The rules – which have never been announced or publicised by the Department for Work and Pensions (DWP) – apply to new universal credit claimants who are waiting for an assessment of their “fitness for work”.
And they mean they could have their benefits sanctioned for up to three months if they fail to follow strict instructions from a job coach with no medical training.
They are forced to take part in work-related activity, such as a work-focused interviews and “work preparation”, which could mean training or employment programmes.
They could also face sanctions if they fail to show they have searched for a job for up to 35 hours a week, and have not made themselves available for paid work.
Potential sanctions will continue to hang over their heads until their fitness for work is eventually tested through the notorious work capability assessment (WCA), which could take months.
Dr Stephen Carty, medical adviser to the Scottish grassroots campaign group Black Triangle (BT), who works as a GP in Leith, on the edge of Edinburgh, said the “substantial risks” of the policy were “incalculable”.
The new rules – uncovered by BT’s sister organisation Disabled People Against Cuts – apply to sick and disabled people who would previously have been eligible for income-based employment and support allowance (ESA), which is gradually being phased out in the move to universal credit, but not to those eligible for the contribution-based form of ESA, which will continue alongside universal credit.
Under ESA, claimants with a “fit note” from their GP are not expected to carry out any work-related activity and continue to receive a lower assessment rate of the benefit until they have had their WCA and a decision is reached on their eligibility.
DWP insisted this week that universal credit claimants with a fit note will only be forced to carry out “reasonable” work-related activity that is “tailored to the individual’s circumstances”, while work coaches will demand no work-related activity “if appropriate”.
But appalled activists said this week that the potential harm caused to severely-ill people could be catastrophic and potentially fatal.
Dr Carty said it was a “dreadful situation and is bound to cause further harm”.
He said: “Seriously sick and/or disabled people may find themselves pressed to attend work-related activity and risk being sanctioned if they fail to attend. Yet to attend may place them at significant risk of harm.”
He added: “Jobs advisers and those overseeing work-related activity lack the information, knowledge or experience to make safe decisions and this will undoubtedly place sick and/or disabled individuals in serious danger.
“It is in my opinion outrageous that a patient with a fit note from me, their GP, stating that in my professional opinion that they are currently not fit for work will automatically be assumed to be treated as fit for all work-related activity.
“A doctor with over 20 years of experience and in possession of the patient’s full medical record will have their professional opinion completely disregarded.”
He said GPs had not been told about the DWP policy, and again “find themselves pawns and complicit in a system that has been shown to be harmful and [is]becoming more dangerous by the day”.
Dr Carty said the consequences would be felt “particularly acutely” in primary care.
He said: “The cumulative impact of this policy on claimants and primary care services will be enormous.
“General practice is in crisis. There is a recruitment and retention problem unheralded in the history of NHS.
“Further disempowerment in the form of complete disregard of professional opinion regarding fitness for work is hardly going to help matters.”
Anita Bellows, a Disabled People Against Cuts researcher, said the universal credit policy was “a very dangerous development”.
She said that any decisions on reducing the work-related activity a person had to carry out would only be at the discretion of the DWP work coach, who would have no medical training and would be likely to have access to little or no information about the claimant’s health.
She said: “How these work coaches are expected to understand the consequences of any mandatory work-related requirements on the health of claimants is a mystery.
“Some claimants will be exempted because they are considered ‘vulnerable’ but the DWP has not made public yet the guidance given to work coaches to help them decide which claimants are vulnerable.
“DPAC is absolutely horrified by this development, which is a recipe for disaster and will hurt claimants.
“DPAC also feels that the professional judgement of GPs is being undermined by being overruled by pen-pushers who have no understanding of disability.”
The rules have apparently been in force since at least 2015 but the impact on disabled people is probably only emerging now because of the slow roll-out of universal credit, which was originally only available in a few parts of the country, and mainly applied to single jobseekers making new benefit claims.
But DPAC discovered a DWP freedom of information response (see page eight) dating from November 2015, which makes it clear that “claimants who have a fit note and are awaiting a WCA” are subject to “all work-related requirements”.
This was confirmed this week by a DWP spokesman.
He said that universal credit claimants who had fit notes from their GP stating that they were not fit for work, and who were awaiting a WCA, were subject to work-related requirements.
The DWP spokesman said: “Work coaches will discuss with universal credit claimants whether any reasonable work related activity is appropriate before their work capability assessment.”
He suggested that the new rules had been applied since universal credit began to be rolled out, but when asked if they put the health of many claimants at risk, he said: “Absolutely not.
“Any actions will be tailored to the individual’s circumstances and work coaches will set no work-related activity if appropriate.
“Universal credit is designed to help more people into work.
“Claimants will therefore have access to a work coach from the start of their claim who can support them in preparing for work.”
Asked when DWP had announced these measures publicly, he said that anyone applying for universal credit (UC) was “made aware of their requirements” by their work coach, and he pointed to a DWP leaflet, Universal Credit and You.
But the leaflet does not appear to make any reference to fit notes and claimants waiting for their WCA.
When DNS suggested that this meant DWP had never announced the measures, either publicly or in written information given to claimants, the spokesman said there was nothing more he could add, although he insisted that DWP was “open about the UC process with claimants”.