• Due to the Medical Examiner’s Certification Integration, CDL and CLP drivers’ medical certificates will be sent to state licensing agencies automatically.

June 23, 2025, the medical certification process changed due to the “Medical Examiner’s Certification Integration” final rule published on April 23, 2015. The biggest change is that commercial driver’s license (CDL) and commercial learner’s permit (CLP) holders licensed in states that have transitioned to the National Registry Phase II (NRII) are not required provide their medical certificates to the state licensing agencies because that information will be transmitted automatically. The following is an overview of the changes related to the integration:

• After an exam, medical examiners (ME) are required to enter exam results in the Federal Motor Carrier Safety Administration (FMCSA) National Registry of Certified Medical Examiners (NRCME) by midnight of the next calendar day. This process has been in place and will continue.
• For licensing authorities that have transitioned to NRII, FMCSA must upload these results to the driver’s licensing agency, which then must post the information to the CDL/CLP driver’s motor vehicle record (MVR) within one business day.
• For CDL/CLP drivers, the MVR is the only official proof of medical certification required in the DQ file along with a copy of any medical variance. Based on the regulations in 391.43(g) on and after June 23, 2025, drivers and their employers do not need the paper medical card because the 15-day window does not apply. Employers must promptly obtain a new MVR after each new medical exam.
  • WATCHOUT: CDL/CLP drivers should still ask the examiner for a medical card before they leave the exam and have the examiner take a copy of their CDL to aid in resolving transfer errors. FMCSA strongly recommends that the CME issues a medical card under the temporary waiver. (See below.)The new information could take 2-4 days or more after the date of the exam to reflect on the MVR. If the driver’s prior certification expired on the MVR, they should not be driving a CMV, per FMCSA.
  • FMCSA temporary waiver: From August 21, 2025, through October 12, 2025, CDL/CLP drivers can carry a copy of their medical card for up to 60 days after each DOT exam as proof of medical certification while operating a CMV. Carriers may also use a copy of the medical card in the DQ file for up to 60 days after each DOT exam. FMCSA strongly recommends that medical examiners issue medical cards to CDL/CLP drivers whose licensing authorities have transitioned to NRII. The waiver was issued due to delays to the most current medical certification information appearing on the CDL MVR. A prior waiver issued July 14, 2025, was superseded by the most recent waiver, allowed 15 days to use the medical card as proof of medical certification. None of the information in the table below reflects the temporary waiver.
• Because the CDL/CLP driver exam results are transmitted through the NRCME in states that have transitioned to NRII, employers are not required to place in the DQ file, proof that the MEs were listed on the National Registry on the date of the exam. For states that have not transitioned to NRII, place the verification note in the DQ file and retain for three years from the date of the document.
• Non-CDL drivers must always carry their medical cards, and their employers must keep a copy file and verify the National Registry listing of their MEs. Nothing has changed.
• Examiners must inform drivers when they are deemed medically unqualified, and that this information will be reported to the FMCSA. When the FMCSA receives the report, it will invalidate any medical cards previously issued to the driver and will electronically transmit this report to the CDL/CLP driver’s state licensing agency.