David Cameron has commissioned a health adviser to review whether people with obesity, alcohol or drug problems should have benefits cut if they refuse treatment to make them fit for work.
About 100,000 people with such long-term, yet treatable, conditions are claiming sickness benefits.
Prof Dame Carol Black will consider whether the welfare system fails to encourage them to get treatment.
The PM said it was unfair for workers to fund those who refuse such help.
"Some have drug or alcohol problems, but refuse treatment," Mr Cameron said.
"In other cases people have problems with their weight that could be addressed, but instead a life on benefits rather than work becomes the choice.
"It is not fair to ask hardworking taxpayers to fund the benefits of people who refuse to accept the support and treatment that could help them get back to a life of work."
'Deeply interested'"In particular, I have asked her to consider whether people should face the threat of a reduction in benefits if they refuse to engage with a recommended treatment plan.
"It is vital that people who would benefit from treatment get the medical help they need."
Currently there is no requirement for people with such health problems to undertake treatment.
About 60% of the 2.5 million people claiming sickness benefits have been doing so for more than five years.
Dame Carol said: "I am deeply interested in trying to overcome the challenges these types of benefit claimants pose.
"These people, in addition to their long-term conditions and lifestyle issues, suffer the great disadvantage of not being engaged in the world of work, such an important feature of society."
Are you claiming sickness benefit? What is your reaction to the review? You can email haveyoursay@bbc.co.uk with your experience.
Please include a telephone number if you are willing to be contacted by a BBC journalist.
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