Universal Credit Sick Note (Fit Note) - How It Works

Updated June 2026

If you cannot work because of a health condition and you claim Universal Credit, the document that supports you is a fit note - the official name for what most people still call a sick note. A fit note from your GP or another healthcare professional tells Universal Credit that your health affects your ability to work, and it is what allows you to be treated as having limited capability for work while the Department for Work and Pensions (DWP) arranges a fuller assessment. This guide explains how fit notes work on Universal Credit: how to get one, what the assessment phase is, what is expected of you while you wait, and how the whole thing leads into the Work Capability Assessment.

What a fit note is

A fit note, also called a sick note or a Statement of Fitness for Work, is an official document confirming that your health affects your capacity to work. It is issued by a healthcare professional after they have assessed you - traditionally your GP, but the rules now allow other professionals such as hospital doctors, registered nurses, pharmacists, physiotherapists and occupational therapists to issue them too.

A fit note will say one of two things:

• You are not fit for work. The healthcare professional considers that your condition means you cannot work for a stated period.
• You may be fit for work. You could work if certain adjustments were made, such as altered hours, amended duties, a phased return, or workplace adaptations. This option is mainly relevant to people who have a job to return to.

For Universal Credit purposes, the fit note is the medical evidence that you cannot work, or are limited in the work you can do, because of your health. It is the starting point of the health journey that can eventually lead to the limited capability for work outcome and, in more serious cases, the LCWRA group.

The first seven days: self-certification

You do not need a fit note for the first seven days of being unwell. For that initial week you can self-certify - simply report in your Universal Credit account that you are not fit for work because of your health. After seven days, you need a fit note from a healthcare professional to continue being treated as unable to work.

This mirrors the position in work, where employers accept self-certification for the first week of sickness absence and ask for a fit note after that. On Universal Credit the principle is the same: a short self-certified window first, then proper medical evidence.

How to report a health condition on Universal Credit

Universal Credit is run mainly through your online account and journal. To start the health route:

1. Report that you are not fit for work in your Universal Credit account. There is usually a health section or a "report a change" option where you record that a health condition affects your ability to work.
2. Provide your fit note. Once the first seven self-certified days have passed, upload your fit note through your journal or hand it in as directed, so the DWP has the medical evidence on file.
3. Keep your fit notes up to date. Fit notes cover a set period chosen by the healthcare professional. The first can cover up to three months, and later ones can cover longer. Provide a fresh fit note before the last one runs out, so there is no gap in your evidence, until your Work Capability Assessment decision is made.

Keeping the fit notes continuous matters. A gap in your evidence can lead to questions about whether you should be in the work-search group, so it is worth booking the next fit note in good time rather than letting one expire.

The assessment phase

Once you have reported a health condition and started providing fit notes, you enter what is commonly called the assessment phase. This is the period while the DWP arranges and carries out your Work Capability Assessment. Three things are true during this phase:

• You are treated as having limited capability for work on the strength of your fit notes, even though no formal decision has been made yet.
• Your work-related requirements are usually limited, so you are not expected to do work-search activity that conflicts with your fit note.
• The health element is not yet added. The extra money tied to a health outcome comes after the assessment, and is normally backdated to the end of a waiting period rather than paid from day one.

The assessment phase commonly lasts around three months before the assessment decision and any health element take effect, although in practice waiting times vary. The structure is the same one used in Employment and Support Allowance, where it is described in our guide to the assessment rate and the 13-week phase. On Universal Credit there is no separate "assessment rate" payment in the ESA sense, but the idea of an assessment period before the health element is added carries across.

Work-related requirements while you wait

A common worry is whether you will be forced to look for work while you are too unwell to do so. While you are providing fit notes and waiting for your assessment, you should be placed in a group with limited or no work-search requirements. Your work coach sets a claimant commitment that is supposed to take your health into account, and you should not be expected to look for, or take up, work that your fit note says you cannot do.

If you are asked to do something that conflicts with your fit note - for example, attend a job-search activity when your fit note says you are not fit for work - raise it with your work coach straight away, through your journal or at an appointment. It is reasonable to ask that your commitment reflects the fit note you have provided. Being clear and prompt about this avoids misunderstandings that could otherwise put your payment at risk through a sanction.

For a wider explanation of how doing any work interacts with a health claim, our guides on whether you can work while claiming and permitted work set out the rules. They are written around ESA but the principles about earnings and health-related claims are useful background for Universal Credit too.

How the fit note leads into the Work Capability Assessment

Fit notes are not the end of the story - they are the trigger for a proper assessment. Once you have been reporting a health condition for long enough, the DWP refers you for a Work Capability Assessment (WCA). This is the same assessment used for Employment and Support Allowance; Universal Credit does not have a separate health test of its own.

The WCA usually runs in two parts:

1. The questionnaire. You are sent a form to describe how each of your conditions affects you. The current form is the WCA50 (previously known as the UC50 on Universal Credit and the ESA50 on ESA). Filling it in fully, with detail about your worst days and the help you need, gives you the best chance of the right outcome. Our UC50 form guide and our guide to filling in the form take you through it.
2. The assessment. Most people then have an assessment, which may be by telephone, video or in person. It is carried out by a healthcare professional on behalf of the DWP. Preparing helps: see our guides on what to say at the assessment and the telephone assessment.

The WCA scores you against 17 work-related activities covering both physical functions and mental, cognitive and behavioural ones. Only the highest-scoring descriptor within each activity counts, and physical and mental scores are added together. Reaching 15 points establishes limited capability for work. Our complete WCA guide and how many points you need explain the scoring in detail, and the descriptors explained covers each activity.

What the assessment decides

The Work Capability Assessment produces one of three outcomes, and it is this decision - not your fit notes - that governs your requirements and payments from then on:

• Limited capability for work and work-related activity (LCWRA). The highest outcome. The LCWRA element is added to your Universal Credit and you have no work-related requirements. This is the Universal Credit equivalent of the ESA Support Group, explained in our guide to LCWRA on Universal Credit.
• Limited capability for work (LCW). You are accepted as currently unable to work but may be asked to take steps to prepare for work in future, such as work-focused interviews.
• Fit for work. You scored fewer than 15 points and none of the special rules apply, so you return to the usual job-search requirements - unless you challenge the decision.

Once the decision is made, you stop needing to provide ongoing fit notes for Universal Credit, because the assessment outcome now sets your requirements. If you are placed in LCWRA, our guide to how to qualify for the higher group explains the Schedule 3 descriptors and the substantial-risk rule that can put you there.

If you are found fit for work

If the decision goes against you and you are found fit for work despite your fit notes, you can challenge it. The route is:

1. Mandatory Reconsideration - ask the DWP to look again, normally within one month of the decision (late requests can be accepted up to 13 months with a good reason). See our Mandatory Reconsideration guide.
2. Appeal to the First-tier Tribunal - an independent panel that is not part of the DWP. Many people who appeal a WCA decision succeed. Our tribunal guide explains how it works.

While you challenge a "fit for work" decision, you can usually continue to provide fit notes to support a request that your work-related requirements be limited in the meantime, so keep getting them from your GP until the dispute is resolved.

Fit notes, Universal Credit and New Style ESA together

Fit notes are not unique to Universal Credit. New Style ESA uses the same fit notes and the same Work Capability Assessment, and if you have paid enough National Insurance you may be able to claim it at the same time as Universal Credit. When held together, New Style ESA counts as income for Universal Credit and is deducted from it, but because it is not means-tested it can give you a more stable, ring-fenced income. The way the two interact is set out in our guide to ESA and Universal Credit together, and the difference between the two kinds of ESA is covered in New Style versus income-related ESA.

If you currently receive an older benefit such as income-related ESA, you may be moved across to Universal Credit through managed migration. Our guide to managed migration from ESA to Universal Credit explains what to expect and how to protect your position.

A quick summary of the journey

The path from sickness to a settled Universal Credit health award runs in a clear order: self-certify the first seven days; get a fit note from your GP and provide it through your journal; keep your fit notes continuous through the assessment phase; complete the WCA50 and attend the Work Capability Assessment; and then move onto whatever the decision sets - ideally the LCWRA group, with its extra money and freedom from work requirements. Getting the fit notes in on time and describing your condition accurately at every stage is what keeps the journey on track.

Official sources

This guide reflects the official Universal Credit and fit note rules. For the source material, see:

• GOV.UK - Universal Credit
• GOV.UK - Health conditions, disability and Universal Credit
• GOV.UK - Taking sick leave and fit notes
• Universal Credit Regulations 2013 - Regulation 39 (LCW)
• Citizens Advice - Universal Credit

Guidance only, not legal advice. Rules can change - always check GOV.UK for the latest.

Frequently Asked Questions

Related Guides

• LCWRA on Universal Credit
• ESA and Universal Credit together
• Complete WCA guide
• UC50 form guide
• What to say at the WCA assessment
• The assessment phase and 13 weeks
• Managed migration from ESA to UC