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, following the expiration of a temporary Federal Motor Carrier Safety Administration waiver. Alaska is the only state exempt from the change.
Paper medical certificates no longer accepted in most states
As of midnight on Oct. 11, 2026, the FMCSA’s temporary waiver connected to the National Registry II rollout expired. Beginning Oct. 12, drivers licensed in every state except Alaska, along with their employers, may no longer use a paper Medical Examiner’s Certificate as proof of medical qualification.
The National Registry II system was established to modernize the medical certification process by replacing paper-based exchanges with electronic transmission of medical qualification information.
Limited transition period under the waiver
During the waiver period, eligible interstate CDL and commercial learner’s permit holders and their motor carriers could rely on a paper certificate for up to 60 days after the certificate was issued, subject to the waiver’s terms and duration. That temporary allowance is no longer available outside Alaska.
The end of the waiver does not automatically invalidate a driver’s medical certification. However, motor carriers must follow applicable federal verification and recordkeeping requirements and obtain medical certification information through the required electronic process.
Alaska remains exempt
CDL and commercial learner’s permit holders licensed in Alaska are the only drivers covered by the exception. Alaska drivers who are required to maintain medical certification must continue submitting their certificates to the Alaska Division of Motor Vehicles.
