARIELLO BRADY, CONNOLLY & MASUDA, PC 243 17WC 11688 KOVACS, JUSTIN QUAD CITY MALLAROS (ECHL) 02/17/17 FLOYD LAW FIRM INMAN & FITZGIBBONS 244 17WC 11776 EDWARDS, TERRY JOHN DEERE HARVESTER WORK 08/06/15 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 245 17WC 12101 THIESSEN, CARRY CHICAGO BRIDGE & IRON CO 04/04/17 HEALY SCANLON LAW FIRM RIPES NELSON BAGGOT KALOBRAT 246 17WC 12551 SPROUSE, STEVEN H HIRSCHBACH MOTOR LINES, I 03/21/16 BETTY NEUMAN & MCMAHON 247 17WC 12744 MILLARD, ANNA M HOPE CREEK CARE CENTER 02/16/16 ELFENBAUM EVERS & AMARILIO BROOKS LAW FIRM 248 17WC 13062 NIMMERS, MARCQUES PFG-THOMAS PROESTLER COMP 03/15/17 RIDGE & DOWNES INMAN & FITZGIBBONS 249 17WC 13676 SIMPSON, WAYNE FIRST STUDENT, INC 09/13/16 BLACK & JONES WIEDNER & MCAULIFFE LTD 250 17WC 14700 GORANSON, MICHAEL JOHN DEERE HARVESTER 01/03/17 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 251 17WC 14834 DECLERCK, JON UPS FREIGHT 03/29/17 MARKS INJURY LAW COZZI & GOGGIN-WARD 252 17WC 14953 PIERCE, JOSH JB EXCAVATING 07/20/15 GALANTI LAW OFFICES RODDY LAW LTD 253 17WC 14989 DOUMASHIE, AKU TYSON FOODS 05/30/14 WINSTEIN KAVENSKY & WALLAC BRYCE DOWNEY & LENKOV LLC 254 17WC 15047 KIVISTO, GRACE KCCDD 11/03/16 SIMPSON PETERSON 255 17WC 15504 PULLIAM, DERRICK BENNIGANS 02/10/17 WINSTEIN KAVENSKY & WALLAC COZZI & GOGGIN-WARD 256 17WC 15852 SCHMIDT, LEE MAINTENANCE AND MECHANICA 05/02/16 HOPKINS & HUEBNER PC CASSANO & ASSOCIATES 257 17WC 16080 BARNES, BRIAN L MAPES ASPHALT SVCS 05/03/16 WINSTEIN KAVENSKY & WALLAC COZZI & GOGGIN-WARD 17WC016081 -C 258 17WC 16095 MARTINEZ, GUILLERMINA TYSON FRESH MEATS, INC. 08/15/14 ANDREW BRIBRIESCO WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 16 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 259 17WC 16099 GETSON, PATTI VAN WESTERN ILLINOIS BROADCAS 08/08/15 VANDERGINST LAW PC HENNESSY & ROACH 260 17WC 16118 WILSON, LAURIE HEALTHCARE SERVICE GROUP 05/25/16 DWORKIN AND MACIARIELLO RUSIN & MACIOROWSKI LTD 261 17WC 16142 KOVACS, JUSTIN QUAD CITY MALLARDS 04/22/17 FLOYD LAW FIRM INMAN & FITZGIBBONS 262 17WC 16474 FRANKS, KATHY L FIRST STUDENT 05/19/17 REESE & REESE WIEDNER & MCAULIFFE LTD 263 17WC 16632 SHELEY, BRYNN JOHN DEERE PDC 05/12/17 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 264 17WC 16966 MCMAHON, GARY P XPO LOGISTICS FREIGHT 04/08/16 HARVEY & STUCKEL RUSIN & MACIOROWSKI LTD 265 17WC 17642 HADDOCK, COY CASEYS GENERAL 06/11/17 DWORKIN AND MACIARIELLO 266 17WC 17739 SCHEMEL, GERHARD ILLINOIS QUAD CITY CIVIC 03/23/17 BLACK & JONES 267 17WC 18105 MEDINA, RAYMOND JOHN DEERE PARTS 03/09/16 HOPKINS & HUEBNER PC CALIFF & HARPER PC 268 17WC 18979 GOOCH, CRYSTAL JOHNSON OIL 07/20/16 WARNER & ZIMMERLE 269 17WC 19200 RABE, FREDERICK BEST COB LLC 06/08/17 BLACK & JONES WIEDNER & MCAULIFFE LTD 270 17WC 19262 MOLER, JOHN BEACON ROOFING SUPPLY/ROO 02/03/16 LOGAN LAW HOLECEK & ASSOCIATES 271 17WC 19286 NAJERA FIGUEROA, JAVIER BELLOTA AGRISOLUTIONS 01/22/17 LOGAN LAW JOSEPH MARCINIAK 272 17WC 19370 TANNER, BRIAN HOSPICE SOURCE 04/06/17 DAVID W MARTAY 273 17WC 19511 VEAL, CELENA JOHN DEERE HARVESTER 06/09/17 HOPKINS & HUEBNER PC CALIFF & HARPER PC 274 17WC 20394 NAUGLE, SHARI KNOX COUNTY NURSING HOME 03/26/17 LEFANTE LAW OFFICES 275 17WC 20588 PEED, JASON TOM NELSON TRUCKING 06/02/17 WINSTEIN KAVENSKY & WALLAC 276 17WC 20713 MCGHEE, POWELL ROCK ISLAND/MILAN SCHOOL 09/15/16 MARSZALEK AND MARSZALEK

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 17 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 277 17WC 20890 BROWN, ERIC B MOLINE POLICE DEPT 01/10/14 RIDGE & DOWNES CALIFF & HARPER PC 278 17WC 20925 STEWART, JACOB ROCK ISLAND COUNTY HEALTH 04/21/17 TAXMAN POLLOCK 279 17WC 21003 WAYLAND, JESSE W III ROCK ISLAND HIGH SCHOOL 06/27/15 WINSTEIN KAVENSKY & WALLAC 280 17WC 21256 CROWE, RUSSELL MCDERMAID ROOFING & INSUL 06/19/17 HORWITZ HORWITZ & ASSOC BRADY, CONNOLLY & MASUDA, PC 281 17WC 21613 HARRISON, WILLIAM C IL DEPT OF EMPLOYMENT SEC @ 06/05/17 HOPKINS & HUEBNER PC ASSISTANT AT0TORNEY GENERAL 282 17WC 21829 HAMERLINK, ADAM JOHN DEERE HARVESTOR WORK 06/28/17 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 283 17WC 21921 MUNOZ, CARMEN TYSON FRESH MEATS, INC. 02/24/14 ANDREW BRIBRIESCO GANAN & SHAPIRO 284 17WC 22297 FIGUEROA, JAVIER NAJERA BELLOTA AGRISOLUTIONS 08/01/16 LOGAN LAW LAW OFFICES JOSEPH MARCINIAK 285 17WC 22515 FORD, DEBRA T QUAD CITY ANIMAL WELFARE 04/30/15 VANDERGINST LAW PC MACIOROWSKI SACKMANN & ULRIC 286 17WC 22966 CALHOUN, MARION STATE OF IL HENRY HILL @ 06/29/17 REHN & SKINNER LLC ASSISTANT ATTORNEY GENERAL 287 17WC 22995 YEAGER, DALE (DECEASED) THA MAY COMPANY # 01/09/81 RIDGE & DOWNES KNELL LAW LLC 288 17WC 23251 RICE, DEMETRIUS TYSON FOODS 07/31/15 MEYERS & FLOWERS GANAN & SHAPIRO 289 17WC 23445 HALSEY, BEVERLY JELLYSTONE PARK CAMPGROUN 05/18/17 LOREN S GOLDEN HENNESSY & ROACH 290 17WC 24216 WOODRUFF, MARK JL BRADY COMPANY LLC 08/16/17 CAPRON & AVGERINOS PC 291 17WC 24550 SEAVEY, REBEKAH SELECT SPECIALTY HOSPITAL 11/30/16 STRONG LAW OFFICE COZZI & GOGGIN-WARD 292 17WC 24763 SWANSON, TINA JOHN DEERE HARVESTOR WORK 05/08/17 RIDGE & DOWNES BOZEMAN NEIGHBOUR PATTON & N 293 17WC 24989 IVES, DAKOTA W KROGER 04/25/17 MERTES & MERTES PC STONE & JOHNSON CHARTERED 294 17WC 25076 WILKINSON, TINA DURBY INDUSTIES 08/04/17 DWORKIN AND MACIARIELLO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 18 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 295 17WC 25194 ONTIVEROS, HECTOR ANDERSON COMMERCIAL CONCR 05/22/17 LEE, MARK N LAW OFFICE BRADY, CONNOLLY & MASUDA, PC 296 17WC 25356 MANGO, BARBARA KEWANEE LIFE SKILLS @ 11/18/16 LAW OFFICE OF CHRIS DOSCOT 297 17WC 25638 GIBSON, ANGELA HY-VEE 02/02/17 WARREN E DANZ, PC HOPKINS & HUEBNER PC 298 17WC 26613 MCSHANE, JEROME ELITE STAFFING 08/31/17 DWORKIN AND MACIARIELLO 299 17WC 26767 JOHNSON, JENNIFER ALDI 06/09/17 BLACK & JONES BRADY, CONNOLLY & MASUDA, PC 300 17WC 27051 JACKSON, TINA DERBY INDUSTRIES, LLC 08/04/17 REHN LAW LLC 301 17WC 27365 PLATT, DENNIS J OLD DOMINION FREIGHT LINE 08/03/17 THOMAS E CADY 302 17WC 27639 IMLER, CHAD D TIMBERLYN LIGHTING MGMT I 04/27/17 SOPHER LAW FIRM 303 17WC 28092 MARKS, KELLY STERLING CHEVROLET 11/01/16 WOLFE LAW PC 304 17WC 28176 NEMETH, SCOTT A GALESBURG COTTAGE HOSPITA 05/25/17 MARKS INJURY LAW WIEDNER & MCAULIFFE LTD 305 17WC 28783 NELSON, DUSTIN BIG RIVER RESOURCES 09/15/17 RIDGE & DOWNES COZZI & GOGGIN-WARD 306 17WC 28831 BARNETT, RYAN ROCK ISLAND POLICE DEPT 09/21/17 RIDGE & DOWNES BETTY NEUMAN & MCMAHON 307 17WC 29400 ZIER, ANTHONY ROCK ISLAND POLICE DEPART 09/09/17 RIDGE & DOWNES BETTY NEUMAN & MCMAHON 308 17WC 29728 HELLE, ROBYN KNOX COUNTY NURSING HOME 08/07/17 REHN LAW LLC 309 17WC 30000 PEREZ-HERNANDEZ, ROSA FARMLAND FOODS 04/12/17 VANDERGINST LAW PC STEPHEN P. KELLY 310 17WC 30170 MILLER, TAMMY HNB OIL CORPORATION 03/25/16 SIMPSON PETERSON RIPES NELSON BAGGOT KALOBRAT 311 17WC 30328 HEMMINGER, MARVIN LEE MAZEL & COMPANY 07/15/17 PIGNATELLI & ASSOCIATES LAW OFFICE PAUL LARIMORE 312 17WC 30533 DELACRUZ, TERRIE FARMLAND FOODS 04/07/15 REHN & SKINNER LLC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 19 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 313 17WC 31076 LINDSAY (VOLOVITZ), JAMIE AUNT MARTHA'S HEALTH 02/20/17 STRONG LAW OFFICE BRADY, CONNOLLY & MASUDA, PC 314 17WC 31148 CORK, TERRY GREEN GABLES 08/08/17 DAVID W OLIVERO POWER & CRONIN LTD 315 17WC 31660 JEWELL, RICHARD MOLINE PUBLIC WORKS 09/27/17 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 316 17WC 31695 CASTRO, ARIEL QUICK ONE DETASSELING 07/08/16 CAPRON & AVGERINOS PC LAWRENCE COZZI - LAW OFFICE 317 17WC 32273 NAERT, SHANE ADVANCED BUSINESS SYSTEMS 04/19/17 VANDERGINST LAW PC GANAN & SHAPIRO 318 17WC 32299 PARKER, JEREMY FRANKLIN MAINTENANCE 07/09/17 PIGNATELLI & ASSOCIATES 319 17WC 32435 PUENTE, MIGUEL CRUZ TYSON FRESH FOODS 06/30/15 HOPKINS & HUEBNER PC GANAN & SHAPIRO 320 17WC 32475 PEREZ, GRWUASLLY ARAMARK UNIFORM SERVICES 12/17/16 ANDREW BRIBRIESCO 321 17WC 32493 LEC, VEZAIP MENK USA 03/17/17 REESE & REESE WOLFE & JACOBSON, LTD 322 17WC 32641 FOSTER, STEVEN UNITED PARCEL SERVICE INC 08/17/17 WINSTEIN KAVENSKY & WALLAC 323 17WC 32658 PARVIN, THOMAS J KENDRA & RENE SOTELO DBA W 04/15/17 REESE & REESE 324 17WC 32825 COURTNEY, SAN D THE BEDDING GROUPO, INC 09/14/17 THOMAS E CADY 325 17WC 32981 WOODS, CAROLE KNOX COLLEGE 07/27/17 LAW OFFICE OF CHRIS DOSCOT 326 17WC 33150 BICAN, GEORGE ROYAL CLEANING 02/06/14 REHN LAW LLC RUSIN & MACIOROWSKI LTD 327 17WC 33367 ERICSON, JASON UNITED FACILITIES 11/07/17 RIDGE & DOWNES COZZI & GOGGIN-WARD 328 17WC 34111 STEPHENS, GARY T ELITE STAFFING INC 10/20/17 ANESI OZMON RODIN NOVAK KO 329 17WC 34138 ATCHISON, MARY LYNN METROPOLITAN AIRPORT AUTH 08/08/17 LEONARD LAW GROUP LLC 330 17WC 34553 PETERSON, JEFF USF HOLLAND 08/02/17 WINSTEIN KAVENSKY & WALLAC HENNESSY & ROACH

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 20 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 331 17WC 34674 HOUGHTON, JOHN FIFTH WHEELS PLUS INC 02/01/17 STRONG LAW OFFICE KNELL LAW LLC 332 17WC 34709 PHEIFFER, BARRY AC MCCARTNEY 04/01/12 LAW OFFICE PATRICK JENNETT GAROFALO SCHREIBER STORM 333 17WC 34991 VARGAS, JOSE THE CROWN GROUP 05/15/17 CHEPOV & SCOTT LLC PERRY GENTILE 334 17WC 35044 CLARK, IVORY BHASED 10/22/15 VANDERGINST LAW PC 335 17WC 35101 NACHE, MICHAEL J SR. EBY-BROWN COMPANY, LLC 07/07/17 BOSHARDY LAW OFFICE PC NYHAN BAMBRICK KINZIE & LOWR 336 17WC 35118 SANFO, SOULEYMANE TYSON FRESH MEATS 10/26/17 CROWLEY BUNGER PRILL GANAN & SHAPIRO 337 17WC 35442 VALLEJO, ISABEL M ARC OF THE QUAD CITIES 10/01/17 STENGEL BAILEY ROBERTSON 338 17WC 35897 HART, ANGELA FRIENDSHIP MANOR 10/27/16 VANDERGINST LAW PC RIPES NELSON BAGGOT KALOBRAT 17WC035898 -C 17WC035899 -C 339 17WC 35954 WRIGHT, DENISE DICK BLICK HOLDINGS, INC 08/30/17 JOHN LESAGANICH 340 17WC 36395 BORYS, MICHAEL JAY NATIONAL FREIGHT INCORPOR 06/27/17 WARNER & ZIMMERLE MACIOROWSKI SACKMANN & ULRIC 341 17WC 36578 ZINKE, CHAD SENSIENT TECHNOLOGIES COR 09/22/17 SCHWEICKERT & GANASSIN GAROFALO SCHREIBER STORM 342 17WC 36647 SHAFFER, PENNY JOHN DEERE HARVESTER WORK 05/16/17 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 343 17WC 36872 SIVELS, BRANDY AVONLEA COTTAGE 09/08/17 DWORKIN AND MACIARIELLO 344 17WC 37065 LACY, DERIC RIVERSIDE STAFFING 11/15/17 WINSTEIN KAVENSKY & WALLAC BRYCE DOWNEY & LENKOV LLC 345 17WC 37075 IBLKOUNLE, DAOUDA TYSON FOODS INC 07/28/15 HOPKINS & HUEBNER PC GANAN & SHAPIRO 346 17WC 37490 DUKE, DARA MARIGOLD NURSING HOME 07/27/17 LAW OFFICE DAVID HUNT KNELL LAW LLC 347 17WC 38031 BAHENA, VICENTE MICRO INDUSTRIES, INC 03/16/17 REESE & REESE 348 18WC 00718 ANDERSON, LARRY O'REILLY AUTO PARTS 06/18/17 CHRISTINE A KEYS PC HENNESSY & ROACH

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 21 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 349 18WC 01104 MORALES, EUGENIO NAPLETON WESTMONT PORSCHE 01/02/18 GOLDBERG WEISMAN & CAIRO L LAW OFFICES FRANCESCA LARSEN 350 18WC 01226 WIGGINS, LEANNDRA WALMART 07/30/17 WINSTEIN KAVENSKY & WALLAC QUINTAIROS PRIETO WOOD & BOY 351 18WC 01538 BELL, YVONNE HALLCON CORPORATION 12/24/17 REHN LAW LLC KNELL & O'CONNOR 352 18WC 01555 HARRINGTON, RUSSELL SEDONA STAFFING 07/01/17 BLACK & JONES GILDEA & COGHLAN 353 18WC 01819 BROOKS, PAUL ELITE STAFFING 09/08/17 DWORKIN AND MACIARIELLO 354 18WC 02071 WARNER, JOSHUA M GATES CORP 01/05/18 HASSELBERG & ROCK 355 18WC 02126 MILLARD, DARWIN PERFORMANCE FOOD GROUP 01/01/18 ELFENBAUM EVERS & AMARILIO INMAN & FITZGIBBONS 356 18WC 02398 ZUNIGA, ADAN CLEAN HARBORS INDUSTRIAL 12/12/17 THE ROMAKER LAW FIRM RODDY LAW LTD 357 18WC 02560 MUHAMMAD, TAWANA CHECKERS 06/14/17 JOSEPH PIEROTTI 358 18WC 02656 TOSSI, PAULIN TYSON FOODS INC 12/07/17 WINSTEIN KAVENSKY & WALLAC 359 18WC 02880 WATERS, CRETA TYSON FRESH MEATS 11/01/17 BLACK & JONES GANAN & SHAPIRO 360 18WC 03112 RANDALL, WILLIAM ALB FREIGHT TRANSPORTATIO W 09/10/17 REHN LAW LLC 361 18WC 03123 WHITTINGTON, RODNEY JOHN DEERE HARVESTER 11/15/16 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 362 18WC 03239 SCHROCK, RICHARD CITY OF AMBOY 04/12/17 KALEEL, DAVID M POWER & CRONIN LTD 363 18WC 03293 RICO-MORALES, EVA TYSON FRESH MEATS INC 08/05/13 GANAN & SHAPIRO 364 18WC 03332 JENKINS, SHAWN E BUILDERS SALES & SERVICE 01/04/18 THOMAS E CADY RIPES NELSON BAGGOT KALOBRAT 365 18WC 03468 MBEMBA, JEAN PAUL EXPORT PACKAGING CO INC 03/30/16 THOMAS E CADY RUSIN & MACIOROWSKI LTD 18WC003469 -C 366 18WC 03617 DETMERS, PAUL FARMLAND FOODS 11/30/16 SIMPSON PETERSON

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 22 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 367 18WC 03790 HUSSEIN, TAREQ JUMER'S CASINO & HOTEL 05/21/16 WARREN E DANZ, PC 368 18WC 03806 DAVIS, JACOB JEWEL-OSCO 01/23/18 WINSTEIN KAVENSKY & WALLAC 369 18WC 04292 HARPER, CLARA XPAC 12/13/17 BLACK & JONES RUSIN & MACIOROWSKI LTD 18WC011810 -C 370 18WC 04411 AKPO, SEBABOU TYSON FRESH MEATS, INC 09/18/17 GANAN & SHAPIRO 371 18WC 04534 BAH, ADAMA HOPE CREEK CARE CENTER 03/21/17 RUBENS AND KRESS BROOKS LAW FIRM 372 18WC 05025 GADJETOR, KOKOU TYSON FRESH MEATS 01/08/16 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 373 18WC 05237 STOCKHAM, BRADLEY CENTURY LINK 10/03/17 GOLDFINE & BOWLES MC ANDREWS & NORGLE LLC 374 18WC 05330 MAUS, TAWNY LAMI INC 01/07/17 COSTELLO LAW FIRM GANAN & SHAPIRO 375 18WC 05486 AUGUSTINE, THOMAS SCHWAN'S HOME SVC 09/23/17 O'CONNOR & NAKOS GAROFALO SCHREIBER STORM 376 18WC 05535 HAJOSTEK, JERRILYN GATES CORPORATION 12/08/17 BROOKS LAW FIRM QUINTAIROS PRIETO WOOD & BOY 377 18WC 05598 DODSON, JEFF UNITYPOINT HEALTH - PROCT 01/15/18 BLACK & JONES STEPHEN P. KELLY 378 18WC 05683 GUERRERO, RITA GREAT DANE TRAILERS 02/22/16 SCHWEICKERT & GANASSIN 379 18WC 05777 COGDALL, CHRISTOPHER T R.H. BOELK TRUCK LINES IN 01/15/18 MERTES & MERTES PC 380 18WC 05829 CUEVAS, DAVID HY-VEE INC 11/04/17 REHN LAW LLC QUINN JOHNSTON HENDERSON ETA 381 18WC 06029 ALBERTSON, DANIEL STERLING RESTORATIONS 09/28/17 PIGNATELLI & ASSOCIATES 382 18WC 06623 MASIAS, GREG CITY OF MOLINE 03/20/17 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 383 18WC 06813 SWIFT, JUSTIN E KREIDER SERVICES 02/10/18 REESE & REESE 384 18WC 06993 SHORT, SALLY WESTROCK 02/22/18 STRONG LAW OFFICE HENNESSY & ROACH PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 23 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 385 18WC 07307 BUNTON, RONALD JOHN DEERE PDC 09/14/16 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 386 18WC 08072 JOHNSON, KIMBERLY IN HOME SERVICES 12/01/17 BLACK & JONES RODDY LAW LTD 387 18WC 08493 SCHEUER, STEVE G5 TECH SOLUTIONS 11/28/17 CHRIS DOSCOTCH WOLFE & JACOBSON, LTD 388 18WC 08827 BENNETT, PEGGY A MUSELMAN INVESTMENTS, LTD 04/21/16 THOMAS E CADY 389 18WC 08850 NIYONGABO, FREDERIC TYSON FRESH MEATS 02/01/18 ELFENBAUM EVERS & AMARILIO WIEDNER & MCAULIFFE LTD 390 18WC 08929 DEYO, DEBRA L MACLEAN-FOGG COMPONENT 12/06/17 TUITE LAW 391 18WC 09346 KEMPEL, JEFFREY JOHN DEERE HARVESTER 08/04/16 WINSTEIN KAVENSKY & WALLAC CALIFF & HARPER PC 392 18WC 09514 ANDERSON, EMILY SEDONA STAFFING 03/01/18 MARC J SHUMAN & ASSOCIATES BETTY NEUMAN & MCMAHON 393 18WC 09598 SANSONE, ROBIN LTC SUPPORT SERVICES, LLC 02/20/18 BROWN & BROWN 394 18WC 10097 BLAIR, HANS UPS PARCEL SERVICE 02/15/18 BOZEMAN NEIGHBOUR PATTON & 395 18WC 10236 WADSAGER, DAVID A JOHN DEERE HARVESTER 01/05/18 MARSZALEK AND MARSZALEK BOZEMAN NEIGHBOUR PATTON & N 396 18WC 10671 WALES, PALEMA J GENERAL EXPRESS DIVISION 01/09/18 WINSTEIN KAVENSKY & WALLAC SCOPELITIS GARVIN LIGHT 397 18WC 10840 SIMMONS, LORI LYNN PETERSEN HEALTH CARE 04/01/17 398 18WC 11092 SIMS, FORREST JR. KISLER BROS INC- HI LO GR 02/09/18 REHN LAW LLC 399 18WC 11135 MAIN, JEREMIE HOLT SUPPLY 12/06/16 LEFANTE LAW OFFICES JOSEPH MARCINIAK 400 18WC 11260 DAINS, DAVID JR WASTE MANAGEMENT 12/04/17 CHRIS DOSCOTCH 401 18WC 11471 PERLEY, LISA M NEW PERSPECTIVE 03/25/18 THOMAS E CADY 402 18WC 11839 DAVIS, PIPER C LONG SHOT SPORTS BAR & GR 04/11/17 MERTES & MERTES PC KOPKA, PINKUS DOLIN, PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 24 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 403 18WC 11985 RICHARDSON, RYON OLSON FARMS 04/07/18 GESMER & REYNOLDS PC RODDY LAW LTD 404 18WC 12052 RUBINGH, KRISTINA JOHN DEERE HARVESTOR 01/05/18 WINSTEIN KAVENSKY & WALLAC 405 18WC 12404 KOSTMAN, PAULA MONDELEZ INTERNATIONAL 01/28/18 STRONG LAW OFFICE WIEDNER & MCAULIFFE LTD 406 18WC 12511 JOHNSON, BRADLEY KRSTIC ENTERPRISES INC 01/20/17 VANDERGINST LAW PC GANAN & SHAPIRO 407 18WC 12782 WOODS, GEOFFREY GEORGE EVANS CORP 04/05/18 BLACK & JONES HOPKINS & HUEBNER PC 408 18WC 12791 WRIGHT, SANDRA AS WIDOW O DOHRN ENTERPRISES, INC. F # 03/28/18 COSTIGAN & WOLLRAB PC GANAN & SHAPIRO 409 18WC 13350 CONWAY, DENNIS LANE GALESBURG WELLNESS CENTER 10/25/16 COLLISON LAW OFFICES RUSIN & MACIOROWSKI LTD 410 18WC 13549 KOSTMAN, PAULA MONDELEZ INTERNATIONAL 09/08/16 STRONG LAW OFFICE WIEDNER & MCAULIFFE LTD 411 18WC 13799 SMITH, ABIGIL HEALTH CARE SVC GROUP 01/14/18 REHN LAW LLC 412 18WC 13995 ANDERSON, RANDALL AG VIEW FS INC 06/21/17 ANKIN LAW OFFICE 413 18WC 14108 CHURCHILL, STEVEN ARAMARK UNIFORM SERVICES 03/09/18 RIDGE & DOWNES 414 18WC 14340 DEVLIN, STAN PIZZA HUT 01/09/18 GOLDFINE & BOWLES HENNESSY & ROACH 415 18WC 14344 STOVER, CALEB HILL CORRECTIONAL CENTER @ 04/23/18 GOLDFINE & BOWLES ASSISTANT ATTORNEY GENERAL 416 18WC 14495 SCHLUNG, RICHARD JOHN DEERE HARVESTER WORK 04/04/18 MCDONALD WOODWARD & CARLSO BOZEMAN NEIGHBOUR PATTON & N 417 18WC 14887 BOSENGA, JULIE SMITHFIELD FARMLAND CORP 02/05/18 REHN LAW LLC STEPHEN P. KELLY 418 18WC 15019 BOYER, DORINE J GANA - A'YOO SVS, CORP 08/29/17 KATZ NOWINKSI PC 419 18WC 15152 HARRELSON, TRACY L JOHN DEERE 11/15/16 KATZ NOWINKSI PC CALIFF & HARPER PC 420 18WC 15613 PACHECO, DELL GALESBURG COMMUNITY UNIT 03/03/17 GOLDFINE & BOWLES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 25 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 421 18WC 15667 MILLER, TANNER S TRISTATE FIRE CONTROL INC 01/05/18 ANKIN LAW OFFICE 422 18WC 15904 LIAN, THAWNG TYSON FRESH MEATS, INC 11/08/13 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 423 18WC 16105 REED-WILMINGTON, DIANE HEARTLAND HEALTHCARE 03/31/18 WINSTEIN KAVENSKY & WALLAC 424 18WC 16225 SHANER, TAMMY L FIRSTGROUP AMERICA, INC D 04/10/18 REESE & REESE 425 18WC 16616 POLITE, GEORGE YRC FREIGHT 04/24/18 RIDGE & DOWNES HENNESSY & ROACH 426 18WC 16779 SCRITCHFIELD, STEPHEN ROCK ISLAND COUNTY 08/19/16 RIDGE & DOWNES BROOKS LAW FIRM 427 18WC 16887 MANONDZO, PHILIPPINE SMITHFIELD FARMLAND CORP 09/21/17 REHN LAW LLC 428 18WC 17055 KESSLER, KYLE MANPOWER 05/14/18 DWORKIN AND MACIARIELLO WIEDNER & MCAULIFFE LTD 429 18WC 17184 WALLACE-MCKENNA, KELLIE HENRY COUNTY HUMANE SOCIE 03/19/18 STEPHENS FIDDES MCGILL ASS 430 18WC 17336 MATEYENDOU, MAYONOU JOHN DEERE 12/12/17 KATZ NOWINKSI PC CALIFF & HARPER PC 431 18WC 17476 ZIGLER, MARY F MICRON INDUSRUES CORP 05/07/18 REESE & REESE HOLECEK & ASSOCIATES 432 18WC 17819 CRAM, KEVIN MULTIBAND, INC. 06/04/18 PIGNATELLI & ASSOCIATES 433 18WC 18053 MYERS, JESSICA PETERSON HEALTH CARE 05/28/18 REHN LAW LLC KNELL LAW LLC 434 18WC 18455 HODGES, TERRY HEAT AND CONTROL 07/01/17 REHN LAW LLC 435 18WC 18757 COX, AARON STATE OF IL HILL CORR CTR 02/27/18 RIDGE & DOWNES ASSISTANT ATTORNEY GENERAL 436 18WC 18881 DAVIS, RUTHY JOHN DEERE HARVESTER 06/05/18 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N 437 18WC 19019 RODGERS, KENNETH TYSON FRESH MEATS 10/08/17 BLACK & JONES WIEDNER & MCAULIFFE LTD 438 18WC 19337 COLON, CRUZ WAL-MART 08/12/17 KENNETH MAHAFFEY 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 MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 439 18WC 19679 APALOO, MESCHAK TYSON FRESH MEATS, INC 01/10/18 WINSTEIN KAVENSKY & WALLAC WIEDNER & MCAULIFFE LTD 440 18WC 19684 STRIPLING, CHRIS CLOVERHILLS APPLIANCE 03/15/18 DWORKIN AND MACIARIELLO CAPUANI, FRANK S 441 18WC 19725 WHITE, DAVID A HAYNES EXPRESS INC 08/24/17 VANDERGINST LAW PC 442 18WC 19905 MARTINEZ, BRANDON S JOHN DEERE HARVESTER WORK 01/11/17 ANESI OZMON RODIN NOVAK KO 443 18WC 19992 ARBAB, AMAD TYSON FOODS, INC 10/19/17 WINSTEIN KAVENSKY & WALLAC 444 18WC 19995 ARBAB, ARBAB TYSON FOODS, INC 02/22/18 WINSTEIN KAVENSKY & WALLAC 445 18WC 20069 DONALDSON, GWENDOLYN GATES CORPORATION * 05/31/18 RIDGE & DOWNES 446 18WC 20327 DEVALKENAERE, MARIAN WAL-MART * 05/19/18 STRONG LAW OFFICE QUINTAIROS PRIETO WOOD & BOY 447 18WC 20406 WILLMAN, MARIE A CASEY'S GENERAL STORE * 03/25/17 REESE & REESE 448 18WC 20784 WELCH, JASON TCI MANUFACTURING * 05/02/18 ACEVES & PEREZ PC RODDY LAW LTD 449 18WC 20959 MERRITT, MICHAEL IL STATE POLICE @ * 05/23/18 RIDGE & DOWNES ASSISTANT ATTORNEY GENERAL 450 18WC 21053 WERDERMAN, JOSEPH EAGLE ENTERPRISES RECYCLI * 11/07/17 JOHN LESAGANICH 451 18WC 21180 HEBELER, STEVE ROCK ISLND INTEGRATED SER * 05/14/18 RIDGE & DOWNES HENNESSY & ROACH PC 452 18WC 21186 STEWART, GREGORY SUSTAINABLE CONSTRUCTION * 05/09/18 GOLDFINE & BOWLES RODDY LAW LTD 453 18WC 21372 JOHNSON, LAKENDRA WENDY'S * 06/20/18 DWORKIN AND MACIARIELLO CAPUANI, FRANK S 454 18WC 21408 SNYDER, ARON DUPONT-DANISCO, INC. * 09/27/17 CAPRON & AVGERINOS PC LITCHFIELD CAVO 455 18WC 21755 LAPORTE, NOLAN QUAD CITY MALLARDS * 12/23/16 FLOYD LAW FIRM 456 18WC 21902 STROM, TODD JOHN DEERE HARVESTER * 05/27/18 WINSTEIN KAVENSKY & WALLAC BOZEMAN NEIGHBOUR PATTON & N

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 27 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 457 18WC 22321 HUMPHREY, TIFFANY MANPOWER GROUP * 07/03/18 REHN LAW LLC HENNESSY & ROACH 458 18WC 22389 LAMB, BRIAN JOHN DEERE * 02/08/18 LOGAN LAW CALIFF & HARPER PC 459 18WC 22467 MARTINEZ, ERNESTINA FARMLAND FOODS INC * 06/07/17 WOODRUFF JOHNSON STEPHEN P. KELLY 460 18WC 22910 BAH, THIERNO TYSON * 04/17/18 VANDERGINST LAW PC GANAN & SHAPIRO 461 18WC 23123 RUSSELL, ALICIA M SMITHFIELD FOODS * 02/01/16 CROWLEY & PRILL STEPHEN P. KELLY 462 18WC 23228 MORGAN, CODY R MH EQUIPMENT * 08/02/16 MERTES & MERTES PC HENNESSY & ROACH 463 18WC 23362 RYBERG, NARCISA DICK BLICK HOLDINGS, INC * 07/16/18 SKINNER & ASSOC 464 18WC 23586 FORBES, LEROY JR. TYSON FRESH MEATS INC * 05/24/17 WINSTEIN KAVENSKY & WALLAC WIEDNER & MCAULIFFE LTD 465 18WC 23665 PALMER, DANNY YMH TORRANCE * 06/08/17 MCCARTHY, CALLAS & FEENEY ACCIDENT FUND HOLDINGS 466 18WC 23763 DE LOPEZ, MARIA TORRES TYSON FOODS INC * 03/01/17 BRIBRIESCO LAW FIRM GANAN & SHAPIRO 467 18WC 23875 LAYTON JR, RICHARD HUSSMAN CORPORATION * 07/11/18 REHN LAW LLC GANAN & SHAPIRO 468 18WC 23991 MATEJKA, SCOTT MENK USA * 08/07/17 THOMAS W DUDA 469 18WC 24406 ABDENNEBI, NADIA TYSON FOODS, INC. * 10/30/17 WINSTEIN KAVENSKY & WALLAC GANAN & SHAPIRO 470 18WC 24424 ABASS, AEMAN X-PAC * 07/25/18 STRONG LAW OFFICE RUSIN & MACIOROWSKI LTD 471 18WC 24518 DIERICKS, JOHN F ROCK ISLAND MILAN SD #41 * 01/29/16 CALIFF & HARPER PC HENNESSY & ROACH 472 18WC 24679 DIKEMAN, LORRETTA AMERICAN PEST CONTROL * 05/23/18 DAVID HUNT 473 18WC 24809 NELSON, RICHARD ROCK ISLAND COUNTY * 09/14/17 RIDGE & DOWNES BROOKS LAW FIRM 474 18WC 25092 KETELSEN, ROBB AERO CONCRETE * 05/29/18 HANAGAN & MCGOVERN PC BRADY, CONNOLLY & MASUDA, PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 28 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 475 18WC 25467 CUSUMANO, CHRISTOPHER CHARTWELL STAFFING SOLUTI * 04/23/18 CAPRON & AVGERINOS PC 476 18WC 25817 PRETZSCH, MIKALYA CHARTWELL STAFFING SOLUTI * 08/17/18 DWORKIN AND MACIARIELLO 477 18WC 25833 MORASKI, MELANIE AUNT MARTHA'S GREAT RIVER * 07/20/17 CUSACK GILFILLAN & O'DAY 478 18WC 26108 TAYLOR, RODNEY JOHN DEERE HARVESTER * 02/21/17 WINSTEIN KAVENSKY & WALLAC 479 18WC 26126 STUART, CHERYL LUDENS POTTER MAHAFFEY AN * 11/11/15 WARD MURRAY PACE & JOHNSON 480 18WC 26210 THOMPSON, DIANE ENCORE UNLIMITED LLC * 01/11/17 ACCIDENT FUND HOLDINGS 481 18WC 26281 BROUGHTON, JAMES E TIMKEN DRIVES, LLC * 11/17/16 NYHAN BAMBRICK KINZIE & LOWR 482 18WC 26420 FRIEND, DAVID HELP INDUSTRIAL SERVICES * 03/22/18 ANKIN LAW OFFICE RODDY LAW LTD 483 18WC 26525 HAAS, LAURIE GALESBURG COTTAGE HOSPTIA * 03/12/18 DAVID HUNT WIEDNER & MCAULIFFE LTD 484 18WC 26544 MARTEL, AIMEE L CAMELOT THERAPEUTIC SCHLS * 01/09/18 KATZ NOWINKSI PC 485 18WC 26929 DENBROOK, LINDA D&D SERVICES D/B/A PREFER * 04/03/18 WINSTEIN KAVENSKY & WALLAC 486 18WC 27083 BAKER, MARY ANNE GENESIS MEDICAL CENTER * 10/06/16 HOPKINS & HUEBNER PC 487 18WC 27124 CHRISTIE, RHONDA MERCER COUNTY SCHOOL DIST * 05/01/17 ASHER, RAYMOND L LTD 488 18WC 27228 ADOSSI, KOMLAN TYSON FRESH MEATS * 06/22/18 ELFENBAUM EVERS & AMARILIO WIEDNER & MCAULIFFE LTD 489 18WC 27324 LILLIG, MASON KEY OUTDOOR, INC * 07/19/18 GOLDFINE & BOWLES 490 18WC 27410 COWDEN, JOEY UNITED FACILITIES, INC * 07/22/18 DWORKIN AND MACIARIELLO 491 18WC 27823 ANGEL, ANTHONY C LA LEASING, INC, D/B/A * 09/07/16 KATZ NOWINKSI PC 492 18WC 28301 BAHRS, JASON JOHN DEERE HARVESTER WORK * 03/15/18 KATZ FRIEDMAN EAGLE ET AL

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 29 C A S E H E A R I N G S Y S T E M MCCARTHY, DOUGLAS 032 ARBITRATION CALL FOR ROCK ISLAND 44002 ON 11/05/2018 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 493 18WC 28406 CASSADAY, BRANDI ORA ORTHOPEDICS * 01/01/10 WARNER & ZIMMERLE 494 18WC 28601 DARNELL, RICHARD LEE CITY OF ROCK ISLAND * 02/12/16 KEYS LAW OFFICES 495 18WC 28690 HARMS, JOHN T VOLT MANAGEMENT CORP * 07/23/18 KATZ NOWINKSI PC 496 18WC 29025 THURMAN, JOHN P HALVERSTON CONSTRUCTION C * 08/07/18 ANESI OZMON RODIN NOVAK KO 497 18WC 29118 GRAY, LUETHER ROCK ISLAND-MILAN SCHOOL * 08/29/18 KATZ NOWINKSI PC 498 18WC 29311 DEGROOT, JAMIE L IFH GROUP * 12/04/17 MERTES & MERTES PC 499 18WC 29433 HARDING, ALLEN WAYNE ED'S HEATING, A/C, * 01/01/18 PATRICK JENNETTEN 500 18WC 29454 JOHNSON, DORIS KCCDD, INC. * 01/16/18 ACCIDENT FUND HOLDINGS 501 18WC 29512 BONEY, MICHAEL E HUFFMAN WELDING & MACHINE * 03/18/16 KATZ NOWINKSI PC 502 18WC 29526 DAUPHIN, KIMBERLEE A THE BON-TON STORES, INC * 08/18/18 WINSTEIN KAVENSKY & WALLAC 503 18WC 29677 RICHARDS, JEREMIAH SLOAN IMPLEMENT CO * 04/26/18 PIGNATELLI & ASSOCIATES 504 18WC 29734 HADSELFORD, ROBERT JOHN DEERE SEEDING * 03/15/17 CALIFF & HARPER PC 505 18WC 29782 RASHID, ADEEBA VITAS HEALTH CARE * 08/16/16 GOMEZ MAY LLP