Frequently Asked Questions

About

Ethics, ethos, and service dog fraud.

We’re huge on ethics and optics around here. We are continually asking ourselves … are we doing this correct, are we staying true to who we are — we want to do the right thing … true, that’s relative … but we’re continually asking and refining.

We also highly respect what therapists do… and the hard work it took to get where you are … and to protect our business, we protect our therapists… they’re out on the tip of the spear.

How are we different? That’s simple.

https://www.esadoggy.com/service-dog/
https://www.esadoggy.com/ethos/
https://www.esadoggy.com/ethics/

Within those pages, I hope you will come to learn we’re trying to rethink/redo the emotional support animal business.

Are your clinical staff members licensed professionals?

From coast to coast, we maintain a network of licensed professionals legally allowed to recommend emotional support animals.

Please review our coverage map.

HIPAA

Top 10 Most Common HIPAA Violations

1. Keeping Unsecured Records

As part of your employee training, all staff members should be required to keep documents with PHI in a secure location at all times. Physical files containing PHI should be locked in a desk, filing cabinet or office. Digital files should require secure passwords to access them, in addition to being encrypted whenever possible.

2. Unencrypted Data

The dangers of leaving PHI data vulnerable without encryption are simple. Encrypting the data is an added protection if a device containing PHI is lost or stolen. It offers an additional layer of security if a password protected device is somehow accessed, such as through hacking. Although it is not a strict HIPAA requirement, it is highly recommended. You should also be familiar with your State HIPAA regulations as many States have passed laws requiring ePHI and PII to be encrypted.

3. Hacking

Although we’d like to think it would never happen to us, hacking is a real threat to medical ePHI. There are people out there who want to use this information for malicious purposes, and therefore medical practices need to protect against hacking wherever possible.

Keeping antivirus software updated and active on all devices containing ePHI is a great place to start. Using firewalls adds another layer of protection as well. Finally, creating unique and difficult to remember passwords, and changing them frequently is another important measure to take to prevent hacking.

4. Loss or Theft of Devices

A case was settled in June of 2016, where an iPhone containing a vast amount of ePHI, including social security numbers, treatment and diagnosis information, medications, and more was stolen.

In addition, the iPhone was neither password protected nor encrypted, leaving all ePHI vulnerable to access by anyone possessing the phone.

The violation occurred at a facility called the Catholic Health Care Services of the Archdiocese of Philadelphia (CHCS). A combination of nursing home residents and family members totaling 412 people were affected by the data breach, and the facility was fined $650,000.

Unfortunately, if devices containing ePHI are not stored in a secure location at all times, they are subject to the possibility of loss or theft. If the information stored on such devices is not encrypted or password protected, the loss or theft of the device becomes an even more severe issue.

5. Lack of Employee Training

When it comes to training employees on HIPAA regulations and compliance, it’s important that every employee who comes in contact with PHI be thoroughly educated. Employee HIPAA training is more than a recommendation – it is a requirement of the HIPAA law. All staff members must be well-trained on the law, as well as on the particular policies and procedures set forth by your individual practice.

6. Gossiping / Sharing PHI

Although general gossip or chit chat by the water cooler can be harmless, PHI should always be off limits. When talking to co-workers, there is no reason to discuss PHI. Plus, it comes with a hefty fine.

Medical practice employees with access to patient PHI need to be careful about the information they share with others. When discussing PHI, should always be aware of who may be listening. Keep conversations about PHI behind closed doors, and only with appropriate office personnel.

7. Employee Dishonesty

Although not always done with a malicious purpose, when employees try to access PHI that they are not authorized to view, this is a HIPAA violation. Often it is merely out of curiosity, but the punishment is the same regardless of the intent. Thorough and precise training and procedures that outline who can access what, as well as a clear indication of the consequences that will result, can help prevent occurrences of this particular HIPAA violation.

8. Improper Disposal of Records

When training your staff members on HIPAA regulations, one of the most important procedures to enforce is proper disposal of PHI records. Staff members should understand that all information that contains PHI, such as social security numbers, medical procedures, diagnoses, etc., should be shredded, destroyed, wiped from the hard drive, etc.

If any of this information is left lying around in a trash can, in a computer’s recent files folder, etc., it could get into the hands of the wrong person, and this would be a serious HIPAA violation. You can prevent this from happening with proper employee training and enforcement by a compliance officer or other staff.

9. Unauthorized Release of Information

This violation most often occurs when members of the media release PHI regarding public figures and celebrities. It can also happen when medical personnel release PHI to family members that are unauthorized, as only dependents and those with a Power of Attorney are allowed access to the PHI of a family member.

10. 3rd Party Disclosure of PHI

When it comes to discussing PHI, it should only be discussed with the people who need to know, such as the patient, the doctor(s), and/or the person(s) billing for the procedure, medication, or other related service. If you have access to PHI and discuss it with those who do not have the right access to this information is a direct violation of HIPAA.

However, it does happen frequently. Again, by educating all staff members with access to PHI about HIPAA regulations such as this, you can eliminate the majority of data breaches caused by this violation.

Another example of 3rd party disclosure would be if a staff member were to release the wrong patient’s information due to human error. In this case, the act may be an accident, but the consequences would be similar to those for a purposeful violation.

What is PHI?

Protected health information (PHI) is any information in the medical record or designated record set that can be used to identify an individual and that was created, used, or disclosed in the course of providing a health care service such as diagnosis or treatment. HIPAA regulations allow researchers to access and use PHI when necessary to conduct research. However, HIPAA only affects research that uses, creates, or discloses PHI that will be entered in to the medical record or will be used for healthcare services, such as treatment, payment or operations.

For example, PHI is used in research studies involving review of existing medical records for research information, such as retrospective chart review. Also, studies that create new medical information because a health care service is being performed as part of research, such as diagnosing a health condition or a new drug or device for treating a health condition, create PHI that will be entered into the medical record. For example, sponsored clinical trails that submit data to the U.S. Food and Drug Administration involve PHI and are therefore subject to HIPAA regulations.

What is not PHI?

In contrast, some research studies use data that is person-identifiable because it includes personal identifiers such as name, address, but it is not considered to be PHI because the data are not associated with or derived from a healthcare service event (treatment, payment, operations, medical records) not entered into the medical records, nor will the subject/patient be informed of the results. Research health information that is kept only in the researcher’s records is not subject to HIPAA but is regulated by other human subjects protection regulations.

Examples of research health information not subject to HIPAA include such studies as the use of aggregate data, diagnostic tests that do not go into the medical record because they are part of a basic research study and the results will not be disclosed to the subject, and testing done without the PHI identifiers. Some genetic basic research can fall into this category such as the search for potential genetic markers, promoter control elements, and other exploratory genetic research. In contrast, genetic testing for a known disease that is considered to be part of diagnosis, treatment and health care would be considered to use PHI and therefore subject to HIPAA regulations.

Also note, health information by itself without the 18 identifiers is not considered to be PHI. For example, a dataset of vital signs by themselves do not constitute protected health information. However, if the vital signs dataset includes medical record numbers, then the entire dataset must be protected since it contains an identifier. PHI is anything that can be used to identify an individual such as private information, facial images, fingerprints, and voiceprints. These can be associated with medical records, biological specimens, biometrics, data sets, as well as direct identifiers of the research subjects in clinical trials.

HIPAA Security Rule

The HIPAA Security Rule requires appropriate Administrative, Physical, and Technical Safeguards to ensure the confidentiality, integrity, and security of protected health information (PHI).

The Security Rule is made up of 3 parts.

  • Technical Safeguards
  • Physical Safeguards
  • Administrative Safeguards

All three parts include implementation specifications. Some implementation specifications are “required” and others are “addressable.” Required implementation specifications must be implemented. Addressable implementation specifications must be implemented if it is reasonable and appropriate to do so; your choice must be documented.

 

HIPAA Breach Notification Rule

The Breach Notification Rule requires most healthcare providers to notify clients when there is a breach of unsecured PHI. The Breach Notification Rule also requires the entities to promptly notify HHS if there is any breach of unsecured PHI, and notify the media and public if the breach affects more than 500 clients.

Learn more about the Breach Notification Rule.

HIPAA Privacy Rule

The HIPAA Privacy Rule establishes national standards to protect individuals’ medical records and other personal health information and applies to health plans, healthcare clearinghouses, and those health care providers that conduct certain health care transactions electronically. The Rule requires appropriate safeguards to protect the privacy of personal health information, and sets limits and conditions on the uses and disclosures that may be made of such information without patient authorization. The Rule also gives clients rights over their health information, including rights to examine and obtain a copy of their health records, and to request corrections.

Business Associates are directly liable for uses and disclosures of PHI that are not covered under their BAA or the HIPAA Privacy Rule itself.

The Privacy Rule requires Business Associates to do the following:

  • Do not allow any impermissible uses or disclosures of PHI.
  • Provide breach notification to the Covered Entity.
  • Provide either the individual or the Covered Entity access to PHI.
  • Disclose PHI to the Secretary of HHS, if compelled to do so.
  • Provide an accounting of disclosures.
  • Comply with the requirements of the HIPAA Security Rule.

HIPAA Administrative Safeguards

The Administrative Safeguards are a collection of policies and procedures that govern the conduct of the workforce, and the security measures put in place to protect ePHI.

The administrative components are really important when implementing a HIPAA compliance program; you are required to assign a privacy officer, complete a risk assessment annually, implement employee training, review policies and procedures, and execute Business Associate Agreements (BAAs) with all partners who handle protected health information (PHI).

There are nine standards under the Administrative Safeguards section.

  • Security Management Process
  • Assigned Security Responsibility
  • Workforce Security
  • Information Access Management
  • Security Awareness and Training
  • Security Incident Procedures
  • Contingency Plan
  • Evaluation
  • Business Associate Contracts and Other Arrangements

Reasonable Accommodation Forms

When is a reasonable accommodation necessary?

A requested accommodation is necessary when there is an identifiable relationship, or nexus, between the requested accommodation and the individual’s disability. Some examples of Reasonable Accommodations are:

  • Assigned parking space for a person with a mobility impairment
  • Assigned lower mailbox for a person who uses a wheelchair
  • Permitting an assistance animal in a “no pets building for a person who is deaf, blind, has seizures, or has a mental disability

What is an assistance animal?

An assistance animal is not a pet. It is an animal that works, provides assistance, or performs tasks for the benefit of a person with a disability, or provides emotional support that alleviates one or more identified symptoms or effects of a person’s disability. Assistance animals perform many disability-related functions, including but not limited to, guiding individuals who are blind or have low vision, alerting individuals who are deaf or hard of hearing to sounds, providing protection or rescue assistance, pulling a wheelchair, fetching items, alerting persons to impending seizures, or providing emotional support to persons with disabilities who have a disability-related need for such support.

For purposes of reasonable accommodation requests, neither the Fair Housing Act nor Section 504 requires an assistance animal to be individually trained or certified.5 While dogs are the most common type of assistance animal, other animals can also be assistance animals.

What information may a provider seek when a reasonable accommodation is requested?

A provider is entitled to obtain information that is necessary to evaluate if a requested reasonable accommodation may be necessary because of a disability. If a person’s disability is obvious, or otherwise known to the provider, and if the need for the requested accommodation is also readily apparent or known, then the provider may not request any additional information. 

If the disability and/or the disability-related reason for the requested accommodation is not known or obvious, the requesting individual, medical professional, a peer support group, a non-medical service agency, or a reliable third party who is in a position to know about the individual’s disability may also provide verification of a disability. In most cases, an individual’s medical records or detailed information about the nature of a person’s disability is not necessary for this inquiry. 

When may a housing provider refuse to provide a requested accommodation?

A housing provider can deny a request for a reasonable accommodation if the request was not made by or on behalf of a person with a disability or if there is no disability-related need for the accommodation. In addition, a request for a reasonable accommodation may be denied if providing the accommodation is not reasonable – i.e., if it would impose an undue financial and administrative burden on the housing provider or it would fundamentally alter the nature of the provider’s operations. The determination of undue financial and administrative burden must be made on a case-by-case basis involving various factors, such as the cost of the requested accommodation, the financial resources of the provider, the benefits that the accommodation would provide to the requester, and the availability of alternative accommodations that would effectively meet the requester’s disability-related needs.

When a housing provider refuses a requested accommodation because it is not reasonable, the provider should discuss with the requester whether there is an alternative accommodation that would effectively address the requester’s disability-related needs without a fundamental alteration to the provider’s operations and without imposing an undue financial and administrative burden.  These discussions often results in an effective accommodation for the requester that does not pose an undue financial and administrative burden for the provider.

Can you notarize my letters and forms?

We are not lawyers, and the following should have not considered the legal advice.

From HUD’s FHEO 2020 (Guidance on Documenting an Individual’s Need for Assistance Animals in Housing)

Housing providers may not require a health care professional to use a specific form (including this document), to provide notarized statements, to make statements under penalty of perjury, or to provide an individual’s diagnosis or other detailed information about a person’s physical or mental impairments.

Need More Information?

Get Started
Chat online or call +1-800-372-4125.
Chat online
or call +1-800-372-4125.

1: Place an Order.

Shop now and enjoy 90-days of McAfee's $100,000 Identity Protection and Stripe's state of the art payment processing technology.

2. Complete an Assessment.

Next, you'll complete our HIPAA-compliant intake assessment, which is based on WHODAS 2.0 and DASS-21.

3: Engage With an Expert.

HUD's 2020 guidance requires clinicians have active therapeutic care and personal knowledge when providing clients with reliable written verification of their disability-related benefit for an emotional support animal.

Travel Form

Signed Medical or Mental Health Professional Document

This piece of documentation is the only one you’re required to obtain for all domestic air carriers. Delta, United, and American each provide a downloadable form to have completed by your medical doctor or mental health professional. Fields include proof of license, assurance that you have a psychological need for the animal, contact information, and a signature. JetBlue and Southwest ask for similar information submitted on an official letterhead. On April 19, Alaska Airlines implemented a new policy, saying passengers “must provide animal health and behavioral documents, as well as a signed document from a medical doctor or mental health professional, at least 48 hours in advance of departure” for all flights departing on or after May 1. United followed suit on March 1, and with American flights starting July 1, you’ll have to “contact the Special Assistance Desk with all required documentation at least 48 hours before your flight.”

International Air Travel Requirements

Can your therapists sign a Medical Information Form (MEDIF)?

No, absolutely categorically not.

You may be asked for proof of your “fitness to fly” when requesting assistance. If you have a stable condition, there is generally no need to be cleared for travel.

There are usually two parts to the medical clearance process:

  1. You will be asked to provide information about your situation or condition and, for many passengers, this will be all you will need to complete.
  2. If the airline has concerns about how flying might impact your particular condition, it will ask you to complete a further form.

You may also be asked to provide medical proof at this stage, often a doctor’s note.

The ESAD Int’l Protocol does not allow any of our therapists to sign off on this form.

Air France-KLM

The transport of assistance dogs in the cabin is free of charge and must respect the same conditions as those for guide dogs:

  • It must comply with all sanitary/hygiene requirements in the departure, arrival and connection countries.
  • It must be identifiable by a dog tag or harness. You must be able to provide proof (along with credible verbal proof) of the animal’s certification and its use.
  • It may travel without a muzzle.
  • It must remain leashed at all times.
  • It cannot obstruct the aisles inside the aircraft.
  • It must be well-behaved in all circumstances.
  • You will be offered a seat with the most space possible, but your dog may not occupy a seat and is forbidden from occupying the space near the emergency exits.

To transport an emotional support animal (ESA) in the aircraft cabin, you must provide a medical certificate that is less than a year old. This certificate must be provided by a mental health specialist (psychologist, psychiatrist…) and testify that you have regular check-ups and need to be with your dog at all times.

On flights longer than 8 hours, we may ask you to demonstrate that you are prepared to handle your dog’s hygienic needs (primarily the natural need to relieve itself).

Air Nippon Airways

Customers who accompany Psychiatric/Emotional Support Dog must provide current documentation (ie. No older than six months from the date of the passengers scheduled initial flight) on the practice letterhead of a licensed mental health professional including medical doctor specifically treating passenger’s mental or emotional disorder (eg. psychiatrist, psychologist, licensed clinical social worker) stating the following.

  1. The passenger has a mental or emotional disability recognized in the Diagnostic and Statistical Manual of mental Disorders –  Fourth or Fifth edition(DSM-Ⅳ or Ⅴ),
  2. The passenger needs emotional or psychiatric service dog as an accommodation for air travel and/or for activity at the passenger’s destination,
  3. The individual providing assessment is a professional mental health professional, and the passenger is under his/her professional care, and
  4. The date and the type of mental health professional’s license and the state or other jurisdiction in which it was issued,

Air Nippon

FHA

What is an Assistance Animal as defined by the U.S. Department of HUD?

An “Assistance Animal” is the recent term HUD adopted to refer to an Emotional Support Animal or a Service Animal in the housing accommodations process:

“An assistance animal is not a pet. It is an animal that works, provides assistance, or performs tasks for the benefit of a person with a disability, or provides emotional support that alleviates one or more identified symptoms or effects of a person’s disability.”

In other words, there should be no difference in treatment between ESAs and Service Animals- they are both equals and neither should be treated with preference. Unfortunately, many housing providers think ESAs must undergo difference scrutiny to be granted a housing accommodation- this is untrue!

Do Service Animals have priority over Emotional Support Animals during the housing accommodations process?

No! This is a huge misunderstanding carried over from public accommodations which should not be applied to housing accommodations. According to HUD there is no difference between a Service Animal or an Emotional Support Animal for the purposes of housing and reasonable accommodations. In fact, both ESAs and Service Animals are considered “Assistance Animals” for the purposes of fair housing and neither are to be treated preferentially.

Does the ADA or the Fair Housing Act apply when I am requesting a housing accommodation for my assistance animal?

When it comes to the review of a housing accommodation for an emotional support animal or service animal all housing providers must meet their fair housing obligations. All housing providers, including the Public Housing Authorities which provide federally funded subsidized housing, “may not use the ADA definition [of “service animal”] as a justification for reducing their FHAct obligations.” [75 Fed. Reg. at 56166, 56240 (Sept. 15, 2010)] Remember that both Emotional Support Animals and Service Animals are assistance animals under the FHAct, and therefore both should be subjected to the same review process outlined by HUD. If your landlord is treating ESAs differently than Service Animals, your landlord might be violating the FHAct.

Can Pit Bull, German Shepherd, Rottweiler, or Doberman Pinscher dogs be banned from housing because of their breed and size?

No! Breed, size, and weight limitations may not be applied to an assistance animal.

If I live in a city or town which bans my assistance animal because of its breed, are my housing rights protected by the Fair Housing Act?

Again, No! Though a town or city may impose a breed ban upon pets, the same cannot be applied to any service animal or emotional support animal. The city could be held liable for violating the Fair Housing Act if they in fact subjected the disabled resident’s assistance animal to their breed ban. Many cities and towns mistakenly believe they are subjected to ADA laws only.

Can a property require medical documentation, or require a letter from a “doctor only” to prove my disability?

A property cannot require detailed medical information, nor can a property require the documentation come only from a doctor or physician. According to HUD, If the disability is “not readily apparent” or known by the housing provider, like PTSD, Autism, or TBI, the housing provider may ask for “reliable documentation” to verify the disability. According to HUD, a reliable source could be “a doctor or other medical professional, a peer support group, a non-medical service agency, or a reliable third party who is in a position to know about the individual’s disability.” So, a property cannot require the reliable source be a doctor, however, a doctor could be a reliable source.

Can my housing provider prohibit me from taking my Emotional Support Animal or Service Animal to the common areas and the amenities on the property? Can I take my animal to the pool area?

If you are disabled and require an assistance animal, you would be able to take your animal anywhere on the property you would normally go- this would include the club house, the pool area, and any social event.

Can a housing provider deny my assistance animal because their insurance policy prohibits my dog’s breed? Can I be required to pay for additional coverage for my assistance animal?

Your assistance animal is not a pet, and therefore it cannot be subjected to pet rules, nor should you be required to pay any additional fees because you require an assistance animal.

Would the housing provider know that I filed a fair housing complaint? I am afraid of the landlord retaliating or threatening me- am I protected?

When you file a fair housing complaint and it is submitted to the U.S. Department of Housing and Urban Development, the housing provider would never know the complaint was filed- it is kept secret at first. If HUD believes you have a great case, they will require you to sign a finalized fair housing complaint about your approval.

At that point, HUD, backed by the Department of Justice, will serve your housing provider with official documents alleging violations of the Federal Fair Housing Act and require the housing provider respond to a number of questions and document requests within 10 days.

No housing provider wants to be served by a Federal agency alleging violations of federal law!

Along with the official notification, the housing provider is notified that there is a very serious “Anti Retaliation, Threatening, and Intimidation” law which prohibits them from interacting with you in any threatening way.

Can management require a resident to recertify an assistance animal at lease renewal time?

From JD Supra:

This is a hot button issue. If a disability is obvious, the answer is a clear no.

For example, if a resident with a sight disability uses a guide dog, we would not seek to recertify the disability and/or need for the animal. If the disability is not obvious, the answer is murkier. I have a federal court decision noting that for certain emotional support animals addressing disabilities which may not be permanent, recertification at, for example, lease renewal time, is in and of itself is not improper.

However, many HUD officials take a contrary view – in that once management has approved an assistance animal, there is no need to ever take a second look. HUD has issued various assistance animal guidance over the past few years, but none has specifically addressed this point. I’ve defended a handful of these cases – but none have gotten to the point of a formal determination/opinion.

At least not yet.

Animal

Do I need to register my emotional support animal?

There is NO REGISTRATION for either a service animal or an ESA. That’s all nonsense — sold by Internet vendors looking to take advantage of those in need.

Does my emotional support animal need to be spayed or neutered?

No, there are no requirements for an emotional support dog to be spayed or neutered.

Does an emotional support animal (ESA) require to wear any identifying clothes or a harness?

Federal law does not require Service Dogs or Emotional Support Animals to wear any type of clothing or harnesses. However, we strongly encourage this since harnesses, leashes, patches and identifying items cut down on the hassles and unnecessary explanations when in public. We have found that these products drastically save time and frustration.

Does my ESA need a vest?

A person who is assisted by an emotional support animal must have a correctly formatted letter from a licensed mental health professional. That’s all. The ESA letter must state that the animal’s handler has an emotional or psychological disability identified in the DSM V and that the animal helps mitigate specific symptoms of the handler’s disability. The letter is all that is required.

To reiterate, however, an ESA vest made of a brightly-colored fabric, such as red or orange will help identify your pet as an emotional support animal.

It is NOT required.

Do emotional support animals need special training similar to a service dog?

Emotional support animals do not require specialized training. However, they do require a therapist letter in order to be considered valid. Service Dogs require specialized training because they perform a specific task for their owner such as acting as a seeing eye dog or calming someone down who has PTSD.

Can you answer questions about Service Animals?

We’re in the emotional support animal business, and given this, we cannot offer advice or support regarding service animals.

Information regarding service animals can be found here and here.

Do you inform clients about an ESA’s rights?

As previously mentioned, we try to educate our clients/potential clients regarding the legal rights on an ESA. All too common though, folks try to extend the rules, make an ESA into a service animal.

We don’t perpetuate that silliness, but we can’t stop individuals.

On a side note, we’re pertpetually “mystery shopped” by service animal activists who want to see if we’re bending the rules.

Who provides the animals?

Some clients come with animals … some get to go to the pound/rescue, etc.

That’s really not “my worry,” as I’m not in the animal biz per se.  We’re in the mental health field.

Does my animal need any specific training?

The short answer is no.

There are no unique training requirements for an ESA, however, it’s important for your animal to be well-behaved. You will be held responsible for any property damage or harm to others.

What is the difference between a service animal and an ESA?

There are three general categories of animals who may be considered under these regulations:

Emotional support animals: These animals are not always explicitly trained, but serve as a comfort to individuals with a documented mental health condition. There is no restriction for the breed of emotional support animals because all domesticated animals can serve as ESAs.

An ESA is not like a Service Animal. SAs have access into the public space. An ESA only penetrates no-pets-allowed housing and on airline flights. A Service Animal performs a task, is often highly trained and penetrates the public space.

Therapy animals: These animals are usually evaluated and registered by an agency and provide emotional support to individuals who need them. They are often used in hospitals, nursing homes and in school reading programs such as Reading Educational Assistance Dogs.

Service animals: These animals have been specially trained to perform tasks their owner can’t do on his or her own. Guide dogs for the blind are perhaps the most well known in this category. Service animals are not required by law to wear vests or have any form of identification.

Eighteen states, including Virginia, Colorado and California, have laws that criminalize fraudulent representation of a service animal. These violations are usually misdemeanors, but repeated violations can result in jail time. West Virginia is not one of the 18 states, however, businesses could pursue a trespassing charge if a second incident occurs. Play it safe with an ESA!

Housing Letter

Can my landlord refuse my reasonable accommodation request?

Only in certain circumstances. If the animal’s accommodation could mean additional administrative costs and other adjustments that would affect housing arrangements, then the landlord might refuse your request. For instance, the animal is disruptive or poses a threat to the health, safety, and property of the other tenants. Make sure to train your ESA so they are not unruly and you are always in control.

ESAD Int’l also accepts no responsibility and makes no guaranty regarding the approval or denial of specific privileges or access in regards to any emotional service animal. Submission of payment and your assessment constitutes acceptance of these and all terms set forth herein.

Can you speak to my landlord?

Housing providers are now, more often, demanding the existence of a therapeutic relationship — in particular, landlords will question when therapy began and number of sessions completed / scheduled. This is the current method (spring 2018) being retained to weed out Internet letter-mill documents.

If you purchase an assessment, choose not to engage in any follow-up sessions, and want us to speak with your landlord, you assume all risk and liability if your reasonable accommodation request is denied.

Before our team can communicate (talk, answer questions via email) with your landlord, you must purchase this option and a signed HIPAA waiver must be in place. This waiver allows us to discuss your protected health information (PHI) with a third party.

Can you notarize my letters and forms?

We are not lawyers, and the following should have not considered the legal advice.

From HUD’s FHEO 2020 (Guidance on Documenting an Individual’s Need for Assistance Animals in Housing)

Housing providers may not require a health care professional to use a specific form (including this document), to provide notarized statements, to make statements under penalty of perjury, or to provide an individual’s diagnosis or other detailed information about a person’s physical or mental impairments.

Need More Information?

Get Started
Chat online or call +1-800-372-4125.
Chat online
or call +1-800-372-4125.

1: Place an Order.

Shop now and enjoy 90-days of McAfee's $100,000 Identity Protection and Stripe's state of the art payment processing technology.

2. Complete an Assessment.

Next, you'll complete our HIPAA-compliant intake assessment, which is based on WHODAS 2.0 and DASS-21.

3: Engage With an Expert.

HUD's 2020 guidance requires clinicians have active therapeutic care and personal knowledge when providing clients with reliable written verification of their disability-related benefit for an emotional support animal.

Can management require a resident to recertify an assistance animal at lease renewal time?

From JD Supra:

This is a hot button issue. If a disability is obvious, the answer is a clear no.

For example, if a resident with a sight disability uses a guide dog, we would not seek to recertify the disability and/or need for the animal. If the disability is not obvious, the answer is murkier. I have a federal court decision noting that for certain emotional support animals addressing disabilities which may not be permanent, recertification at, for example, lease renewal time, is in and of itself is not improper.

However, many HUD officials take a contrary view – in that once management has approved an assistance animal, there is no need to ever take a second look. HUD has issued various assistance animal guidance over the past few years, but none has specifically addressed this point. I’ve defended a handful of these cases – but none have gotten to the point of a formal determination/opinion.

At least not yet.

Orders

Do you accept medical insurance?

Unfortunately, due to the problematic nature of being reimbursed by insurance companies for emotional support animal exams, we regret that we are not able to accept medical insurance at this time. In light of this, we have tried our best to make the approval protocol as accessible and as affordable as possible.

What is your cancellation and refund policy?

Please review our cancellation and refund policy to learn more.

Legal

What about my protected health information?

We are committed to the full protection and confidentiality of all patient information in compliance with Federal Laws. Pursuant to CFR §164.506 airlines are only permitted to verify the authenticity of your recommendation, however, we are not permitted to reveal any other personal information without your express consent. Additionally, we do not collect personal credit information such as social security numbers or driver’s license numbers.

Does my pet get entered into a government registry?

That’s a red-flag, as there’s no govermental registry for ESAs.

What laws protect me?

Emotional Support Animals are protected under the Air Carrier Access Act, Fair Housing Act, and the Americans With Disabilities Act (ADA).

Travel Letter

Can you notarize my letters and forms?

We are not lawyers, and the following should have not considered the legal advice.

From HUD’s FHEO 2020 (Guidance on Documenting an Individual’s Need for Assistance Animals in Housing)

Housing providers may not require a health care professional to use a specific form (including this document), to provide notarized statements, to make statements under penalty of perjury, or to provide an individual’s diagnosis or other detailed information about a person’s physical or mental impairments.

Need More Information?

Get Started
Chat online or call +1-800-372-4125.
Chat online
or call +1-800-372-4125.

1: Place an Order.

Shop now and enjoy 90-days of McAfee's $100,000 Identity Protection and Stripe's state of the art payment processing technology.

2. Complete an Assessment.

Next, you'll complete our HIPAA-compliant intake assessment, which is based on WHODAS 2.0 and DASS-21.

3: Engage With an Expert.

HUD's 2020 guidance requires clinicians have active therapeutic care and personal knowledge when providing clients with reliable written verification of their disability-related benefit for an emotional support animal.

Can your therapists sign a Medical Information Form (MEDIF)?

No, absolutely categorically not.

You may be asked for proof of your “fitness to fly” when requesting assistance. If you have a stable condition, there is generally no need to be cleared for travel.

There are usually two parts to the medical clearance process:

  1. You will be asked to provide information about your situation or condition and, for many passengers, this will be all you will need to complete.
  2. If the airline has concerns about how flying might impact your particular condition, it will ask you to complete a further form.

You may also be asked to provide medical proof at this stage, often a doctor’s note.

The ESAD Int’l Protocol does not allow any of our therapists to sign off on this form.

Need More Information?

Get Started
Chat online or call +1-800-372-4125.
Chat online
or call +1-800-372-4125.

1: Place an Order.

Shop now and enjoy 90-days of McAfee's $100,000 Identity Protection and Stripe's state of the art payment processing technology.

2. Complete an Assessment.

Next, you'll complete our HIPAA-compliant intake assessment, which is based on WHODAS 2.0 and DASS-21.

3: Engage With an Expert.

HUD's 2020 guidance requires clinicians have active therapeutic care and personal knowledge when providing clients with reliable written verification of their disability-related benefit for an emotional support animal.