Paper Medical Cards End—Except for CDL Holders in One State
Nearly all commercial driver’s license and commercial learner’s permit holders must now rely on electronic medical-certification records rather than paper Medical Examiner’s Certificates. Alaska is the only state covered by an exception allowing certain CDL and CLP holders to use paper certificates temporarily.
NRII waiver expires nationwide
The Federal Motor Carrier Safety Administration’s temporary waiver connected to the National Registry II rollout expired at midnight on Oct. 11, 2026. The waiver had allowed interstate CDL and CLP holders, along with their motor carriers, to use a paper Medical Examiner’s Certificate as proof of medical qualification for up to 60 days after the certificate was issued.
Beginning Oct. 12, medical-certification information for CDL and CLP holders is generally required to move electronically from the certified medical examiner through FMCSA to the driver’s state driver licensing agency.
Alaska receives limited exception
FMCSA’s provisional ruling allows commercial drivers in Alaska to continue relying on paper medical certificates for up to 60 days after issuance. The temporary allowance is scheduled to remain available through October 2027.
The Alaska provision does not change the electronic-certification requirements in other states. CDL and CLP holders outside Alaska must have their medical-certification information processed through the electronic system.
What the change means for carriers and drivers
The National Registry II system was established to replace paper-based medical-certification procedures with an electronic process. Medical examiners are responsible for transmitting examination results to FMCSA, which then provides the information to the appropriate state licensing agency.
Drivers and carriers must comply with the requirements that apply in the state where the CDL or CLP was issued. Paper certificates are no longer generally accepted as the primary proof of medical qualification outside the limited Alaska exception.
