The Federal Motor Carrier Safety Administration has extended a waiver of new medical card requirements. Originally set to expire on Sunday, October 12, the waiver now expires on January 10, 2026.

The Federal Motor Carrier Safety Administration initially put the waiver in place in July after it became clear that many states were not ready for a June deadline that changed the process of sending commercial driver medical cards to state licensing agencies.

What Changed in the Medical Card Process?

The medical certificate, often referred to as a med card, confirms that drivers are physically qualified to drive a commercial motor vehicle under federal regulations, based on a medical exam by a professional on the FMCSA's National Registry of Certified Medical Examiners.

Drivers with commercial driver’s license were responsible for giving a paper copy of medical card to their state’s driver licensing agency.

The medical professionals performing those exams were required to submit results to the FMCSA registry of certified examiners, but that process was often delayed or incomplete. Meanwhile, state licensing agencies had to manually update those license records.

The Medical Examiner’s Certification Integration final rule was originally published in 2015, but the full rollout has been slow.

Under new integration rules that were scheduled to go into effect on June 23, drivers no longer have to provide a paper copy of their medical card to their state’s driver licensing agency. Now, certified medical examiners will send the medical exam results directly to the national registry at FMCSA.

The FMCSA then will electronically transmit those results to state licensing agencies, which will link them up with that driver’s records.

What the Waiver Does for Trucking Companies and Truck Drivers

However, according to the renewed waiver, there are still 12 states that have not yet implemented what is called NRII and are continuing to rely on the paper medical examiners’ certificate.

“FMCSA is aware that during this initial period of transition to NRII, some CLP applicants and CDL holders may face delays in the time between receipt of their medical certification and the update to their CDLIS driver MVR as medical examiners and SDLAs onboard to the new system," FMCSA said in its renewed waiver.

Under the waiver, motor carriers can continue to use a copy of the medical examiner’s certificate as proof of the driver’s medical certification for up to 60 days from the date of the medical certification. 

Similarly, commercial drivers can continue to use a copy of the paper medical card as proof of the driver’s medical certification for up to 60 days from the date of the medical certification.

FMCSA strongly recommends that medical examiners continue to issue paper med cards to drivers until further notice, in addition to submitting the results electronically,

The paper copy allows the driver to troubleshoot and resolve issues with their state driver licensing agencies during the transition.

Which States Aren't Ready?

As of October 10, there are still 12 states whose licensing agencies aren't able to accept these electronic transmissions. CDL drivers in these states are instructed to continue following the old process of obtaining a paper med card and taking it to their state licensing agency to link with their driving record.

• Alaska

• California

• Florida

• Iowa

• Kentucky

• Louisiana

• New Hampshire

• New Jersey

• New York

• Oklahoma

• Vermont

• Wyoming