North Carolina DOT Medical Certificate and NRII

North Carolina uses electronic medical-certification reporting for eligible CDL and CLP drivers. Your medical examiner reports your DOT examination results to FMCSA’s National Registry. FMCSA then sends the applicable information to your licensing state. You do not submit your paper medical certificate directly to NCDMV under the ordinary NRII process.

CDL and CLP drivers in North Carolina

NCDMV stopped accepting Medical Examiner’s Certificates directly from commercial drivers on June 28, 2025. Medical certification applies to CDL/CLP holders and applicants who self-certify in a non-excepted interstate or non-excepted intrastate category. The electronic certification information on your state driving record is the ordinary proof of medical certification. Your employer obtains the licensing-state CDLIS motor vehicle record for its driver qualification file.

When does the examiner report the exam?

For examinations covered by the federal reporting requirement, the deadline is midnight local time on the next calendar day after the examination is completed. This includes examinations with an unqualified result. Submission to FMCSA does not guarantee an immediate update to your state driving record.

Keep your paper certificate

FMCSA continues to recommend that examiners issue a paper Medical Examiner’s Certificate, Form MCSA-5876, to qualified CDL/CLP drivers for their records and to help resolve reporting problems. Keeping a copy does not replace checking that the electronic state record is correct.

Update effective October 12, 2026: The nationwide paper-certificate exception has ended. North Carolina CDL/CLP drivers and their employers must use the electronic certification record; a paper certificate no longer provides temporary proof. The renewed exception applies only to Alaska-issued CDL/CLP licenses, subject to its conditions. See FMCSA’s October 2026 notice. Non-CDL paper-certificate requirements remain separate.

Non-CDL drivers follow a different process

If you are medically qualified and will operate a vehicle that does not require a CDL or CLP, the examiner must give you the original paper MCSA-5876. Non-CDL drivers covered by federal medical-certification rules must carry the original or a copy while on duty. NRII does not create the CDL electronic state-record update for a non-CDL driver. Requirements depend on your vehicle and operation; do not assume every non-CDL driver needs a DOT medical certificate.

Self-certification is separate from the medical exam

North Carolina’s CDL-MED-1 form tells NCDMV which type of commercial operation applies to you. It is separate from the examiner’s electronic reporting. Follow the current NCDMV commercial-license instructions to submit or change your self-certification. If another state issued your license, follow that state’s instructions.

If your record has not updated

1. Ask your examiner to confirm that the examination result was successfully submitted to the National Registry.
2. Check that your name, date of birth, license number, and licensing state match your license. Ask the examiner to address any reporting error.
3. Contact your licensing agency about the state record. Do not assume a paper copy resolves a missing electronic record or authorizes you to drive.

For North Carolina self-certification or record questions, NCDMV lists CDLmedical@ncdot.gov and: CDL Medical Certification Unit, 3126 Mail Service Center, Raleigh, NC 27697-3126. This is not an instruction to mail or email your paper medical certificate.

Preparing for an exam? See our DOT physical appointment information and DOT medical-card guide.

Official references: FMCSA NRII Learning Center; 49 CFR 391.43; 49 CFR 391.41; 49 CFR 391.23. General guidance checked October 4, 2026; temporary-exception update checked October 12, 2026.