Ari Silverstein writes:

Horse****, the determination of "fit for flight" is a medical one
performed only by a physician so approved. Once you flunked the
medical, /then/ you are screwed for the PPPL.

So don't take the medical /if/ you think you are going to flunk it.

If the medical determines your fitness for flight, and you don't take it
because you know you would fail it, then you know you are unfit for flight,
and thus you are not eligible for a Light Sport license. That's why having a
revoked or suspended medical isn't allowed, either.