What you need to know:
- Effective dates: The exemption began April 11, 2026, and is scheduled to run through Oct. 11, 2026.
- 60-day rule: Commercial driver’s license (CDL) and commercial learner’s permit (CLP) holders may rely on a paper copy of their medical examiner’s certificate for up to 60 days after the date of issuance.
- Scope: The waiver applies to all interstate CDL and CLP holders and their employers.
Federal officials have issued a temporary exemption allowing commercial truck and bus drivers to use paper medical certificates as proof of physical qualification, citing ongoing technical transitions in how driver health data is transmitted to states.
The Federal Motor Carrier Safety Administration announced the measure to support drivers and motor carriers as state licensing agencies and medical examiners move toward a fully electronic system. Under the National Registry II (NRII) final rule, this data is eventually intended to be shared via secure electronic transmission.
The rule officially took effect on June 23, 2025, but was immediately followed by waivers for states not yet compliant. A temporary waiver for paper medical cards was issued, covering October 13, 2025, to January 10, 2026, and later extended through April 10, 2026. As of April 13, Alaska, California, Kentucky, Louisiana, and New Hampshire have not implemented NRII.
The agency indicated this is likely the final reprieve for the industry regarding these specific digital requirements, adding it does not anticipate granting additional, nationwide NRII waivers or exemptions after the six-month duration of this exemption.
Guidance for drivers and examiners
While the industry moves toward a digital-first system, the FMCSA is advising a "belt and suspenders" approach to paperwork. The agency recommends that certified medical examiners continue to provide drivers with a physical Form MCSA-5876 in addition to uploading the results to the federal electronic registry.
The transition to the National Registry II system is designed to streamline the verification process and reduce fraud by ensuring that only examinations performed by certified professionals are linked to a driver's permanent record. However, the move has required significant infrastructure updates for State Driver’s Licensing Agencies across the country.
