I just learned the hard way that NY DMV has changed their rules regarding the DOT Medical Card. I got a letter a couple weeks ago that my CDL had been suspended due to an expired medical card, yet I had renewed it last October. I went to the local DMV office to find out what had happened and learned that NY DMV now requires you to send a copy of the renewed medical certificate to them prior to the old one expiring. This was never the case previously, you were on your honor to keep it up to date or risk a ticket if you happened to be stopped or have a DOT inspection. I was required to produce my birth certificate and pay $17.50 in order to have my CDL and endorsements restored. Hopefully this helps someone avoid the same problem.