FMCSA again extends paper medical card waiver for truckers as eight states fail to move to electronic system

The Federal Motor Carrier Safety Administration (FMCSA) will continue to allow truck drivers to continue to use paper copies of their medical examiner’s certificate (MEC) as several states continue to lag behind on implementing the electronic system.

FMCSA extended an expiring waiver that will allow commercial driver’s license (CDL) holders, commercial learner’s permit (CLP) holders to use a paper copy of the MEC as proof of the driver’s medical certification for up to 60 days after the date the medical examiner’s certificate was issued.

The newest waiver is valid January 11 through April 10, 2026.

The previous waiver extension issued in October 2025 was set to expire on January 10, 2026.

The waiver extension was issued due to the fact that “eight States have not yet implemented NRII and are continuing to rely on the paper MEC.”

The FMCSA’s Medical Examiner’s Certification Integration (NRII) rule went into effect in June 2025. It seeks to streamline the CDL and CLP holder medical certification process by requiring that medical examiners electronically transmit the results of an applicant’s physical exam directly to the FMCSA’s National Registry. The FMCSA then transmits the exam results to State Driver’s Licensing Agencies (SDLA), eliminating the need for CDL and CLP holders to submit their own MEC to SDLAs.

FMCSA is also encouraging medical examiners to continue to issue paper copies of MECs amid the transition to the electronic system.

“FMCSA finds that the granting of this waiver is in the public interest to ensure that the operations of interstate CDL holders, CLP holders, and motor carriers are not interrupted, and drivers may continue transporting the Nation’s goods to businesses, customers, and communities safely, reliably, and efficiently,” the agency said.

For additional information, you can view the newest waiver here.