The Federal Motor Carrier Safety Administration has granted an exemption allowing truckers to continue using a paper copy of their medical certification for the next six months.

In December 2025, the Commercial Vehicle Safety Alliance petitioned the FMCSA to issue guidance to commercial motor vehicle enforcement officials stating that paper copies of exams are permitted as evidence of medical certification.

The group’s request came months after the agency announced it would be rolling out the long-awaited Medical Examiner’s Certification Integration rule. Commonly known as NRII, and originally published in April 2015, the final rule requires medical examiners to electronically submit results from medical certification exams to the FMCSA and state licensing agencies. Additionally, the new electronic system would also eliminate the need for truckers to carry a paper copy of their certification.

Since June, a number of states have experienced issues implementing the new system. Currently, five states – Alaska, California, Kentucky, Louisiana and New Hampshire – have still not implemented NRII, leading to issues for many drivers. As a result, FMCSA issued a series of waivers allowing drivers to continue using paper copies of their medical certification, with the most recent expiring on April 10.

In response to the group’s letter, FMCSA said it was unable to issue the guidance requested “because it would conflict with the regulations currently in effect, which are binding on regulated entities.” Because of this, the agency treated the group’s request as an application for exemption and opened a 30-day public comment period, which closed on March 9.

This past week, the agency announced it would grant a six-month exemption allowing carriers to continue relying on paper cards for medical certification for up to 60 days after their exam. The exemption went into effect on April 11 and is set to expire on October 11.  

“The purpose of the exemption is to ensure that drivers with valid medical certification and their employers are not penalized for delays outside of their control as five remaining States implement the Medical Examiner’s Certification Integration final rule,” the agency said.

FMCSA said it did not anticipate granting additional waivers or exemptions regarding NRII, meaning the Oct. 11 expiration date will effectively serve as a deadline for the final five states to become fully compliant.

“The agency believes that a shorter-term exemption of six months allows sufficient time for most of the remaining States to implement NRII and reduces any uncertainty as to the expected duration of the regulatory relief,” FMCSA said. “States, motor carriers, and drivers should not expect additional nationwide waivers or exemptions beyond the six-month duration of this exemption.”

In total, the FMCSA received nine comments on the exemption request. The Owner-Operator Independent Drivers Association supported the group’s petition and urged FMCSA to grant the exemption.

“No driver who has been medically cleared should be forced off the road due to external processing errors,” the Association said in its comments signed by President Todd Spencer. LL