The paper medical card waiver ended. CDLIS is the record now, except in Alaska.

Update, October 12, 2026: The nationwide paper medical card exemption is over. FMCSA's October 8 notice (91 FR 64454, FR Doc. 2026-20649) says 49 states and the District of Columbia are now on National Registry II. Alaska is the only state left. As of October 12, 2026, drivers and carriers everywhere else can't use the paper Medical Examiner's Certificate as proof for any length of time. Alaska-issued CDL and CLP holders, and the carriers that run them, got a one-year exemption from October 12, 2026 through October 12, 2027, and can still use the paper card as proof for up to 60 days.

FMCSA's nationwide paper medical card exemption ran out at the end of October 11, 2026. Since October 12, the paper copy of your Medical Examiner's Certificate isn't your 60-day roadside proof anymore, unless your CDL or CLP is from Alaska. For everyone else, what counts is the medical status on your Commercial Driver's License Information System (CDLIS) record. That's what your state posts and what roadside inspectors check.

Your physical didn't expire on October 11. The exemption was only about proof. Your examiner still has to be on the National Registry. The only thing that changed is how your result gets from the clinic onto your license record.

Why there was an exemption at all

FMCSA granted the six-month exemption effective April 11 and published it April 14 (91 FR 19255, FR Doc. 2026-07173). It kept drivers and carriers from being cited while the last states finished connecting to National Registry II, the electronic pipeline that sends exam results to the state licensing agency and onto CDLIS. By October every state but Alaska was connected, so FMCSA only renewed it for Alaska.

What it means for you

If your CDL or CLP is from any state but Alaska, the paper card is a backup, not your proof. The normal rule in 49 CFR 391.41 is back: for CDL and CLP holders, the CDLIS driving record is the proof, not the paper.

If your license is from Alaska, you can still carry the paper card, and your carrier can keep a copy, as proof for up to 60 days from the date it was issued, through October 12, 2027.

If the paper card and the electronic record don't match, the electronic record wins. 49 CFR 383.71(h)(4) says the medical certification information FMCSA sends electronically controls. A valid-looking paper card won't override a not-certified status on your MVR.

Check your record

Pull a fresh MVR after your exam. You're looking for a medical certification status of certified, the expiration date, and any variance. If it's blank or says not-certified, call your examiner and your state licensing agency now. Don't wait to find out at a roadside inspection.

States are supposed to mark a record not-certified within 10 calendar days of an expired or voided certificate, and finish a CDL downgrade within 60 days after that. Those deadlines are in 49 CFR 383.73.

FMCSA has also asked examiners to keep issuing the paper certificate, until further notice, even while they submit electronically. Keep the paper copy. Just don't count on it as your official record unless you hold an Alaska license.

If your certification depends on an FMCSA medical variance, you still need to carry that variance document on duty. The exemption never changed that.

Check CDLIS, and if your exam hasn't shown up, call your licensing state.

Sources

• Federal Register notice, 91 FR 64454, FR Doc. 2026-20649: exemption renewed for Alaska only (published October 8, 2026; Alaska exemption October 12, 2026 through October 12, 2027)
• FMCSA newsroom: temporary exemption to support NRII (posted April 10, 2026; exemption April 11 through October 11, 2026)
• Federal Register notice of final disposition, 91 FR 19255, FR Doc. 2026-07173 (published April 14, 2026)
• FMCSA FR document page
• NRII Learning Center
• 49 CFR 391.41, physical qualifications / paper certificate
• 49 CFR 383.71, including (h)(4) electronic record controls
• 49 CFR 383.73, medical status and CDL downgrade clocks
• National Registry of Certified Medical Examiners

Access date for linked pages: October 12, 2026. Not legal advice. Check your medical status with your licensing state and the National Registry before you act.