Paper medical cards stop counting, and emergency HOS relief is back to 30 days

Posted October 12, 2026

FMCSA made two changes between October 5 and October 12, 2026. One touches every driver file. The other matters the next time a hurricane, wildfire or fuel shortage hits.

1. Paper medical certificates are done (except in Alaska). Under the National Registry II (NRII) rule, medical examiners send DOT physical results to FMCSA electronically, and the results get posted to the driver’s state record (the CDLIS driving record). That electronic record is now the official proof. While states caught up, FMCSA issued temporary waivers that let drivers and carriers rely on a paper medical examiner’s certificate. The last waiver ran out on October 11, 2026.

• Since October 12, 2026: a paper copy no longer proves medical certification for drivers licensed in the other 49 states and D.C.
• Alaska only: Alaska is the one state that has not switched over. Alaska-licensed CLP and CDL holders and their carriers can rely on a paper certificate for up to 60 days after it was issued. That exemption runs until October 12, 2027.

2. Emergency relief goes back to 30 days. A final rule published and effective October 5, 2026 changes the automatic relief after a regional emergency declaration (by a governor or FMCSA) from 14 days back to 30 days. The relief covers hours-of-service limits (49 CFR 395.3 and 395.5) for trucks giving direct help to restore essential services and supplies. It ends sooner if the emergency itself is shorter, and FMCSA can still extend it. FMCSA cut the window to 14 days in 2023. OOIDA and the National Propane Gas Association asked to have it put back.

What to do:

• Drivers: after your DOT physical, ask the examiner for a copy anyway, then make sure the new certification shows up on your state driving record. If it doesn’t, the examiner has to fix the mismatch.
• Carriers: don’t take a paper card as proof for a driver licensed outside Alaska. Check medical status on the driver’s CDLIS driving record and keep that in the driver qualification file.
• Emergency loads: read the actual declaration before you dispatch. Relief only covers direct assistance, only covers hours of service, and only lasts as long as the emergency does, up to 30 days.

Plain-English summary for general information, not legal advice. Check the source before acting.