The information about writing Emotional Support Animal (ESA) Letters and who can receive them can often be confusing. There appears to be many resources of varying legitimacy available to clients and clinicians alike. It is our hope that this information helps to clarify the process for writing and qualifying for ESA letters.
Who can receive an ESA Letter?
A client that has been determined to (1) have a mental health disability and (2) that their animal clinically helps with the symptoms of that mental health disability can receive a letter from a licensed mental health provider that supports an Emotional Support Animal.
Who can write an ESA letter?
ESA letters can be written by mental health providers that can assess an individual for disability.
These mental health providers must be both licensed AND qualified to determine the disability. If the person is disabled due to a condition that the mental health provider can both diagnose and treat, then that provider can do an assessment for an ESA letter.
If you are seeking a mental health provider to write an ESA letter, a good question to ask might be “can you assess for disability?”
What is considered a “mental health disability”?
A disability would be considered a condition that substantially limits one or more major life activity (e.g. walking, seeing, speaking, hearing, breathing, learning, etc.). An ESA would need to help alleviate the effects of one or more of the determined disabilities.
The Social Security Administration (SSA) lists several mental disorders that would qualify for disability:
- Neurocognitive disorders
- Schizophrenia spectrum and other psychotic disorders
- Depressive, bipolar and related disorders
- Intellectual disorder
- Anxiety and obsessive-compulsive disorders
- Somatic symptom and related disorders
- Personality and impulse-control disorders
- Autism spectrum disorder
- Neurodevelopmental disorders
- Eating disorders
- Trauma- and stressor-related disorders
We highly recommend reviewing the information from the Social Security Administration (SSA) for more information on the mental disorders listed here.
Ethical considerations and conflicts of interest
It could be considered a conflict of interest if a clinician is writing an ESA letter for their own therapy patient.
If you are a therapist, consider referring your client to receive an outside assessment. If you are an assessment provider and not the client’s therapist (that is, there is no on-going relationship), it is considered ethical to provide a disability assessment for an ESA letter.
Legal Obligations for ESA Letters
The only two laws that directly apply to the use of ESAs for public accommodations are the Air Carrier Access Act (ACAA, 2003) and the Fair Housing Act (FHA, 1968).
Housing and air travel are the only two contexts in which an ESA is legally protected.
Emotional Support Animals vs. Service Animals
According to the Americans with Disabilities Act, Emotional Support Animals are not considered “service animals”. Service animals are dogs (no other animal) that are specifically trained to perform tasks for a person with a disability; these tasks must be directly related to the disability.
An example of a service animal is a guide dog who helps an individual with severe vision impairment or who is blind. When it comes to service animals, having a doctor’s note does not automatically qualify a dog as being a service animal. The law on what defines a service animal is different from state to state and it is recommended to check the laws in your state.
ESA Letters and Disability Diagnosis at UCEBT
Because ESA letters require that the client has a disability, UCBET can provide a full evaluation on an individual’s psychiatric/neurodevelopmental condition and determine if that condition contributes to a disability according to SSA standards.
However, just because UCEBT conducts an evaluation does not guarantee a diagnosis. Even if an individual receives a diagnosis, that does not guarantee that the diagnosis will qualify for legal disability.
If you're interested in pursuing a full psychological evaluation at UCEBT, please keep in mind that we do not accept insurance. Rates for a comprehensive assessment range from approximately $2,200 to $2,800 depending on a variety of factors. Please complete this online form for a free consultation to learn more.
Other Places to Find Qualified Providers
You may consider looking at Psychology Today and searching for providers that can provide a “disability evaluation”.
Helpful Resources:
Emotional Support Animal Assessment/Letter Checklist (National Board of Forensic Evaluations)
Standards that should be followed when providing an ESA letter
University of Utah’s documentation requirements for disability accommodations
Do’s and Don’ts for Certifying Disability Due to Mental Illness
What qualifies for Social Security Disability Insurance (SSDI) Benefits
Utah’s Disability Determination Services
