The FMCSA has announced temporary permission to use paper medical certificates for truck drivers up to 15 days after they are issued. 

The measure is valid until October 12, 2025 due to delays in the transition to an electronic data transmission system.

The new NRII system, introduced on June 23, 2025, requires medical examiners to send examination results to the FMCSA National Registry by midnight the next day. 

This simplifies the process by eliminating the need for drivers to independently submit certificates to state licensing authorities.

However, only 38 states and the District of Columbia have implemented NRII, and 12 states continue to use paper certificates. 

The FMCSA recommends that medical examiners provide drivers with paper copies of certificates in addition to electronic data transmission.