The module itself works fairly well, however beware that this module requires Reference Transactions be enabled on your Paypal account. They claim this is free and extremely easy to get, but that's not really the case.
We had to call Paypal 3 separate times in order to get this enabled on our account. The first Paypal rep was adamant a PayPal Payments Pro account ($35/month) was required to enable the feature. The second rep told us a minimum amount of transactions per month was required to have the feature enable. It was only until the third call to Paypal we informed told the request was submitted and should be processed within a couple days.
While this is not an issue with the module itself, it should be made clear on the developer's website that the process is not as simple as they make it sound and is in reality quite the run-around and pain in the arse to get enabled on your account.
Dax, thanks for the review - we really appreciate your feedback. We try to convey as clearly as possible to potential customers about the requirement of Reference Transactions being needed for this gateway on our module page, checkout & documentation. Additionally, our support team is available 24/7 to walk clients through best practices for contacting PayPal (besides the step-by-step instructions in our documentation), as well as a few workarounds.
We're glad you got Reference Transactions enabled on your account, and we'd appreciate you updating the stars on your review to 5, considering that this isn't an inherent module issue, as we go above and beyond to compensate for this weakness on PayPal's side. :)