When a patient walks into your practice with a dog, you must quickly decipher: is this a service animal, an emotional support animal, or is this patient simply trying to get away with bringing Fido along for fun? That’s not a trick question, but it might feel like a tricky one to answer.
There’s been an influx in the amount of people who bring their animals with them everywhere they go — some of these individuals have disabilities and are legitimately traveling with their service animals, but a newer trend is to travel with an emotional support animal.
These FAQs will help you understand how to manage a situation when a patient brings a service animal or an emotional support animal into your practice — so you can avoid lawsuits, damage to your reputation, or losing patients!
Is It a Service Animal or an Emotional Support Animal?
Sorry cat people; dogs rule! The Americans with Disabilities Act (ADA) recognizes service animals as dogs (and more recently, small horses) that are trained to perform tasks and recognize medical conditions for people with disabilities.
The task must be directly related to the person’s disability, such as alerting a deaf individual of danger or recognizing the onset of a seizure and protecting the individual from harm. Service animals are classified as working animals, not pets.
On the other hand, an emotional support animal provides therapeutic benefits, comfort, or emotional stability to someone who has been diagnosed with a mental or emotional disability.
The emotional support animal is usually part of an individual’s on-going treatment — although it isn’t trained to perform a task or recognize any medical condition — and it is prescribed to an individual by either a physician or a mental health professional. An emotional support animal is not a service animal, and — sorry dog people — does not have to be a dog.
Is a Dog for Anxiety a Service Animal or Emotional Support Animal?
It depends. Many individuals use an emotional support animal to calm anxiety. But the ADA only recognizes those who have been trained to sense the oncoming anxiety attack and take an action that would help the individual avoid it or lessen the impact.
A dog that simply provides comfort to an owner who suffers from anxiety is not a service animal as recognized by the ADA. A dog that’s trained to bring an individual medication or a phone to call for help during an impending attack is.
Important: State and local laws may offer a looser interpretation of a service animal than the ADA. For example, some states allow animals other than dogs and miniature horses to act as service animals, provided they are trained to perform work or a task, and some states provide protection for emotional support animals. Check with your State Attorney General’s office for specific legal information regarding your state.
What Questions Can You Legally Ask to Determine If a Dog is a Service Animal?
If you are unsure if a patient’s dog is a service animal, you are permitted under the ADA to ask two — and only two — very specific questions:
- “Is the dog a service animal required because of a disability?”
- “What work or task has the dog been trained to perform?”
You are not allowed to:
- request any documentation for the dog,
- require that the dog demonstrate its task, or
- inquire about the nature of the person’s disability.
Beware: The ADA doesn’t require individuals to certify their service animals, but there are an increasing number of organizations selling service animal certifications online. If a patient presents you with this type of documentation, it doesn’t necessarily mean the animal is recognized by the ADA as a service animal.
Does the ADA Protect Emotional Support Animals?
No, an emotional support animal does not have the same protection as a service animal under the ADA. Emotional support animals have rights that are protected under the Fair Housing Amendment ACT (FHAA). This gives emotional support animals accommodations to housing facilities that don’t usually allow pets. The Air Carrier Access Act (ACCA) provides emotional support animals the privilege to travel by air without fees.
Bottom line: Service animals are allowed into all public places — including retail establishments, restaurants, and your practice — but an emotional support animal is allowed only in apartments (even ones with no-pet policies!) and on airplanes.
How Can You Protect Your Practice from Emotional Support Animal Complaints?
Because it’s not always cut and dry if an animal accompanied by a patient is a legitimate service animal, emotional support animal, or simply a pet that the patient wishes to have in tandem, you must be careful how you react to the animal on your premises. To offer your practice the best protection from a legal mess, do the following:
- implement a written policy that abides by the federal and your state laws regarding what animals you will allow at your practice
- make sure your staff members are trained on this policy
- educate staff on how to respond to patients who show up with animals without causing a scene
Did you know that if you’re faced with a disruptive service animal in your office but the individual in charge isn’t able to control the animal, you are legally allowed to request that the patient remove the animal from the premises? But what if the person refuses?
There’s a lot to consider when drafting your policy. You need to address how you will:
- deal with other patients who object to animals in your practice’s waiting room
- respond to other patients who have allergies to the animals that you do permit
- handle cleaning up pet messes or dogs barking and scaring other patients
- handle a patient who you believe is lying about her animal being a service animal — and what you can and can’t legally do about it
These really are tricky questions — and the answers aren’t always simple. This is where healthcare compliance attorney, Heidi Kocher, BS, MBA, JD, CHC, can help.
Heidi is presenting a 60-minute online training, “” specifically designed to help healthcare practices handle patients who want to bring Service and Emotional Support Animals into their office in a way that avoids legal violations, litigation, and reputational damage.
