For years, the Federal Motor Carrier Safety Administration (FMCSA) has been working toward a fully digital medical certification process. That transition has been notoriously bumpy. However, a solution is finally here, and it’s critical for drivers and carriers to understand what’s changing, and how to stay compliant.
Why the change?
The move to electronic medical certificates is part of the National Registry II (NRII) initiative. This system integrates medical examiners’ certifications directly into state driver licensing agencies, reducing paperwork errors, and ensuring faster updates to driver records.
National Registry II (NRII), also called Rule II, is the system that officially ends the use of paper medical cards. It was initially proposed that starting June 23, 2025, all medical exam results would be sent in electronically. Under this rule, certified medical examiners would have to upload your DOT exam results to the National Registry by the next day. However, due to technical and security issues with the FMCSA’s IT system, a temporary waiver was put in place.
Beginning October 13, 2025, the Federal Motor Carrier Safety Administration (FMCSA) extended its temporary waiver permitting drivers to use paper medical examiner’s certificates for up to 60 days after issuance. This waiver remains in effect until January 10, 2026, allowing paper medical cards to be accepted through that period.
In states using the digital system, medical examiners must send exam results straight to the FMCSA. The FMCSA then passes those results on to state licensing agencies, so drivers no longer have to turn in their own medical certificates. If your digital record isn’t showing up yet, you can still use a paper medical card until the waiver expires.
What companies must do:
- Continue to collect copies of medical cards for accurate recordkeeping.
- Review MVRs to confirm medical certifications are updated within 10 days of the appointment.
- Ensure driver examiners submit results electronically for streamlined compliance.
- Keep drivers fully compliant to prevent being put out of service.
What drivers must do:
- Keep a paper copy temporarily: During the waiver period, drivers are advised to carry a paper medical certification.
- Monitor your MVR (Motor Vehicle Record): Ensure your medical certification is properly updated in the system.
- Work with your examiner: Medical examiners are required to submit results electronically, but will still provide paper copies for your records.
- Stay compliant: Failure to transition could result in CDL downgrades
Bottom line-
The FMCSA’s digital transition is here to stay. Drivers should confirm their medical certifications are updated electronically, keep a backup paper copy until the system is fully reliable, and stay ahead of compliance deadlines. Carriers should implement tracking systems to avoid costly fines and keep fleets running smoothly.
✅ Action Step: If you’re a CDL holder, check your medical certification status today. Don’t wait until your license is at risk.