There is generally a lot of questions recently about remedical and NDVO as slowed down and a lot of people's medical is expiring before they go PPR. In generally, if you are sep/oct/nov applicants, i would recommend you wait for your remed letter as you would enter IP and it seems the remed letter are issued quickly around that time.
As for individuals who are april-july'ish ones whose med have expired over 2-3 months now with no remedical request, jsut get it done and send it to NDVO. This is what happened in my case, the med expired, waited a long time, went for it ourselves and got a full remed. After going IP, they sent us the remed request and i sent a case specific inquiry letting them know that we had already sent an updated new medical and got a reply back from NDVO after a month stating that they have received the new med and to ignore the request letter they sent. exactly a month from that email, we got PPR. so, from IP to DM/PPR for us is around 2.5 months which seems to be the standard time lately.
Remember that without a valid, NDVO will never issue a PPR or actual visa. They extend it before *it expires* to accomadate your travel but i doubt they extend after it has already expired. So, try to keep your medical always valid for you files to move forward.
