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Latest health and behavior news and advice from the veterinarians at Tufts University.

Features August 2015 Issue

Service Dog or Emotional Support Animal?

The rules differ — and they’re easy to bend.

You’re sitting in a white-tablecloth restaurant when who should be seated at the table right next to yours but a patron with a large, somewhat unruly dog. The animal is wearing a vest, so you keep quiet, but it is having so much trouble settling down — sniffing all about and whimpering — that you finally speak to the maître d’.

“I’m sorry, Sir [or Madam],” he says. “They have provided a letter.” And the letter goes something like this:

    To whom it may concern: Ms. Jones has been evaluated for and diagnosed with a mental health disorder as defined in the DSM-5 [fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, a kind of Bible for the American Psychiatric Association]. Her psychological condition affects daily life activities, ability to cope, and maintenance of psychological stability. Ms. Jones has a dog that provides significant emotional support and ameliorates the severity of symptoms that affect her daily abilities. Without the companionship, support, and care-taking activities of her dog, her mental health and daily living are compromised. It is, in my view, a necessary component of treatment to have an Emotional Support Animal (ESA).

Emotional Support Animal, or unhappy tag-along?

The vest has the words “Service Dog” on it so you let it go.

But is the restaurant legally required to allow the dog? What about if the person presented the letter to a landlord with a no-pet policy? Or to an airline while making a reservation, demanding that the dog be allowed to fly in her lap — for free — rather than in a cage under the seat or, if she is too big for that, in the belly of the plane, for which other customers are charged a fee?

 

The distinction between a Service Dog and an Emotional Support Animal

First, it’s important to be aware that anyone can buy a dog vest that is marked with the words “Service Animal.” You don’t have to present papers. That’s important because the dog described in the hypothetical scenario above (although real-life examples are becoming more and more common) is not a service dog. She’s an emotional support animal.

Here’s the difference. A service dog is trained to conduct highly specific tasks to help people with disabilities. Examples include, but are not limited to, guiding people who are blind, pulling a wheelchair, protecting a person who is having a seizure, calming a person who has post traumatic stress disorder (PTSD) during an anxiety attack, flipping light switches, emptying a clothes dryer, picking up dropped objects, distracting someone who has started stimming (engaging in a repetitive body movement), and alerting deaf people to an alarm. Not only is a service dog trained to perform such tasks, but she is also trained for deportment. She will virtually never come over and sniff other people in the crotch, bark when she isn’t supposed to, or cause other disturbances. Service dogs are not, in fact, pets in the pure sense of the word. They are animals with a job. The Internal Revenue Service classifies them as a deductible medical expense.

Emotional support animals, on the other hand, do not perform specific tasks to help ameliorate the effects of recognized disabilities. They simply provide generalized comfort and companionship to those who have a health professional’s note for such psychological conditions listed in the DSM as “anxiety” or “depression.” It’s not that anxiety and depression are never severe enough to become disabling; it’s that emotional support animals aren’t trained do something specific to attenuate the effects of the problem. That’s why they are not covered under the Americans with Disabilities Act, which allows true service dogs to go anywhere the public is normally allowed to go: restaurants, museums, libraries, the emergency room of a hospital, houses of worship, and so on.

So where do people have a legal right to take emotional support animals? Not restaurants, museums, and the like, but on airplanes and in housing units otherwise off limits to pets. The Air Carrier Access Act entitles an emotional support animal (which doesn’t have to be a dog) to fly with you, gratis, either on your lap or under your seat. People with an emotional support animal do not have to follow the usual rule of caging the animal and, if it does not fit under the seat, flying it in the belly of the plane.

Furthermore, because of the Fair Housing Act, landlords (unless there are few apartment units in the building and they themselves live in one of those units) must also allow tenants with emotional service animals.

Gaming the system

On the surface, it doesn’t seem so unreasonable. Someone who doesn’t have a disability that requires a dog to perform specific physical tasks but who claims to suffer from, say, anxiety or depression can get a letter from a health professional attesting that an emotional support animal such as a beloved dog provides comfort and should be allowed on a plane or with the person in his or her apartment. The problem is that the bar is set so low, you can even purchase a letter from a health professional you never met through a number of online services. If you google “Emotional Support Animal,” you can find a social worker or some other health professional who, for a fee of $100 to $200, will interview you over the phone (or right online) and write the necessary letter. Presto, someone claims to have an anxiety issue, and he and his dog are flying across the country together, with the dog on his lap. No cage or stow-away required.

In 2013, 48 million prescriptions for the anti-anxiety drug Xanax were dispensed, along with 41 million prescriptions for the anti-depressant Zoloft. Not that you need proof of those disorders when you buy a letter from a health professional you find online, but that in itself adds up to a lot of people who are potentially eligible for emotional support animal benefits.

To be sure, some people with depression or anxiety truly are debilitated to the point that an emotional support animal would provide a therapeutic benefit in their homes or on a plane. But the line between “necessary” and “not necessary” can get blurry.

Why doesn’t anyone crack down?

To protect people’s rights and privacy, the Americans with Disabilities Act allows an owner or manager to ask someone who walks into a restaurant or other establishment with a dog only two questions: one, is the animal required because of a disability? And two, what work or task has the animal been trained to perform? Most restaurant maître d’s, store owners, museum guards, and others don’t know this. They might know, however, that if you violate the Americans with Disabilities Act by asking the wrong question or more questions than you’re allowed, you can be in trouble with the law and end up having to pay a very hefty fine. Moreover, people tend not to be cynical. If they see someone with a dog, especially if it’s wearing a vest, they assume there is a real need for the animal, even a purely emotional one, and that the person cannot be out in public without it. They do not think someone would abuse the system because they like having a dog with them as a kind of accessory or because they don’t want Fido to be left home alone — or because they want to fly their dog for free or live in a particular apartment that otherwise wouldn’t allow dogs.

The question for conscientious pet owners, however, is this: Would Fido rather be left home alone?

What about emotional support for the dog?

If you’re reading this newsletter, you love your dog — and no doubt have had to leave your pet at home at times when you wished you could have taken your canine friend with you so there wouldn’t be too many hours to while away alone. At the same time, however, you realized that as much as your dog dislikes being on her own, the alternative wouldn’t necessarily have been better. That’s because you’re aware it’s not a dog’s life. It’s a person’s, with dogs needing to constantly accommodate themselves to what works for us. A lot of dogs might soon become very uncomfortable in a restaurant, where the odors waft tantalizingly across the room but the food is off limits and all the interesting new people are not there to make friends with them. And a dog may become unnerved in a place like a department store, with lots of mirrors and escalators and smooth, shiny floors and racks of clothing that brush against their backs. Oftentimes home, while boring when no one’s there, is infinitely more comforting than being out and about in strange places with an owner. Not being able to eat the food or go exploring in a new environment can be depressing in its own right.

It might be good to talk to an acquaintance about this who you know likes to take his dog around as an emotional support animal even though the person doesn’t really need the canine company for his mental health and may not be thinking about what’s best for the dog.

Having an emotional support animal unnecessarily hurts people who really need one, too. You can reason with someone that even if it would be great to be able to reside with a dog in an apartment that didn’t otherwise allow pets because they have a letter attesting that their pet is an emotional support animal — or even if they could take their pal on the plane with them — abusing the rules makes it more difficult for people who really do need the comfort of an emotional support animal covered by the law.

That is, we fully support the use of emotional support animals for those people who are plagued by conditions like anxiety, depression, or social phobia to the point that life would be unbearable if they could not live with or fly with a dog. But if too many people start claiming that their pet is a therapeutic necessity when it is not, law enforcement agencies are going to crack down, making it harder for those who have a real need.

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