Keith,

Your post got me thinking, so I went & did a search in the e-APIS & CBP documents to find out where it says a medical is required as it surprised me.

Found it here - on page 23, but it won't let me copy. It does seem an odd requirement.

http://www.cbp.gov/linkhandler/cgov/...yers_guide.pdf

Have you tried contacting the "Private Aircraft Support" section of the CBP directly to ask why a medical is still required? Their email is Private.AIRCRAFT.SUPPORT@dhs.gov

Good luck!