*****Eligibility is passed only once RPRF request is made****** That is an Hard Core fact.
Coming to your medical concern , A person gets medical request when Junior VO/Subordinates of VO determine the Eligibility as passed , Later it goes for VO for final view/recommendation , Most of the times the eligibility determined earlier is never overturned by VO to fail if its passed earlier which makes its most of the times obvious "Medical Request" means ELIGIBILITY passed.
But Sometimes being human Junior VO can fail to impress/convince VO for the ELIG recommendation which he/she has provided , which in like "1%" chances are there . That is the time when App can fail even after medical request.