Difference Between an ESA and a Service Animal

An Emotional Support Animal is not the same as a Service Animal under the Americans with Disabilities Act (ADA).

Under the ADA, a service animal is generally a dog that has been individually trained to perform work or specific tasks directly related to an individual's disability.

Examples may include a trained service animal that:

• guides a person who is blind;

• alerts a person who is deaf;

• retrieves medication or other needed items;

• assists with mobility;

• alerts to certain medical conditions;

• interrupts or responds to a specific disability-related behavior; or

• performs another individually trained disability-related task.

Providing comfort, companionship, reassurance, or emotional support by the animal's presence alone does not constitute the trained work or task necessary for an animal to qualify as an ADA Service Animal as these animals go through rigorous training. Accordingly, a determination by MIND BODY SOULUTIONS that an individual may clinically benefit from an Emotional Support Animal does not certify, designate, or establish that the animal is a service animal.

Therapy Animals Are Also Different

A Therapy Animal is also different from both an Emotional Support Animal and a Service Animal.

Therapy animals are typically used by handlers or professionals to provide comfort, support, engagement, or therapeutic benefit to multiple individuals in settings such as:

• hospitals;

• schools;

• counseling settings;

• nursing facilities;

• rehabilitation programs; or

• community programs.

A therapy animal generally provides services to other people rather than functioning as an individually prescribed disability accommodation for its handler. Participation in a therapy-animal program, completion of therapy-animal training, or use of an animal in therapeutic settings does not automatically make that animal either an ESA or an ADA service animal.

Scope of ESA Evaluation

An ESA assessment may include:

• clinical interview;

• biopsychosocial assessment;

• review of mental health symptoms and diagnoses;

• assessment of functional impairment;

• review of current and previous treatment;

• assessment of the requested accommodation;

• discussion of the client's relationship with the animal;

• evaluation of how the animal assists with identified symptoms or limitations;

• review of the animal's behavior, care, and living environment when clinically relevant;

• discussion of the client's ability to provide appropriate care for the animal;

• assessment of potential risks or contraindications;

• review of available records or collateral information; and

• additional clinical assessment measures when appropriate.

The clinician may request documentation from other treatment providers or other relevant sources when additional information is needed to support a determination.

Disability-Related Need

An ESA recommendation is based upon the individual's clinically supported disability-related need rather than preference for an animal, general comfort from pet ownership, or a desire to avoid ordinary housing requirements.

The evaluation may consider whether the animal's presence or assistance helps reduce symptoms or functional limitations associated with the client's condition.

Potential areas of functioning may include:

• emotional regulation;

• sleep;

• anxiety management;

• trauma-related symptoms;

• ability to remain independently housed;

• social or interpersonal functioning;

• daily routines;

• behavioral regulation; or

• other clinically relevant major life activities.

The existence of a diagnosis alone does not automatically establish the need for an ESA.

Assessment of the Animal and Client Responsibilities

The clinician's evaluation primarily concerns the client's mental health and disability-related need. MIND BODY SOULUTIONS does not provide veterinary evaluation, animal certification, obedience testing, or professional animal training.

Clients remain responsible for the animal's:

• health and veterinary care;

• licensing or vaccinations when required;

• supervision;

• cleanliness;

• appropriate behavior;

• humane care;

• safety;

• compliance with applicable laws; and

• prevention of damage or inappropriate disruption.

An ESA recommendation does not excuse dangerous, destructive, uncontrolled, or unlawful behavior by an animal.

Clinical Determination

Following completion of the assessment, the evaluator may determine that:

• available information supports an ESA recommendation;

• additional information is required before a determination can be made;

• another clinical or medical evaluation is appropriate;

• the available evidence does not support a disability-related need for an ESA; or

• the requested documentation falls outside the clinician's professional role or scope of practice.

Participation in an ESA assessment does not guarantee that an ESA recommendation or letter will be provided. A clinician will not issue documentation solely because a client requests a particular outcome.

ESA Documentation

When the evaluation supports an ESA-related recommendation, the clinician may provide documentation that addresses clinically appropriate information regarding:

• the existence of a disability-related mental or behavioral health condition or diagnosis when legally and clinically appropriate;

• relevant functional impairment;

• the disability-related need for the animal; and

• the relationship between the animal's support and the identified impairment.

Documentation will be limited to information reasonably necessary for the intended purpose. The Practice will not intentionally disclose unnecessary diagnostic or treatment information when more limited documentation is sufficient.

Housing and Reasonable Accommodation

ESA documentation is commonly used when an individual requests a disability-related reasonable accommodation in housing. A clinician's recommendation represents a clinical opinion regarding the client's disability-related need. The housing provider or other entity independently determines whether a requested accommodation is approved according to applicable federal, state, or local law. A recommendation from MIND BODY SOULUTIONS therefore does not guarantee approval of a housing accommodation.

Public Access Limitations

• An ESA determination does not provide the same public-access rights associated with an ADA Service Animal.

• An ESA generally does not have an automatic right to accompany its owner into restaurants, stores, health-care facilities, workplaces, or other public accommodations where pets are otherwise prohibited.

• Federal ADA guidance specifically distinguishes emotional support animals from service animals because emotional support alone is not a trained disability-related task.

No Certification or Registration Requirement

• MIND BODY SOULUTIONS does not provide or endorse commercial ESA registrations, identification cards, certificates, vests, or online registries as substitutes for a legitimate clinical assessment.

• An ESA evaluation provided by the Practice is based upon clinical assessment and professional judgment.

• The Practice does not certify the animal itself as safe, trained, or suitable for public access.

Ongoing Treatment Relationship

• An ESA evaluation may occur within an established treatment relationship or as a specifically arranged assessment service.

• When an individual is not an established psychotherapy client, the clinician may require sufficient assessment contact and documentation to establish a professional basis for making an ESA determination.

• The amount of clinical contact required will depend upon the complexity of the client's presentation, available records, and the clinician's professional judgment.

• The clinician may decline to provide an ESA determination when insufficient information exists to support a reliable clinical opinion.

• On-going therapy is strongly recommended based on the expressed need of an Emotional Support Animal.

Limitations of ESA Documentation

An ESA assessment or recommendation:

• is not a service-animal certification;

• does not establish ADA public-access rights;

• does not guarantee housing approval;

• does not constitute a veterinary assessment;

• does not certify the animal's temperament, training, or safety;

• does not determine eligibility for air-travel accommodations;

• does not automatically establish eligibility under another institution's disability policies; and

• does not replace legal advice regarding disability rights or reasonable accommodations.

Clients with questions regarding their legal rights may be encouraged to consult the relevant governmental agency, disability-rights resource, housing authority, or qualified attorney.

Fees for ESA Assessment

ESA assessment services may involve fees separate from routine psychotherapy.

Fees may include time associated with:

• assessment interviews;

• review of medical or clinical records;

• standardized assessment measures;

• collateral information;

• clinical interpretation;

• preparation of documentation; and

• additional consultation or follow-up when necessary.

Fees and services included in the ESA assessment will be explained before the evaluation begins.

Insurance may not cover ESA assessment or documentation services, and the client may be responsible for associated fees.