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by Chelsea Goldstein, Dysautonomia Information Network

IMG_DoggoneConfusing.jpg.b854895c872de4f9d01eedb9599525b4.jpgPet ownership is known to have positive impacts on depression, anxiety, blood pressure, and heart rate, to name just a few benefits. The advantages of having a furry (or scaly, or feathery) family member are no secret - 68% of US households have at least one (1).

The values of pet ownership have been such a hot topic lately, that they have led to some confusion around the differences between pets, emotional support animals (ESAs), and service animals. The misuse and abuse of terms like ESA and service animal have created particular challenges for people living with chronic illnesses and disabilities who may benefit from either of these types of support animals. 

The rest of this article will clarify the differences between ESAs and service animals to provide a better understanding of how each may or may not be an appropriate addition to your home.

What are Service Animals and Emotional Support Animals?

It's important to know the difference.

Service Animals

Service animals are individually trained to perform tasks that help an individual with disability live more independently (2).  As defined by the Americans with Disabilities Act (ADA), these animals can support individuals with a physical, sensory, psychiatric, intellectual or other mental disability (1). To be considered a service animal, it is important that the work the animal is trained to do directly supports the individual handler.

According to the ADA, only dogs and, in rare cases, miniature horses can be legally defined as service animals. Some state and local laws may have more inclusive definitions of service animals, which will be discussed in more detail below (3). 

Nonetheless, dogs remain the most common service animal in the US. Labrador Retrievers and Golden Retrievers are the most popular breeds because they are known for their intelligence, loyalty, and patience - all qualities needed for this important work (1)!

Emotional Support Animals (ESAs)

Emotional Support Animals (ESAs) do NOT fall under the ADA classification of service animals. Rather, they are defined as providing companionship, comfort, and/or emotional support to individuals with psychiatric or mental health conditions (3). An ESA should be prescribed by a licensed mental health professional who will provide the owner with an ESA letter (5). This letter will be important if the owner is bringing their pet places, such as in housing complexes and on airplanes, that may otherwise restrict animals. While there are several online registration systems for ESAs, it is important to note that there is not an official or accredited registration process that is required (6).

Dogs and cats are the most common types of ESAs, but any domesticated animal can be classified as one as long as the handler goes through the proper channels. ESAs do not require any specific training, but are expected to be well behaved in public places (5).

What Tasks Do Service Animals and Emotional Support Animals Do?

Guide dogs have an important job of assisting a person who lives with vision impairment, and they may be one of the most recognized types of service dogs. However, service dogs are trained in a variety of specific tasks to help individuals with different needs.

Types of Service Dogs

  1. Guide Dogs help people with severe vision impairment or blindness travel and navigate their environments (2).
  2. Hearing or Signal Dogs are trained to alert individuals with severe hearing impairment or deafness when there is a sound, such as a knock on the door (2).
  3. Psychiatric Service Dogs work to detect and lessen the effects of psychiatric episodes. For example, they may turn on the lights for a person with Post Traumatic Stress Disorder, interrupt their handler if they are self-mutilating, or keep a disoriented person out of danger (2). 
  4. Sensory Dogs are primarily trained to assist people with autism. They can do a variety of tasks for their handlers, including calming them if the person is experiencing sensory overload (2).
  5. Seizure Response Dogs may stand guard over people who have seizures, or warn them to sit down if they can sense a seizure coming (2).
  6. Mobility Dogs can assist with tasks such as retrieving items from the floor, pulling wheelchairs, or pushing elevator buttons (1).

As mentioned above, all service dogs are trained in specific tasks for their handler. The categories of service dogs discussed here are not mutually exclusive or exhaustive. For example, a dog could be trained to help an individual with mobility difficulty pick things up off the floor, and also trained to sense when that person is about to have a seizure.

It is also important to note that psychiatric service dogs are different than ESAs because they are trained in instrumental tasks, even though they likely provide companionship and emotional support to their handlers, like ESAs. This is not to devalue ESAs - their support and companionship for individuals with mental health conditions can be life changing. 

Individuals with dysautonomia can benefit from both service dogs and ESAs. For example, someone with POTS-induced syncope could benefit from a dog trained to provide a warning signal when they sense pre-syncope symptoms. This could help the person find a safe place to sit or lay flat and prevent dangerous situations, especially when out of the home (1)! An ESA could help someone who has health-related depression and/or anxiety. Companionship of an ESA could be especially beneficial for a person who feels isolated due to the limitations dysautonomia has placed on their life. The most important consideration for getting a  support animal is to have a strong and realistic understanding of one's specific needs.

Where are These Animals Allowed?

Knowing the laws about where you can bring your animal can help you prepare for any pushback.

Service Animals

According to the ADA, service animals are allowed in housing, workplaces, on transportation, in educational institutions, and in any other spaces that allow the public, customers, or program participants (1,2). This includes businesses or programs that have a "no pet" policy because service animals are not considered pets (2). These organizations cannot charge any pet fees for service animals, and breed restrictions do not apply to them. They may, however, charge fees for damage caused by the animals (2).  

If you have a service animal, others cannot ask you for proof of the animal's certification, or about your disability. They can only ask:

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

The Air Carrier Access Act (ACAA) states that individuals can fly with their service animals without additional fees. The airlines can ask the following questions for "verbal assurance" of the need for a service animal:

  1. What tasks or functions does the animal perform for you?
  2. Would you describe how the animal performs these tasks for you? (2, 7).

Emotional Support Animals

Emotional support animals are not protected by the ADA and, therefore, are not granted the same access to public spaces as service animals (5). However, the ADA is a federal regulation, and each state may have different laws regarding where ESAs are allowed (1). If you have, or are considering getting, an ESA, it may be wise to learn about your state's regulations here

ESAs do, however, have some protections under the ACAA and Fair Housing Act. The ACAA allows individuals to fly with their ESAs without additional charges. Airlines may ask the owner for an ESA letter stating that the individual has a mental health condition, that the animal is needed for travel, and information regarding the issuing professional's date and type of mental health licensure (2). 

ESAs are also considered "assistance animals" under the Fair Housing Act. This means that housing entities must make reasonable accommodations to allow ESAs in housing units that may otherwise prohibit pets. They also cannot charge pet fees for ESAs, and breed restrictions should be waived (8). 

Regulations, Responsibilities, and Etiquette

Unfortunately, we have all heard of (and maybe even witnessed) instances when people take advantage of service animal and ESA classifications to get their pets places they wouldn't normally be allowed. It is important to know the regulations and responsibilities of these animals in order to protect the rights and needs of people who truly need them.


The term service animal is based on federal regulations set forth by the ADA. These regulations are upheld nationally, and some common questions about them are answered here. It is also important to note that several states have individual laws about the inclusion and exclusion criteria of service animals and ESAs. While the ADA supersedes state law, these regulations can provide more clarity on where ESAs are allowed in each state. They can be found here, or on your state's Attorney General website.


As a handler, it is your responsibility to ensure that your service animal or ESA is behaved in public, and trained to support you in specific tasks in the case of service animals. While there is not a single training or accreditation required by the ADA for service animals (9), it is dangerous and irresponsible to have a poorly or improperly trained service animal. In an era when service dog vests are readily available online, individuals living with disability, especially invisible disability, are judged and put in danger when people don't believe their service dog is legitimate (1). Read our additional articles on acquiring and training service animals to learn more about responsible options.


For Handlers: The ADA states handlers need to have control of their service animals. This is often done by keeping the animal on a leash or harness when outside the home, but there may be instances when such a device restricts the animal's ability to assist their handler. In these cases, the animal should be trained to respond well to voice commands (2). While businesses are not allowed to deny a service animal access to their spaces, they can ask a handler and service animal to leave if the animal's behavior is disrupting their business or posing a threat to other patrons. For example, a dog that is barking repeatedly in a movie theater could be asked to leave, as well as a dog that is growling and snapping at other shoppers in a grocery store (2). This is why it is important to ensure that service animals are well trained to be in a variety of public spaces. 

For passersby: Passersby should always remember that service animals are not pets, and stopping to pet, or otherwise distract, a service animal while out in public can be dangerous. These animals need to be focused on their handlers at all times to ensure they do not miss the subtle cues they need to perform their trained tasks (1). Please remember this next time you pass a service animal, and do not hesitate to tell passersby that they may not pet your service animal while it is working.


Article Citations 

  1. Driscoll, E. (2019, June 4). The ins and outs of owning and training a service dog. Dysautonomia Information Network (DINET). https://www.dinet.org/info/newsletters/the-ins-and-outs-of-owning-and-training-a-service-dog-r222/
  2. Brennan, J. (2014). Service animals and emotional support animals: Where are they allowed and under what conditions? The ADA National Network. https://adata.org/guide/service-animals-and-emotional-support-animals
  3. ADA requirements: Service animals. (2020, February 24). U.S. Department of Justice Civil Rights Division. https://www.ada.gov/service_animals_2010.htm
  4. Wisch, R. (2019). FAQs on emotional support animals. Michigan State University Animal Legal & Historical Center. https://www.animallaw.info/article/faqs-emotional-support-animals
  5. Gibeault, S. (2019, October 3). Everything you need to know about emotional support animals. American Kennel Club. https://www.akc.org/expert-advice/news/everything-about-emotional-support-animals/
  6. Harper, H. (2019, August 28). Do you need an emotional support animal? Here's what to know. Health.com https://www.health.com/pets/emotional-support-animals
  7. Gjelten, E. (2020). Flying with service dogs and emotional support animals. NOLO.com https://www.nolo.com/legal-encyclopedia/flying-with-service-dogs-and-emotional-support-animals.html
  8. Assistance animals. (n.d.) Housing and Urban Development. https://www.hud.gov/program_offices/fair_housing_equal_opp/assistance_animals
  9. Frequently asked questions about service animals and the ADA. (2015, July). U.S. Department of Justice Civil Rights Division. https://www.ada.gov/regs2010/service_animal_qa.html

Additional Resources

  1. National Organization on Disability. http://www.nod.org
  2. Job Accommodation Network. https://askjan.org/
  3. Americans with Disabilities Act. https://www.ada.gov/
  4. Dog Owner. https://www.dogowner.co.uk/
  5. The Dog Alliance. https://www.thedogalliance.org/

NOTE:  this article is available in pdf format below.  Printed copies for support or community groups are available by request to webmaster@dinet.org  Please include the purpose, name of the group and number of copies requested. 

PDF Link:


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