If you still keep a paper medical examiner’s certificate in the cab, that habit is fine — but as of October 12, 2026, that paper card is no longer accepted as proof of medical certification in every state except Alaska, including Illinois.
Here is what changed. For much of the past year, FMCSA allowed drivers and motor carriers in all states to use a paper copy of the medical examiner’s certificate, often called a med card, as proof of medical certification for up to 60 days after it was issued. That nationwide exemption expired at the end of October 11, 2026. FMCSA had already said it did not expect to grant another nationwide waiver.
On October 8, 2026, FMCSA published a Federal Register notice that draws a clear line. Drivers with a CDL or CLP issued by any state other than Alaska, and their employers, may no longer rely on the paper certificate as proof of medical certification for any period of time as of October 12, 2026. Alaska is the only state that has not yet implemented the electronic system known as National Registry II, or NRII. FMCSA granted Alaska drivers and their employers a one-year provisional exemption, through October 12, 2027, to keep using a paper copy for up to 60 days after it is issued.
For everyone else, medical certification is supposed to move electronically. Under NRII, exam results go from the medical examiner through FMCSA’s National Registry to the state driver’s licensing agency, and then onto the Commercial Driver’s License Information System. Roadside inspectors and carriers are meant to rely on that record, not on a paper card in the wallet.
If you have an Illinois CDL or CLP, or you hire drivers licensed in Illinois or in any other state except Alaska, this applies to you. After a DOT physical, give the electronic filing time to land, then confirm that the medical certification actually shows on the license record before the driver is on the road. Keep the driver qualification file current. A medical examiner may still hand you a paper copy of Form MCSA-5876. That copy can be useful as a personal record, but it is not proof of certification in every state except Alaska, including Illinois.
This is not only an inspection issue. When underwriters review Trucking Insurance, they may look at driver qualification records and safety history. A gap between the exam date and what appears on the CDL record can create delays at the roadside and questions at renewal.
If you are unsure whether a driver’s medical certification is on file, sort it out before the next trip, not after a problem comes up.
Questions? Call or text (847) 874-6263, or request a quote.
This article is general information, not legal or coverage advice. Rules can change, and your situation may differ. Coverage is subject to underwriting.
Sources: FMCSA, April 10, 2026; Federal Register, April 14, 2026 and October 8, 2026 (91 FR 64454), https://www.federalregister.gov/documents/2026/10/08/2026-20649/qualification-of-drivers-commercial-vehicle-safety-alliance-application-for-exemption
