Service Animals and Patient Rights under the ADA

Executive Summary 

Service animals are trained for specific tasks and have rights under the Americans with Disabilities Act (ADA). Emotional support or therapy animals are not service animals and are not afforded any of the rights that service animals have under the ADA, even if they are prescribed as a part of a treatment plan. 

Recommended Actions  

• Consider educating employees on the differences between service animals and emotional support or therapy animals. 
• Ask patients who come into the office with a dog if their service animal is required because of a disability, and what work or task has the dog been trained to perform. 
• Avoid asking about the person’s disability, medical documentation, identification card or training documentation. 

There is often confusion around service animals and patient rights. For example, there are stark differences between emotional support animals, comfort animals and therapy dogs. The distinction between service animals and other types of support animals matters, because service animals and their handlers (patients) have rights under the Americans with Disabilities Act (ADA), a federal civil rights law. Other support or therapy animals are not covered under the ADA and thus are not afforded the same rights.  

Service Animal Defined 

• A service animal is one that is trained to do work or a specific task for a person with a disability. Generally speaking, only dogs can be service animals under the ADA. 
• The service dog must be specifically trained to perform a task to fit into the ADA’s service animal definition. Examples include guide dogs, which help guide the blind or hearing impaired, and seizure response dogs. 
• Service animals are working animals and are not pets. 

Other Support Animals Defined

• Emotional support or therapy animals are not service animals and are not afforded any of the rights that service animals have under the ADA. 
• They are not service animals even if they are prescribed as a part of a treatment plan since they are not trained to perform a specific task. 

Determining if an Animal is a Service Animal 

A provider may ask only two questions to determine if an animal is a service animal. 

1. Is the dog a service animal required because of a disability? 
2. What work or task has the dog been trained to perform? 

If a person cannot identify the work or tasks the animal was trained to perform, it is likely not a service animal and has no right to enter the premises. 

Staff cannot ask about the person’s disability, require medical documentation, require a special identification card or training documentation for the dog, or ask that the dog demonstrate its ability to perform the work or task. This means that the animal does not need a vest, ID tag or specific harness. 

Allergies and Fear of Dogs 

Allergies and fear of dogs are not valid reasons for denying access or refusing service to people using service animals. 

Allowable Access for Service Animals 

Service animals can accompany people with disabilities in all areas of a facility the public is typically allowed to access. That would include patient rooms, clinics, cafeterias or exam rooms. 

Service animals cannot be in sterile areas (e.g., operating rooms, burn units, MRI machines and certain intensive care units). If service animals would fundamentally alter the nature of a service or program, or pose a direct threat to the health and safety of others, they may be prohibited. 

Service Animal Behavior 

A service animal can be excluded from public areas if it isn’t housebroken or is out of control and the owner has not taken effective action to control it. A facility also is not responsible for caring for the animal. 

Lessons Learned  

• Ensure that staff membersare trained regarding the characteristics of a service animal and where they are allowed access throughout the healthcare organization. 
• Consider implementing a facility protocol when a patient arrives with a therapy or otherwise non-trained animal. 

Potential Damages 

Prohibiting service animals or denying a patient with their service animal appropriate access can result in a discrimination lawsuit under the ADA. Although lawsuits for service animals are relatively infrequent, damages and the cost of a suit can become costly to healthcare organizations.