ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 1 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 01/08/2021 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 1 01WC 20295 ST VINCENT, CAROL SUE CHRYSLER CORPORATION 03/03/01 THOMAS R LICHTEN WILLIAMS & MCCARTHY 02WC038639 -C 03WC037758 -C DAIMLER CHRYSLER CORPORATI 05WC005739 -C 05WC005740 -C DAIMLER CHRYSLER CORPORATI 07WC029633 -C 2 07WC 37748 JONES, DEAN NICOR GAS 06/09/07 BLACK & JONES RUSIN & MACIOROWSKI LTD 07WC037749 -C 07WC048432 -C 3 08WC 10425 TAYLOR, PAULA ST OF IL - IDFPR-DPR @ 12/04/07 DREW J FERRACUTI ASSISTANT ATTORNEY GENERAL 11WC009621 -C STATE OF ILLINOIS 4 09WC 38391 BURNELL, DAVIS S & S CARTAGE 10/11/08 BLACK, JIM LAW OFFICE HINSHAW & CULBERTSON 5 09WC 52126 CHEMELLO, JUDY CRUSANDER CLINIC 08/01/09 BLACK & JONES LAW OFFICES JOSEPH MARCINIAK 09WC052127 -C 09WC052128 -C 09WC052129 -C 6 11WC 20798 JOHNSON, PAUL R L LEEK 04/30/11 BLACK & JONES CHILTON YAMBERT PORTER LLP 7 12WC 02773 SMITH, MICHAEL CHEM TOOL INC 09/20/11 JOHN S. ELIASIK LAW OFFICES JOSEPH MARCINIAK 8 12WC 07220 CUMBA, MARIBELLE JAC BELVIDERE CROSSLINK A 02/03/12 KATZ FRIEDMAN EAGLE ET AL GANAN & SHAPIRO 15WC026858 -C IAC BELVIDERE CROSSLINK 15WC026859 -C 17WC011558 -C IAC BELVIDERE CROSSLINK AK 9 12WC 11534 DOWNING, JEFFREY A FREEPORT METAL SPECIALTIE 03/09/11 TUITE LAW BRADY CONNOLLY & MASUDA PC 10 12WC 12635 NACHAMPASSACK, KINGKAMONE TESTORS CORPORATION 03/01/11 KATZ FRIEDMAN EAGLE ET AL EVANS & DIXON 11 12WC 12636 NACHAMPASSACK, KINGKAMONE TESTORS CORPORATION 01/18/11 KATZ FRIEDMAN EAGLE ET AL EVANS & DIXON 12 12WC 13666 MINARDI, ANTHONY R CARDINAL GLASS COMPANY 03/15/12 TUITE LAW ROBERT L. SMITH 13WC017675 -C 20WC007751 -C

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 2 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 01/08/2021 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 13 12WC 24517 DAVIS, GERALD T STERLING COMMERCIAL ROOFI 06/04/12 CACCIATORE, WILLIAM T PAUL A COGHLAN & ASSOC 14 12WC 29417 MACAULAY, YVONNE BERNER FOOD & BEVERAGE 04/12/12 THOMAS J STIBERTH LAW OFFI CAPUANI, FRANK S 12WC036465 -C 15 13WC 00712 CARRILLO, KELLI LUMEA STAFFING 12/19/09 BLACK & JONES 16 13WC 11687 JACOBS, PAUL CHRYSLER ASSEMBLY PLANT 01/30/13 ANESI OZMON RODIN NOVAK KO WIEDNER & MCAULIFFE 17 13WC 16325 HULTQUIST, RICHARD L ED TRNYRE & CO 01/01/11 BLACK & JONES CLARK FROST 18 13WC 29206 MELTON, ANTHONY DOUBLE A ROOFING W 11/04/12 BLACK & JONES 19 13WC 40593 GUTIERREZ, ZENON AUSTIN-WESTRAN 05/20/13 ANESI OZMON RODIN NOVAK KO RIPES NELSON BAGGOT KALOBRAT 14WC029921 -C 20 13WC 42632 DELEHANTY, GENE TH FOODS 12/12/13 FRANCINE B WHITE HOLECEK & ASSOCIATES 21 14WC 01497 BILJESKOVIC, LUKA ZENITH CUTTER 12/19/12 HORWITZ HORWITZ & ASSOC COZZI & GOGGIN-WARD 22 14WC 06990 SOLORIO, MARIA G COURTYARD BY MARRIOTT 12/20/13 GANAN & SHAPIRO 23 14WC 07333 LUNDSTROM, JEFF HILDEN REMODELING 09/13/13 BLACK & JONES 24 14WC 19733 NGUYEN, HA HAMILTON SUNDSTRAND 06/01/11 BLACK & JONES RUSIN & MACIOROWSKI LTD 25 14WC 33731 BAUMAN, MICHAEL D CITY OF ROCKFORD 03/05/14 THOMAS W DUDA HEYL ROYSTER VOELKER & ALLEN 16WC003687 -C 26 14WC 39510 FLETCHER, JAMES WINNEBAGO COUNTY HIGHWAY 09/19/13 BLACK & JONES WILLIAMS MCCARTHY LLP 27 14WC 42688 TORIBIO, ALEJANDRO JAN CORTEZ/JC REMODELING W 10/22/14 BLACK & JONES 28 15WC 00032 GRAMMER, TYLER CATCH THE WAVE 10/29/14 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 29 15WC 01838 WRIGHT, WALTER MAHONEY ENVIRONMENT 12/18/14 PETER F FERRACUTI & ASSOCI LITCHFIELD CAVO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 3 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 01/08/2021 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 30 15WC 14333 AVILA, RODRIGO R & D THIEL INC 02/17/15 GALLIANI DOELL & COZZI LTD WIEDNER & MCAULIFFE LTD 31 15WC 18311 FLETCHER, JAMES WINNEBAGO COUNTY HWY DEPT 10/28/14 BLACK & JONES WILLIAMS MCCARTHY LLP 32 15WC 20853 MCKEE, KARA SECRETARY STATE OF ILLINO @ 05/20/15 BLACK & JONES ASSISTANT ATTORNEY GENERAL 33 15WC 22576 SHORES, KEVIN SPG INTERNATIONAL LLC 07/01/12 BLACK & JONES LAW OFFICES FRANCESCA LARSEN 34 15WC 23583 LANEGRAFF, EDWARD KOJA CONSTRUCTION 02/04/15 BLACK & JONES BRYCE DOWNEY & LENKOV LLC 35 15WC 24636 BECK, KAITLYN DAIRY QUEEN 04/03/15 GWC INJURY LAWYERS LLC 36 15WC 25543 FIEDLER, LORI WOODWARD GOVERNOR 11/04/14 MARKS INJURY LAW HINSHAW & CULBERTSON 37 15WC 27540 CARRISON, JOHN W ACCURATE CNC MACHING INC 06/22/15 GREG TUITE & ASSOC WIEDNER & MCAULIFFE LTD 38 15WC 28561 MCGUIRE, CHARLES L ROCKFORD BOARD OF EDUCATI 06/19/12 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE 39 15WC 34397 ROFFERS, MONICA (WIDOW OF HAGEMANN TRUCKING LLC # 07/14/15 JAMES M KELLY 40 15WC 35019 ALLEN, LAURELL K CHRYSLER 02/12/15 BLACK & JONES WILLIAMS MCCARTHY LLP 15WC035020 -C 15WC035022 -C 41 15WC 35090 REYES, ANA NORTHERN PRECISION PLASTI 04/21/15 BLACK & JONES 42 15WC 37805 MORRIS, BRAD ADVANCE AUTO PARTS 05/19/14 BLACK & JONES 43 15WC 39325 SPEARMAN, SAMMIE STPHENSON NURSING HOME 11/15/15 BLACK & JONES INMAN & FITZGIBBONS 44 15WC 41808 STREIT, KEVIN A MONDELEZ GLOBAL LLC 10/16/14 GREG TUITE & ASSOC 45 16WC 00276 WALLACE, RONALD JR ED ENTYRE 11/24/15 DWORKIN AND MACIARIELLO CLARK FROST

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 4 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 01/08/2021 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 46 16WC 01452 ROMAN, LORENA GRUPO ANTOLIN 10/22/15 KATZ FRIEDMAN EAGLE ET AL HENNESSY & ROACH PC 47 16WC 04132 BEAMUS, PAMELA FCA US LLC 08/06/15 BLACK & JONES WIEDNER & MCAULIFFE LTD 15WC009735 -C CHRYSLER CORP. 15WC034471 -C 16WC004131 -C 16WC016894 -C 48 16WC 05656 DIEHL, DAN L STATE OF IL DEPT OF TRANS @ 01/27/14 TUITE LAW ASSISTANT ATTY GENERAL 18WC013548 -C 49 16WC 07471 JORDAN, TIARA DASCO PRO 02/29/16 BLACK & JONES WOLFE & JACOBSON, LTD 50 16WC 09573 NAYONIS, MICHAEL WOODWARD GOVERNOR CO 07/08/04 BLACK & JONES HINSHAW & CULBERTSON 16WC009574 -C 51 16WC 11140 VEGA, REBECCA FCA USA, INC 01/21/16 GESMER & REYNOLDS PC WILLIAMS MCCARTHY LLP 52 16WC 12930 BACON, GEANETTE CHRYSLER DIVISION FCA US 06/26/15 RICHARD O. GREENFIELD WIEDNER & MCAULIFFE LTD 19WC004702 -C 53 16WC 16180 BRINKMEYER, WESLEYAN CENTRAL RUBBER COMPANY 05/16/16 RIDGE & DOWNES MC ANDREWS & NORGLE LLC 54 16WC 20151 MACIEL, YAYA J SLIDEMATIC PRECISION COMP 02/11/16 GESMER & REYNOLDS PC LAW OFFICES JOSEPH MARCINIAK 55 16WC 21252 BAUMAN, MICHAEL D CITY OF ROCKFORD 04/02/16 THOMAS W DUDA HEYL ROYSTER VOELKER & ALLEN 56 16WC 21826 DAUGHERTY, JENNIFER BERGSTROM MFG CO 04/01/16 BLACK & JONES WOLFE & JACOBSON, LTD 57 16WC 22497 LEMBKE, JAMES MCDERMAID 08/11/14 HORWITZ HORWITZ & ASSOC LAW OFFICES OF EDWARD J. KOZ 58 16WC 23733 ANDRADE, CONCEPCION LAWNCARE BY WALTER 06/10/16 O'CONNOR & NAKOS RIPES NELSON BAGGOT KALOBRAT 59 16WC 24069 BROWN, EDITH TESTORS 07/12/16 BLACK & JONES 60 16WC 24610 RILEY-STEELE, MELENDY FCA US LLC 10/07/14 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 5 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 01/08/2021 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 61 16WC 26227 THOMAS, LUTHER SYNCREON 05/03/16 BLACK & JONES KEEFE CAMPBELL BIERY & ASSOC 62 16WC 27022 MCWETHY, TANYA INTERNATIONAL AUTOMOTIC 02/07/14 STRONG LAW OFFICE GANAN & SHAPIRO 16WC027028 -C 16WC027029 -C 63 16WC 27242 19B WACKER, CARRIE B. ILLINOIS STATE TOLL @ 04/26/16 TUITE LAW GANAN & SHAPIRO 18WC011134 -C 64 16WC 28857 RODRIGUEZ, EMILIO JR FCA US 12/11/15 HORWITZ HORWITZ & ASSOC WILLIAMS MCCARTHY LLP 65 16WC 30034 BADER, KRISTIE UTC AEROSPACE SYSTEMS 04/19/16 KATZ FRIEDMAN EAGLE ET AL RUSIN & MACIOROWSKI LTD 66 16WC 30522 PETSCH, JOSEPH LANE'S AUTO SERVICE, INC 03/17/16 GESMER & REYNOLDS PC 67 16WC 31572 MACKENZIE, THERESA C PACKAGING COORDINATORS, I 09/15/16 TUITE LAW JOSEPH MARCINIAK 68 16WC 31901 MUSSER, MARJORIE K KOLB-LENA, INC 10/20/13 TUITE LAW KEEFE CAMPBELL & ASSOC LLC 16WC038115 -C 18WC026684 -C 69 16WC 32909 HIRTH, COLE M REGAL PRODUCTS 02/13/15 FRANCINE B WHITE PERRY GENTILE 70 16WC 34127 DONEGAN, DELOREAN WALMART SUPERCENTER 06/06/16 BLACK & JONES QUINTAIROS PRIETO WOOD & BOY 71 16WC 34224 DIBBIN, EDWARD WINNEGAGO COUNTY 03/19/15 GOTTREICH & GRACE 72 16WC 34269 SMITH, KEITH FCA US LLC 04/11/15 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE 73 16WC 34271 CHIPMAN, PAMELA GE AVIATION AIR 03/10/16 KATZ FRIEDMAN EAGLE ET AL RUSIN & MACIOROWSKI LTD 74 16WC 36935 THATCHER, JOHNNY M FCA US LLC 06/27/16 TUITE LAW WIEDNER & MCAULIFFE 75 16WC 37130 SIVERIO, EWA K WAL-MART STORES, INC. 11/23/15 TUITE LAW QUINTAIROS PRIETO WOOD & BOY 76 16WC 37799 LOGAN, JAMES IMAGE PROS ASPHALT MAINTE 11/10/15 BLACK & JONES CHILTON YAMBERT PORTER LLP 77 16WC 37856 JONES, ROBERT ACCURIDE CORP DBA GUNITE 07/01/16 LAWFIRST 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 ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 01/08/2021 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 78 16WC 39367 RIOS, LUIS LC AUTO SALES W 11/08/16 MC HARGUE & JONES VELLA & LUND 79 17WC 02522 ZIMMERMAN, KATHRINE VAN MATRE HEALTHSOUTH REH 07/29/16 BLACK & JONES SPIEGEL & CAHILL, PC 80 17WC 03945 BARRERA, PASCUAL ANCO STEEL COMPANY, INC 05/12/16 KINNALLY FLAHERTY KRENTZ & WOLFE & JACOBSON, LTD 81 17WC 04750 CONTRERAS, ALEJANDRO RW DUNTEMAN CO 08/08/14 JONATHAN SCHLACK 82 17WC 05876 FINK, JUDY, WIDOW OF VAN GALDER COACH USA # 01/22/17 MARKS INJURY LAW POULOS & DIBENEDETTO LAW 83 17WC 06083 WILLIAMS, EARL METRO STAFFING INCORPORAT 11/21/16 BRASSFIELD KRUEGER & RAMLO WIEDNER & MCAULIFFE LTD 84 17WC 06655 ROSE, DANIEL S TARGET 09/30/16 ALEXANDER, PETER LTD. NYHAN BAMBRICK KINZIE & LOWR 85 17WC 07117 CONGRAVE RUDE, CHENIN OSF ST ANTHONY MEDICAL CE 12/26/16 FRANCINE B WHITE HINSHAW & CULBERTSON 86 17WC 08728 STOVALL, BRENT ROCKFORD BOARD OF EDUCATI 01/24/17 GESMER & REYNOLDS PC WIEDNER & MCAULIFFE 87 17WC 09101 KASKE, JOSHUA MODERN ADVANCED MANUFACTU 12/08/15 KATZ FRIEDMAN EAGLE ET AL 88 17WC 10298 MARONDE, CHRISTINA STATE OF ILLINOIS @ 11/14/16 GESMER LAW OFFICES, PC HELEN LOZANO 89 17WC 11068 BLAZER, DONALD PTO SERVICES 03/07/17 BLACK & JONES 90 17WC 11628 MCVAY, JORDAN BEHR IRON METAL 06/30/14 GESMER LAW OFFICES, PC 91 17WC 12830 LUNDE, JACOB ROCKFORD SPECIALTIES CO 02/28/15 BLACK & JONES WOLFE & JACOBSON, LTD 92 17WC 13214 CASAZZA, MEREDITH BON TON STORES, INC 10/26/16 BLACK & JONES BRADY CONNOLLY & MASUDA PC 18WC020119 -C 93 17WC 14849 WILLIAMS, LAWRENCE BOONE COUNTY AUTO BODY 10/07/16 BLACK & JONES GANAN & SHAPIRO 94 17WC 15006 HARRISON, JOSEPH P COILCRAFT 01/03/17 PIGNATELLI & ASSOCIATES HENNESSY & ROACH PC 95 17WC 15446 GEHRT, COLE IDOT @ 08/19/15 FRANCINE B WHITE HELEN LOZANO

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 7 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 01/08/2021 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 96 17WC 15508 BRANT, KRISTINA NICAA HEAD START 03/29/17 BLACK & JONES RUSIN & MACIOROWSKI LTD 97 17WC 16860 SHEETS, MATTHEW UNITED PARCEL SERVICE 10/14/16 ROSS TYRRELL NYHAN BAMBRICK KINZIE & LOWR 98 17WC 17368 CROFFOOT, CRAIG S STEPHENSON COUNTY SHERIFF 12/20/16 HAUSER LAW LLC INMAN & FITZGIBBONS 99 17WC 17949 WILBOURN, JOHN SNAK KING CORP 11/14/16 MARKS INJURY LAW COZZI & GOGGIN-WARD 100 17WC 17994 GOMEZ-SANCHEZ, ARISTEO CPM RECYLING SERVICES 11/23/16 BLACK & JONES 101 17WC 17997 MARQUEZ, JONATHAN CHEMTOOL INC 05/07/17 BLACK & JONES RUSIN & MACIOROWSKI LTD 102 17WC 18432 BUCK, KAREN WINNEBAGO COUNTY HEALTH D 02/15/17 NICHOLAS ROBERT RECCHIA WILLIAMS MCCARTHY LLP 103 17WC 18715 GOWAN, LYNWOOD MEADE ELECTRIC CO, INC 09/16/16 SCHWEICKERT & GANASSIN RUSIN & MACIOROWSKI LTD 104 17WC 20882 ELLIS-GOOCHER, STEPHANI EASTER SEALS METRO 04/27/17 STORTO FINN & ROSINSKI NOBLE & ASSOCIATES PC 105 17WC 21124 MARTIN, ERIK C FCA USA, LLC 06/14/17 ANKIN LAW OFFICE WIEDNER & MCAULIFFE LTD 106 17WC 22577 ETHRIDGE, RONALD K MALCOLM EATON ENTERPRISES 07/11/14 HAUSER LAW LLC COZZI & GOGGIN-WARD 107 17WC 22852 BERTUCCI, DEBORAH GALENA & ASSOC, INC DBA 04/01/16 DEPAOLO & ZADEIKIS GANAN & SHAPIRO 108 17WC 23062 VICKERMAN, JUSTIN ONE OF A KIND WALL DESIGN 07/26/17 BLACK & JONES 109 17WC 25541 O'CONNOR, MARY VISITING NURSES ASSN 04/19/17 CLARK FROST WIEDNER & MCAULIFFE 110 17WC 25753 EVANS, BETTEY L PINNACLE LOGISTICS 06/15/17 GESMER & REYNOLDS PC KEEFE CAMPBELL BIERY & ASSOC 111 17WC 25941 HARRIS, JEFF MULLER PINESHURST 01/17/17 BRASSFIELD KRUEGER & RAMLO 112 17WC 26373 EDMONDS, CHARLES J EAST DUBUQUE NITROGEN 06/14/16 KATZ FRIEDMAN EAGLE ET AL

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 8 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 01/08/2021 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 113 17WC 26466 ROOS, LAWRENCE SIMOS INSOURCING SOLUTION 08/15/17 BLACK & JONES BRADY CONNOLLY & MASUDA PC 114 17WC 26717 HANOOSH, SALIH N FURST STAFFING SERVICES, 04/23/17 BLACK & JONES ACCIDENT FUND HOLDINGS 18WC038078 -C 115 17WC 26927 FOREMAN, ELIJAH MONDELEZ INTERNATIONAL 03/09/15 FRANCINE B WHITE WIEDNER & MCAULIFFE LTD 116 17WC 27217 SWEAT, AMANDA L MERIDIAN CUSD #223 05/16/17 TUITE LAW NYHAN BAMBRICK KINZIE & LOWR 117 17WC 28373 PRICE, AMY FCA US LLC 09/01/17 KATZ FRIEDMAN EAGLE ET AL WILLIAMS MCCARTHY LLP 118 17WC 28627 SCHABACKER, EUGENE S SPARKY'S ELECTRICAL 08/08/17 TUITE LAW HEYL ROYSTER VOELKER & ALLEN 119 17WC 30007 COLLINS, JAVAR FURST STAFFING 07/10/17 DERANGO & CAIN 120 17WC 30302 RAISBECK, TIMOTHY STATE OF ILLINOIS/IDOT @ 09/09/16 ROSENBERG EISENBERG ASSOC ASSISTANT ATTORNEY GENERAL 17WC030303 -C 18WC029987 -C 121 17WC 30777 MONTANA, MARIAN ROCKFORD SCHOOL DIST #205 01/30/17 GESMER LAW OFFICES, PC WIEDNER & MCAULIFFE LTD 17WC030765 -C 122 17WC 30948 ZERKEL, SUSAN ST RITA'S CHURCH 09/12/17 WOODRUFF & JOHNSON KEEFE CAMPBELL BIERY & ASSOC 123 17WC 31292 LANE-BARRY, JERRY 3P CONSTRUCTION AND REMOD W 05/15/17 BLACK & JONES 124 17WC 31568 BRAUER, TAMRA MEIJER 10/16/17 GESMER & REYNOLDS PC KOPKA, PINKUS DOLIN, PC 125 17WC 32102 HALL, GREGORY METRO STAFFING 10/12/17 BLACK & JONES SLAVIN & SLAVIN 126 17WC 32274 RIVERA, MARIO AELDRIDGE ROOFING & SIDIN 10/13/17 GESMER LAW OFFICES, PC 127 17WC 32407 ZIMMERMAN, NICHOLE L FEDERAL EXPRESS CORPORATI 03/08/17 BLACK & JONES HANSON LAW OFFICE 19WC026163 -C FEDEX

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 9 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 01/08/2021 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 128 17WC 32507 VAN BARRIGER, JOSEPH R BAY VALLEY FOODS 08/25/17 GESMER LAW OFFICES, PC KEEFE CAMPBELL BIERY & ASSOC 129 17WC 32563 MUHASKY, DAVE HOLLAND MOTORS 04/11/12 GOLDBERG WEISMAN & CAIRO L HENNESSY & ROACH PC 19WC015896 -C 130 17WC 32796 RICHARDSON, JOHNETTA ROCKFORD HOME SERVICES DR 09/27/17 ASSISTANT ATTORNEY GENERAL 131 17WC 33158 GUY, ANDREA WOODS EQUIPMENT 08/01/17 PIGNATELLI & ASSOCIATES WOLFE & JACOBSON, LTD 132 17WC 33759 RIVERA, MARIO ANGEL ORTEGA 10/13/17 GESMER & REYNOLDS PC HENNESSY & ROACH PC 133 17WC 33858 PETERS, MARY KOLB-LENA CHEESE CO 07/29/17 BLACK & JONES KEEFE CAMPBELL & ASSOC LLC 134 17WC 34036 OVERTON-MILLER, DAWN R SEARS HOLDINGS CORPORATIO 10/24/17 TUITE LAW GAROFALO SCHREIBER STORM GRA 135 17WC 35749 LOVE, GERALD R ILLINOIS DEPARTMENT @ 03/07/17 FRANKS, GERKIN & MCKENNA P 136 17WC 36428 SAGER, RANDY BENNETT BOALS TRUCKING, I 05/30/17 BRADY CONNOLLY & MASUDA PC 137 17WC 37589 PRINE, BRIAN CITY OF ROCKFORD 10/12/17 GESMER LAW OFFICES, PC HEYL ROYSTER VOELKER & ALLEN 138 18WC 00292 HALL, JEFFRY A COUNTY OF WINNEBAGO 07/28/17 TUITE LAW WILLIAMS MCCARTHY LLP 19WC023931 -C 139 18WC 00569 GILMORE, BONNIE L HOMEGOODS, INC 01/12/17 TUITE LAW BRADY CONNOLLY & MASUDA PC 140 18WC 01034 SHONDEL, DAWN CARDINAL STAFFING 10/26/17 DWORKIN AND MACIARIELLO HENNESSY & ROACH PC 141 18WC 01522 PEHL, SUSAN QPS STAFFING 11/03/17 GESMER LAW OFFICES, PC WOLFE & JACOBSON, LTD 142 18WC 01566 VIEDERIS, PAT CARDINAL GLASS COMPANY 01/30/17 HORWITZ HORWITZ & ASSOC BRADY CONNOLLY & MASUDA PC 143 18WC 01702 COLE, GABRIELLE CASEYS GENERAL STORES 05/07/17 WHITESIDE & GOLDBERG LTD HEYL ROYSTER VOELKER & ALLEN 144 18WC 01863 THOAMS, MARZAVIOUS UPS 10/10/17 BLACK & JONES

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 10 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 01/08/2021 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 145 18WC 02024 STROH, VANESSA ROCHELLE GARDENS CARE CEN 11/16/17 BLACK & JONES KNELL LAW LLC 146 18WC 02874 BIRD, MICHAEL OAKLEY SUB-ASSEMBLEY 12/14/17 MARTIN V KUGIA ACCIDENT FUND HOLDINGS 18WC005095 -C 19WC005965 -C 19WC005966 -C 19WC005967 -C 147 18WC 03322 MARYOTT, HOLLY M DARDEN RESTAURANTS, INC 01/13/18 TUITE LAW WIEDNER & MCAULIFFE LTD 148 18WC 03366 GROOMS, DANA L SWEDISH AMERICAN HOSPITAL 01/05/17 KELLY & KING WILLIAMS MCCARTHY LLP 149 18WC 03639 MARTINEZ-VALDEZ, MAYRA JONES NATURAL CHEWS 09/20/17 BLACK & JONES ACCIDENT FUND HOLDINGS 150 18WC 04431 CUMBA, MARIBELLE RESOURCE MFG/PROLOGISTIX 07/07/17 KATZ FRIEDMAN EAGLE ET AL NYHAN BAMBRICK KINZIE & LOWR 151 18WC 04548 NAVA, NICANDRO CHRYSLER, LLC/ 11/20/17 RUEDA, IVAN A WILLIAMS MCCARTHY LLP 152 18WC 05245 SMITH, MARK MORNING DISPOSAL, INC 01/10/18 GESMER & REYNOLDS PC RIPES NELSON BAGGOT KALOBRAT 153 18WC 05577 SMITH, APRIL PARKVIEW NURSING HOME 01/22/17 BLACK & JONES BRYCE DOWNEY & LENKOV LLC 154 18WC 05700 STOREY, RHONDA S AJ KENT, INC DBA GOODTIME 09/17/13 TUITE LAW 155 18WC 06198 19B TORRES, JOSE WASTE CONNECTIONS 01/04/18 ADRIAN MURATI BRADY CONNOLLY & MASUDA PC 156 18WC 07468 ERUINS, LASHONDA ROSECRANCE, INC 09/11/17 PUMILIA LAW LLC 157 18WC 08070 STRAM, JASON SPAHN AND ROSE LUMBER 11/22/17 GESMER & REYNOLDS PC HEYL ROYSTER VOELKER & ALLEN 158 18WC 08727 DANNO, PATRICK ILLINOIS STATE TOLL @ 02/06/18 GESMER & REYNOLDS PC NYHAN BAMBRICK KINZIE & LOWR 159 18WC 08860 WATTS, ANDREA CHRYSLER 11/11/17 COVEN LAW GROUP WIEDNER & MCAULIFFE 160 18WC 09262 REINE, COLLEEN ROCKFORD RIGGING, INC 10/15/17 NASH LAW OFFICE PC 161 18WC 09596 REINE, COLLEEN ROCKFORD RIGGING, INC. 10/31/17 NASH LAW OFFICE PC

ILLINOIS WORKERS' COMPENSATION COMMISSION PAGE 11 C A S E H E A R I N G S Y S T E M ERBACCI, ANTHONY 033 ARBITRATION CALL FOR ROCKFORD 45001 ON 01/08/2021 SEQ CASE NBR PETITIONER NAME RESPONDENT NAME ACCIDENT DATE ATTORNEY NAME ATTORNEY NAME *********************************************************************************** * = NEW CASE # = FATAL @ = STATE EMPLOYEE W = IWBF - 162 18WC 09767 PYFER, JAMES SHEET METAL CONNECTORS 06/22/16 GESMER & REYNOLDS PC HOLECEK & ASSOCIATES 163 18WC 10579 NUNEZ, REINALDO MIDCOR SUPPLY 03/31/18 BOTTO GILBERT WIEDNER & MCAULIFFE LTD 164 18WC 11004 SMELSER, JONATHAN DCA US LLC 10/11/16 KATZ FRIEDMAN EAGLE ET AL WIEDNER & MCAULIFFE LTD 165 18WC 11071 NEMENSKI, PHILLIP R MIDSTATES CONCRETEINDUSTR 09/11/17 SOSTRIN AND SOSTRIN PC GAROFALO SCHREIBER STORM GRA 18WC011072 -C 18WC015826 -C 18WC015827 -C 166 18WC 11288 GELENCIR, JOHN CHRYSLER 09/06/17 BROWN & CROUPPEN WIEDNER & MCAULIFFE LTD 167 18WC 12779 ESTATE OF JENNIFER M CARO ROCKFORD PARK DISTRICT 03/07/18 LAWFIRST HENNESSY & ROACH PC 168 18WC 13694 CALDERA, MARIBEL DIVERSIFIED MAINTENANCE 03/27/18 BLACK & JONES HARRIS DOWELL FISHER & HARRI 169 18WC 14130 PHILLIPS, MYRNA BERNER FOODS 05/05/18 O'CONNOR & NAKOS HOLECEK & ASSOCIATES