Your examiner now sends the card to the state
Since June 2025 certified examiners send your CDL medical certification to the state themselves. What you no longer do, and what still falls on you.
5 min readFenix Truck School
For years, getting a DOT physical was only half the job. You then had to get the paper certificate to your state licensing agency yourself, and drivers lost their CDL privileges over that step constantly — not because they failed anything, but because a fax never arrived. That changed on June 23, 2025.
Since that date, certified medical examiners transmit examination results electronically to FMCSA, which passes the certification data to state licensing agencies for posting to your driving record. The rule behind it is the Medical Examiner's Certification Integration rule, implemented through what FMCSA calls National Registry II.
What changed on June 23, 2025
The compliance date was June 23, 2025. Three things are different.
Examiners transmit results. A certified medical examiner must submit the result of every examination to the National Registry by midnight local time of the next calendar day following the exam. That includes results where the driver was found not physically qualified — under the revised 49 CFR 391.43(g)(3), an examiner who determines you are not qualified must tell you so and tell you it will be reported to FMCSA.
Paper certificates stop being the proof for CDL holders. Medical examiners are no longer required to issue the original paper Medical Examiner's Certificate, Form MCSA-5876, to CDL and commercial learner permit holders. Motor carriers can no longer rely on a paper certificate as proof of your certification — they verify it on your driving record instead.
You stop submitting it yourself. FMCSA's driver materials are direct about this: qualified CDL and CLP applicants no longer have to submit a paper certificate to their state agency, and no longer have to carry the original MCSA-5876 as proof of certification. The electronic record on your commercial driving record is the proof.
What Florida says
Florida is doing it. FLHSMV's CDL medical certification page states that the requirement for the medical examiner to transmit exam information electronically took effect June 23, 2025, and that drivers are not required to carry a med card once it has been submitted. Florida suggests carrying it for at least fifteen days after the exam while the record updates — which is sensible advice everywhere, not just here.
If you drive in a state that had not implemented National Registry II by the compliance date, FMCSA's guidance for that situation tells examiners to issue a paper certificate and still report to the National Registry, and tells drivers to submit the paper copy to their state agency the old way. Ask your examiner which applies where you are licensed.
What still falls on you
Do not read "the examiner handles it" as "nothing is your job." Four things are still yours.
Self-certification. Florida still requires every CDL applicant and renewal to certify which of four categories they operate in — non-excepted interstate, excepted interstate, non-excepted intrastate, or excepted intrastate. That is a separate step from the medical exam, it is not automated, and most new drivers are Category A, non-excepted interstate. The FLHSMV CDL medical certification page has the exact wording of each category.
Getting a copy anyway. FMCSA's own driver materials recommend requesting a copy of your certificate for your records, precisely so you can troubleshoot a transmission that did not land. Ask for it at the exam. It costs you nothing.
Checking that it posted. Give it a couple of weeks, then confirm your medical certification status shows current on your Florida record. If it does not, you have a paper copy and a phone number for the clinic, and you fix it before it becomes a downgrade.
Renewing on time. Nothing about electronic transmission renews your card. A lapsed medical certification still leads to CDL disqualification or a downgrade to a non-commercial license. If you carry a one-year card — common with blood pressure at Stage 1 or on treatment — the interval comes around faster than you expect.
If you do not hold a CDL
National Registry II does not apply to you. Non-CDL drivers who need a medical certificate — drivers of commercial vehicles under the CDL weight thresholds, for instance — still receive a paper Medical Examiner's Certificate and still have to carry it when operating. There is no commercial driving record for the data to post to.
Why this is genuinely better
The old system failed drivers in a specific, stupid way. You passed your physical, the certificate sat in a glovebox, the deadline passed, and the state downgraded your license. The problem was never medical. It was administrative, and it cost people weeks of work.
Removing the hand-off removes most of that. It also means an examiner's not-qualified finding is now a federal record, which is worth knowing: going to a second examiner without changing anything about your situation is not a fresh start. What actually disqualifies you and what only pauses you is the thing to sort out before you rebook.
The reporting runs both ways, too. If you carry an exemption or are certified under an alternative standard, that variance information moves with your record rather than living in a folder you have to produce.
What to do next
At your next DOT physical, ask the examiner two questions: did you transmit this, and can I have a copy for my records. Then check your Florida record a couple of weeks later. That is the whole routine now.
If you are earlier than that — still working toward the permit — the sequence is medical card, then self-certification, then the knowledge tests. How the permit fits into the timeline and what the physical itself covers are the two things to read first, and the Florida CLP-to-CDL timeline tells you how the weeks stack up. When the medical side is handled, get your Monday start locked in and call (904) 898-9989 if you need the nearest certified examiner to the yard.