Service dog trained by patient

[the5thelement]

Patient wants a letter for a service dog which is trained by her for 2 years . I have never come across a request like this.
I did some digging and looks like no certifications are required.

Redirecting…

How do I know if the patient can alleviate her ptsd symptoms ?
Can anyone just point to their pet and say thats my service dog.?

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[deleted1100659]

I dont do letters for service animals, personally. And if I ever did one, it would be ambiguous "Patient may or may not benefit from this dog as a service animal. I can not personally attest to the nature of the dog, or the actions the dog may commit, as that responsibility falls on the owner and she/he personally acknlowdges this and agrees to this"

 

[WisNeuro]

"I am not trained/qualified to assess the capabilities or training adequateness of service animals. If you would like a letter confirming the diagnosis that I am treating you for, I can do that."

 

[calvnandhobbs68]

I mean I don't see how you have to be involved in this process at all. They don't need any attestation from you that this is a service animal, the same way a blind person wouldn't need an attestation from their ophthalmologist that their seeing eye dog is really a seeing eye dog. If they're requesting one, I would say that they should not require one if this is truly a service animal and you are not qualified to assess if this is a service animal or not.

 

[comp1]

Politely decline and explain that animal assessments are outside of your scope, ie you have no training in this area.

 

[Celexa]

"I am not trained/qualified to assess the capabilities or training adequateness of service animals. If you would like a letter confirming the diagnosis that I am treating you for, I can do that."

This is the answer

 

[Ironspy]

“Sally Smith is currently under my care. She
Feels that her dog/ostrich/alligator helps with her anxiety. I cannot attest to her particular service animal as I have no formal training in evaluating service animals. She accepts full responsibility for all actions of this animal.”

 

[wolfvgang22]

“Sally Smith is currently under my care. She
Feels that her dog/ostrich/alligator helps with her anxiety. I cannot attest to her particular service animal as I have no formal training in evaluating service animals. She accepts full responsibility for all actions of this animal.”

This is what I do, but I add what diagnosis the patient has (usually PTSD) with the patients consent. Patients often request a letter because airlines won't let them travel with their service dog without a letter. These same patients bring their service dogs when they see me. They have usually been trained with the help of a local trainer service dog trainer we know. Only twice have I declined because the dog is not trained.

 

[PsyDr]

"The ADA makes a distinction between psychiatric service animals and emotional support animals. If the dog has been trained to sense that an anxiety attack is about to happen and take a specific action to help avoid the attack or lessen its impact, that would qualify as a service animal. However, if the dog's mere presence provides comfort, that would not be considered a service animal under the ADA."

 

[FlowRate]

"The ADA makes a distinction between psychiatric service animals and emotional support animals. If the dog has been trained to sense that an anxiety attack is about to happen and take a specific action to help avoid the attack or lessen its impact, that would qualify as a service animal. However, if the dog's mere presence provides comfort, that would not be considered a service animal under the ADA."

There's so much lore around "service animals" and their being expertly and specifically trained. But, as you point out, the bar is actually pretty low to qualify for "service animal." If patients were a little more creative/informed they could just make their pets into service animals and leave us out of the ESA request.

It may be legit for someone (employer, housing) to ask for verification of a disability if the disability is not readily apparent.

 

[Trismegistus4]

There's so much lore around "service animals" and their being expertly and specifically trained. But, as you point out, the bar is actually pretty low to qualify for "service animal." If patients were a little more creative/informed they could just make their pets into service animals and leave us out of the ESA request.

It may be legit for someone (employer, housing) to ask for verification of a disability if the disability is not readily apparent.

As I understand it, there is essentially no bar to qualify for "service animal."

Redirecting…

Famously, the ADA states that the only thing the staff of a public accommodation or establishment may do, is ask only two questions of a person purporting to have a service animal: (1) is the dog a service animal required because of a disability, and (2) what work or task has the dog been trained to perform. The thing is, the ADA contains no requirement that the person provide a truthful answer to those questions. And thus the system seems ripe for abuse, and it's actually really surprising we haven't seen more of it.

With the ADA in place, you can take fluffy into a Michelin five-star restaurant. If the maître d' says "I'm sorry, sir, we don't allow pets," you can simply lie and say "this is a service animal which I require because of a disability." And at that point they're hamstrung. All they can do is ask you "what work or task has the dog been trained to perform?" And you can simply lie again and say "he nudges me with his nose to alert me if I'm about to have a seizure." They're not allowed to ask for any evidence whatsoever that you have a seizure disorder, or that the dog has in fact been trained to perform this task. If they do, they're violating the ADA. Your word as an allegedly "disabled" person is sacrosanct. Sure, if they really feel certain you're lying, they can try to call your bluff and kick Fluffy out anyway, because if it went to court, there would subpoenaing of medical records and expert witnesses and such, and then you'd have to actually provide evidence for your assertions. (Not to mention that you could also face penalties if you live in one of many states which make it illegal to misrepresent a non-service animal as a service animal.) But do you really think they're going to risk bringing down a federal agency on them?

I'm honestly shocked more cluster B people aren't doing this. Why ask a doctor for an "emotional support animal" letter, when you can just lie and say your pet is a service animal?

 

[calvnandhobbs68]

As I understand it, there is essentially no bar to qualify for "service animal."

Redirecting…

Famously, the ADA states that the only thing the staff of a public accommodation or establishment may do, is ask only two questions of a person purporting to have a service animal: (1) is the dog a service animal required because of a disability, and (2) what work or task has the dog been trained to perform. The thing is, the ADA contains no requirement that the person provide a truthful answer to those questions. And thus the system seems ripe for abuse, and it's actually really surprising we haven't seen more of it.

With the ADA in place, you can take fluffy into a Michelin five-star restaurant. If the maître d' says "I'm sorry, sir, we don't allow pets," you can simply lie and say "this is a service animal which I require because of a disability." And at that point they're hamstrung. All they can do is ask you "what work or task has the dog been trained to perform?" And you can simply lie again and say "he nudges me with his nose to alert me if I'm about to have a seizure." They're not allowed to ask for any evidence whatsoever that you have a seizure disorder, or that the dog has in fact been trained to perform this task. If they do, they're violating the ADA. Your word as an allegedly "disabled" person is sacrosanct. Sure, if they really feel certain you're lying, they can try to call your bluff and kick Fluffy out anyway, because if it went to court, there would subpoenaing of medical records and expert witnesses and such, and then you'd have to actually provide evidence for your assertions. (Not to mention that you could also face penalties if you live in one of many states which make it illegal to misrepresent a non-service animal as a service animal.) But do you really think they're going to risk bringing down a federal agency on them?

I'm honestly shocked more cluster B people aren't doing this. Why ask a doctor for an "emotional support animal" letter, when you can just lie and say your pet is a service animal?

Well and on the off chance fluffy really DOES nudge you with his nose to alert you of seizures, they aren't going to risk all the headache and money they'd lose...even if 99/100 people lied about the service animal, it's still probably financially worth it to them to just not challenge anyone so they don't get nailed by the 1/100 person who had a disability and they refused service to.

 

[Crayola227]

Keep in mind that if the animal is disruptive, even if it's a bona fide service animal that is capable of injecting you with insulin for your diabetic glycemic coma or doing chest compressions when your pacemaker fails or can cure cancer handling test tube like that cat in that meme, the restaurant can still kick you and Fluffy out regardless.

So the restaurant is only at risk of letting lying people with well behaved pets hang out. Still annoying but it's not like they have to suffer bad pets of either disabled people or liars.

Obviously in practice even with obnoxious animals a restaurant may not want to take various risks by confronting someone.

 

[comp1]

They need to stop medicalizing this. If it's safe for a completely undefined service animal to be somewhere, it's safe for any well behaved animal to be there. Disabilities should not be involved. Start defining what well behaved is and quit attaching anything to disabilities or a specific need for help. There's so much that doctors get dragged into that we should not be...

 

[hamstergang]

“Sally Smith is currently under my care. She
Feels that her dog/ostrich/alligator helps with her anxiety. I cannot attest to her particular service animal as I have no formal training in evaluating service animals. She accepts full responsibility for all actions of this animal.”

Why even write the sentence that the patient feels the animal helps? I get writing the medical diagnosis you've made as a medical doctor. I get writing recommendations for interventions/accommodations others can do/make when medically indicated for these medical conditions.

But to write what the patient's opinion is? Let the patient say that themselves. It is their claim, not yours, after all.

Can you even legally assign blame to the patient this way?

 

[Trismegistus4]

Why even write the sentence that the patient feels the animal helps? I get writing the medical diagnosis you've made as a medical doctor. I get writing recommendations for interventions/accommodations others can do/make when medically indicated for these medical conditions.

But to write what the patient's opinion is? Let the patient say that themselves. It is their claim, not yours, after all.

Can you even legally assign blame to the patient this way?

I agree, I think providing statements like that are just an attempt to straddle the fence by not having to confront the patient and give them a flat "no," while at the same time assuaging one's conscience by not coming out and directly stating something you don't believe in (i.e., that the patient provably, medically needs this animal to be present.) The thing is, I would still worry that a landlord or whoever would be reading this would still feel bound by it--"oh crap, Sally has a signed letter on fancy letterhead from a doctor, now I have to let her do what she wants or I'll get sued."

 

[Trismegistus4]

Keep in mind that if the animal is disruptive, even if it's a bona fide service animal that is capable of injecting you with insulin for your diabetic glycemic coma or doing chest compressions when your pacemaker fails or can cure cancer handling test tube like that cat in that meme, the restaurant can still kick you and Fluffy out regardless.

I'm envisioning a comedy skit about a genius biomedical researcher dog who finds a cure for cancer, but still can't resist peeing on the floor and eating people's food off the table when they're not looking.

 

[WisNeuro]

I'm envisioning a comedy skit about a genius biomedical researcher dog who finds a cure for cancer, but still can't resist peeing on the floor and eating people's food off the table when they're not looking.

Another sequel in the Air Bud series? Biomedical Bud?

 

[FlowRate]

They need to stop medicalizing this. If it's safe for a completely undefined service animal to be somewhere, it's safe for any well behaved animal to be there. Disabilities should not be involved. Start defining what well behaved is and quit attaching anything to disabilities or a specific need for help. There's so much that doctors get dragged into that we should not be...

In theory, I agree. In practice, I think businesses should be free to choose to refuse animals unless a compelling exception exists (service animal.)

I agree, I think providing statements like that are just an attempt to straddle the fence by not having to confront the patient and give them a flat "no," while at the same time assuaging one's conscience by not coming out and directly stating something you don't believe in (i.e., that the patient provably, medically needs this animal to be present.) The thing is, I would still worry that a landlord or whoever would be reading this would still feel bound by it--"oh crap, Sally has a signed letter on fancy letterhead from a doctor, now I have to let her do what she wants or I'll get sued."

We've beaten it to death in the other recent ESA thread, but landlords in my state have wisened up to the state laws as to what licensed MH professionals (psychiatrists, psychologists, and social workers) are required to document regarding ESA's and it's exactly what you're saying--either state that the patient needs an animal to ameliorate their disability or state if there is insufficient information to make that determination. A lot of the landlords have made their own forms with that guidance.

But I don't write ESA letters as a policy so I don't get involved in trying to battle landlords with inappropriately worded forms.

 

[Stagg737]

As I understand it, there is essentially no bar to qualify for "service animal."

Redirecting…

Famously, the ADA states that the only thing the staff of a public accommodation or establishment may do, is ask only two questions of a person purporting to have a service animal: (1) is the dog a service animal required because of a disability, and (2) what work or task has the dog been trained to perform. The thing is, the ADA contains no requirement that the person provide a truthful answer to those questions. And thus the system seems ripe for abuse, and it's actually really surprising we haven't seen more of it.

With the ADA in place, you can take fluffy into a Michelin five-star restaurant. If the maître d' says "I'm sorry, sir, we don't allow pets," you can simply lie and say "this is a service animal which I require because of a disability." And at that point they're hamstrung. All they can do is ask you "what work or task has the dog been trained to perform?" And you can simply lie again and say "he nudges me with his nose to alert me if I'm about to have a seizure." They're not allowed to ask for any evidence whatsoever that you have a seizure disorder, or that the dog has in fact been trained to perform this task. If they do, they're violating the ADA. Your word as an allegedly "disabled" person is sacrosanct. Sure, if they really feel certain you're lying, they can try to call your bluff and kick Fluffy out anyway, because if it went to court, there would subpoenaing of medical records and expert witnesses and such, and then you'd have to actually provide evidence for your assertions. (Not to mention that you could also face penalties if you live in one of many states which make it illegal to misrepresent a non-service animal as a service animal.) But do you really think they're going to risk bringing down a federal agency on them?

I'm honestly shocked more cluster B people aren't doing this. Why ask a doctor for an "emotional support animal" letter, when you can just lie and say your pet is a service animal?

It's interesting because you ADA reference says:
"1) is the dog a service animal required because of a disability, and (2) what work or task has the dog been trained to perform. 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."

However multiple states in the second reference you provided require individuals to provide an ID card containing training documentation. I'd be curious to know if there are any cases where a state court ruled that the ID card had to be provided and it was taken to the federal level.

Keep in mind that if the animal is disruptive, even if it's a bona fide service animal that is capable of injecting you with insulin for your diabetic glycemic coma or doing chest compressions when your pacemaker fails or can cure cancer handling test tube like that cat in that meme, the restaurant can still kick you and Fluffy out regardless.

So the restaurant is only at risk of letting lying people with well behaved pets hang out. Still annoying but it's not like they have to suffer bad pets of either disabled people or liars.

Obviously in practice even with obnoxious animals a restaurant may not want to take various risks by confronting someone.

This gets even more vague because the ADA doesn't even define what disruptive or "control" of the animal is. Below is their entire definition for this:

"A service animal must be under the control of its handler. Under the ADA, service animals must be harnessed, leashed, or tethered, unless the individual’s disability prevents using these devices or these devices interfere with the service animal's safe, effective performance of tasks. In that case, the individual must maintain control of the animal through voice, signal, or other effective controls."

So if a dog starts barking and doesn't immediately stop, is it out of control? What if it decides to sit instead of laying down and won't obey that command? The laws are ridiculously vague where being specific really matters. To be expected I guess given the non-sensical definition of 'disability' put forth by the ADA...

 

[Trismegistus4]

However multiple states in the second reference you provided require individuals to provide an ID card containing training documentation. I'd be curious to know if there are any cases where a state court ruled that the ID card had to be provided and it was taken to the federal level.

Interesting. But I just did searches of that page for both "card" and "identifi" and almost all of the references are to service dogs in training. Maine apparently has a licensing law requiring "a service dog certification form approved by the department in consultation with the Maine Human Rights Commission" to obtain a license. Minnesota requires that the "service dog must be capable of being properly identified as from a recognized school for seeing eye, hearing ear, service, or guide dogs" but doesn't specify how that identification is to take place. Montana requires that it be identified by "a leash, collar, cape, harness, or backpack that identifies in writing that the animal is a service animal in training" which of course you can buy online or make at home. South Dakota has a similar requirement. Utah says that the person is "encouraged to identify" the animal but doesn't say they're required to do so.

So apparently Maine has the strictest requirement. I wonder if that's ever been challenged on the basis of the ADA.

 

[smalltownpsych]

I tell patients that our APA stated that I have to have extensive training in this area and be able to evaluate both patient and pet (excuse me “service animal”) and if I don’t follow this then I could be in big trouble. I don’t mention that this is the same APA that first said waterboarding was Ok For psychologists to do and then threw them under the bus when it was politically expedient for them. Their guidance on this topic of emotional support and service animals that saves me from getting involved might be the one thing they have done for me and makes up for all those years of paying membership dues.

 

[nexus73]

I tried explaining the difference between an emotional support animal, which has rule under the Fair Housing Act, versus a support animal that requires specific training, like a seeing eye dog, that can be taken anywhere. A dog without specific training for a specific task to assist a disability is not a service dog.

Patient's response: Oh, I'll train him.

Sure you will.