No sir its not the additional documents request. I had got that in July 2011 and my ecas status has been "In Process" for the past 15 months since I submitted the additional docs then. This is the pure "medical request" time with which they are asking for the updated forms again which to my knowledge is something new! Anyhow that is ok for me that they might be needing my recent info. I just thought that they usually ask for the "Right for Permanent Resident Fee" just before issuing the visa. I dont know how it has been for other applicants.
Regards