The MAC has gotten calls from members and/or their staffs about the office’s rights and responsibilities regarding patients who bring an animal – most often a dog – into their clinic, and the distinctions between “service animals” and “emotional support animals.” This article will attempt to answer some frequently asked questions about service animals, emotional support animals, the difference between the two, and your responsibilities (if any) as a chiropractor under the Americans with Disabilities Act relating to service and emotional support animals.
What is the Americans with Disabilities Act (ADA)?
The Americans with Disabilities Act (ADA), which became law in 1990, is comprehensive civil rights legislation that prohibits discrimination and guarantees that people with disabilities have the same opportunities as everyone else to participate in the mainstream of American life. It requires “public accommodations” to provide people with disabilities equal access to goods, services, privileges, accommodations, etc. “Public accommodations” includes such private entities as chiropractic offices, medical clinics, hospitals, and other health care providers. Service dogs are covered under the ADA.
What is a “Service Animal?”
The term “service animal” is defined by Title II and Title III of the ADA. A service animal is any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability. Tasks performed can include guiding the blind, pulling a wheelchair, retrieving dropped items, alerting a deaf person to a sound, reminding a person to take medication, pressing an elevator button, etc. Service animals are working animals, not pets, and the task or work they are trained to perform allows their owner to perform vital tasks they would not be able to perform without the aid of the animal.
Only dogs (and sometimes miniature horses) are considered service animals. Cats, “helper monkeys,” and other species of therapy animals are not considered service animals for the purposes of the ADA.
What is an “Emotional Support Animal?”
The Michigan Department of Civil Rights says that emotional support animals (also known as “therapy animals,” “assistance animals,” “comfort animals,” etc.), while they may be part of a medical treatment plan, are not considered service animals, as they are not specifically trained to perform a task related to an individual’s disability. The owner may derive a sense of safety or well-being from the presence of the animal, and it could provide genuine therapeutic benefits, but these factors alone do not make it a service animal.
Even if a patient has a note from a doctor stating that they have a disability and need the animal for emotional support, this alone does not make it a service animal either. Comfort animals are not covered by the ADA or other federal laws protecting the use of service animals.
There are two federal laws, the Air Carrier Access Act and the Fair Housing Act, that govern the use of emotional service animals in housing or on commercial aircraft, but neither of these apply to a chiropractic office.
Is There Such a Thing as a “Psychiatric Service Dog?”
Emotional support animals are different from psychiatric service dogs, which are specifically trained to assist with a psychiatric disability, such as PTSD, schizophrenia, depression, anxiety, etc. These dogs are trained to perform such tasks as providing safety checks or room searches for those suffering from PTSD, preventing someone from harming themselves, etc. The handlers of psychiatric service dogs have all the same rights as those disabled individuals with other types of service dogs.
How Can I Tell if an Animal is a Service Animal?
It is possible that a patient may come into your office and it is not immediately apparent what service an animal provides. If you are unsure about an animal brought in by a patient, you can ask only two questions:
You may not:
Where is the Service Animal Allowed?
Businesses and organizations that serve the public must allow people with disabilities to bring their service animals into all areas of the facility where customers are normally allowed to go – as long as they are well-behaved (more on this later). They may not be segregated from other patients. This applies to all businesses open to the public, including the offices of health care providers like chiropractors.
What Responsibilities Does the Animal’s Owner Have?
The Michigan Department of Civil Rights advises that “the care or supervision of a service animal is solely the responsibility of his or her owner.” The ADA requires the service animal to be under the control of the handler, through the use of a harness, leash, or other tether. In a case in which the handler is unable to hold a tether, voice control is an acceptable form of control.
What Can I Do if the Service Animal is Being Disruptive?
There are situations in which you can ask a patient to remove their service dog from your office. According to the Michigan Department of Civil Rights, a service animal handler may be asked to remove the animal from the premises, if:
Examples of an “out of control” animal include one that is growling, barking, or posing a direct threat to the health and/or safety of you, your staff, or your other patients. While such an animal can be removed, you must offer the handler the opportunity to receive care without the animal present.
Note: Allergies or a fear of animals are generally not valid reasons for denying access or refusing service to people with service animals. The Michigan Department of Civil Rights advises: “When a person who is allergic to dog … dander and a person who uses a service animal must spend time in the same room or facility, they both should be accommodated by assigning them, if possible, to different locations within the room or different rooms in the facility.”
What if a Service Animal Damages My Office?
If you would normally charge a patient for damage they cause, the service animal’s handler may be charged for any damage caused by the service animal.
What are the Penalties for Violating the ADA?
Failure to provide access for a person with a disability requiring a service animal can lead to civil monetary penalties assessed/enforced by the Justice Department’s Civil Rights Division. For a first-time violation under Title III, the maximum penalty is $75,000; for subsequent violations, the maximum penalty is $150,000.
What Does Michigan Law Say?
In 2015, the Michigan Legislature moved to make the state’s laws consistent with federal laws regarding service animals. The new Michigan law, Public Acts 144 and 145 of 2015, include protections for veterans who have been diagnosed with post-traumatic stress disorder, traumatic brain injury, or other service-related disability and allow those veterans to use service animals in places of public accommodation. The law also includes requirements for reasonable modifications to permit the use of a service animal by a person with a disability.
Under the Michigan bill, a public accommodation that violates the bill’s provisions will be guilty of a misdemeanor, punishable by up to 90 days’ imprisonment and/or a maximum fine of $500.
This article is intended to be informational only, and does not constitute legal advice regarding any specific matter or situation. Legal advice may be given only on the basis of specific facts relayed by a client to any attorney.
Michigan Department of Civil Rights, Service Animal Frequently Asked Questions (FAQs), Rev. 2 – April 15, 2016
U.S Department of Justice, Civil Rights Division, Disabilities Rights Section, Frequently Asked Questions about Service Animals and the ADA, July 20, 2015
U.S Department of Justice, Civil Rights Division, Disabilities Rights Section, ADA Business Brief, April 2002
Senate Fiscal Agency Bill Analysis of Senate Bills 298 and 299