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Service Animals in the Chiropractic Office – ADA Compliance

Wednesday, September 6, 2017   (0 Comments)
Posted by: Adrienne J. Hersh, JD
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Service Animals in the Chiropractic Office – ADA Compliance


The Americans with Disabilities Act (ADA) and the Civil Rights Act require business owners, including chiropractic offices, to make a variety of accommodations for persons with disabilities who patronize the business.  The ICS has previously written about required structural accessibility, auxiliary aids for hearing, sight and speech impairments, and translation requirements for persons with limited English proficiency.  ICS members may refer to: and:


Many persons with disabilities use a service animal to assist in activities of daily living.  The ADA requires public businesses to make reasonable modifications in their policies, practices and procedures to accommodate persons with disabilities.  Service animals fall under this principle.  Therefore, physician offices with a “no pet” policy must revise the policy to permit service animals on their premises.


Unfortunately, the need for service animals by some legitimately disabled persons has been misused by some non-disabled people as a way of allowing them to take non-service pets into public places where they otherwise would not be allowed.  This misuse has led to confusion about what physician offices must do to comply with ADA policy regarding service animals.  The U.S. Department of Justice Civil Rights Division has provided useful guidance, some of which may be surprising.   Their FAQs may be found at:


Under the ADA, a service animal is defined as a dog that has been individually trained to do work or perform tasks for an individual with a disability.  The task(s) performed by the dog must be directly related to the person's disability.  The dog must be trained to take a specific action when needed to assist the person with a disability.  Dogs (and miniature horses!) are the only types of animals recognized under the ADA as service animals.  The DOJ provides the following examples: a person with diabetes may have a dog that is trained to alert him when his blood sugar reaches high or low levels; a person with depression may have a dog that is trained to remind her to take her medication; or a person who has epilepsy may have a dog that is trained to detect the onset of a seizure and help the person remain safe during the seizure.


The biggest source of confusion pertains to emotional support, therapy, comfort, or companion animals.  The DOJ says they are not considered service animals under the ADA, because they have not been trained to perform a specific job or task, they do not qualify as service animals under the ADA.  Simply because they provide comfort to the owner does not qualify them as a service animal. However, 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, the dog would qualify as a service animal under the ADA.


Under the ADA, physician offices are only required to allow service animals on their premises.  However, some state or local governments have laws that allow people to take emotional support animals into public places.  Therefore, the ICS recommends that physician offices check with state and local government agencies to find out about these laws.


How should office staff respond when a patient presents to the office with a pet?  Of course, a health care office has concerns for sanitation and allergies of other patients.  Staff must determine whether the animal is a service animal.  In situations where it is not obvious that the dog is a service animal, staff may ask only two specific questions: (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 are not allowed to request any documentation for the dog, require that the dog demonstrate its task, or inquire about the nature of the person's disability. 

Surprisingly, the ADA does not require that service animals be certified as such, so office staff may not require documentation, such as proof that the animal has been certified, trained, or licensed as a service animal, as a condition for entry.  Although private organizations sell service animal certification or registration documents online, these documents do not convey any rights under the ADA, and the Department of Justice does not recognize them as proof that the dog is a service animal.  Physician offices must rely on the two questions cited above, rather than any “certifications.”  Additionally, the ADA does not require service animals to wear a vest, ID tag, or specific harness, so staff may not deny access because of the absence of these items. 


 The exceptions to service animal access are extremely limited and apply only when the presence of service animals would “fundamentally alter” the nature of the goods, services, programs, or activities provided to the public.  For example, service animals might be restricted from a certain area of a dormitory reserved for students with severe dog allergies.  However, the “fundamental alteration” standard probably does not apply in a most chiropractic physician offices.  If a physician is aware that a service dog will be in the office at the same time as a person with allergies, the physician probably must allow the dog and make an accommodation.  This could include rescheduling the patients so they are not present at the same time, or keeping them as far apart as possible in the office and not placing the allergic patient in the same room after the service dog has occupied it.   


The only other exception to required access is when a service animal is out of control and the handler does not take effective action to control it, or if it is not housebroken.  However, those situations are extremely rare with true service dogs.


Note: This FAQ is an excerpt from the article National Association of Chiropractic Attorneys Meeting June 2017: Online Reviews; FAA Exams; Service Animals in the Office by Adrienne Hersh, JD.


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