Alaska CDL holders get one more year of paper medical cards

The Federal Motor Carrier Safety Administration on Thursday granted a one-year provisional exemption that lets commercial drivers in Alaska keep using paper medical examiner's certificates, according to the Commercial Carrier Journal on Oct. 8.

Alaska is now the only state that has not implemented FMCSA's Medical Examiner's Certification Integration (NRII) final rule. In the other 49 states and the District of Columbia, where digital integration is complete, paper certificates can no longer prove medical qualification — Louisiana was the next-to-last to comply, crossing the finish line Sept. 15. The exemption covers Alaska-licensed CDL and commercial learner's permit holders and their employers, who may rely on a paper copy of the medical certification for up to 60 days after issuance. Alaska's DMV has not finished the digital pipeline needed to automatically receive and process FMCSA's electronic medical data.

The NRII rule took effect June 23, 2025, but delays prompted a series of temporary waivers: the first covered Oct. 13, 2025, through Jan. 10, 2026, extended through April 10, with a third extension in April when five states were still noncompliant. The Alaska-only exception takes effect Oct. 12 — the day after the current temporary waiver for non-compliant states expires.