Did You Buy a Bogus Emotional Support Animal Letter?

Thanks in no small part to the peacock on the airlines, an emotional support turkey, and one ESA squirrel, the online world for purchasing emotional support animal letters and related goodies (quick fixes, cheap letters, and instant certificates) has caught the watchful eye of the federal government.

Welcome my friends to the Wild West of the ESA internet business.

With a flood of scurrilous websites selling hokum, both the Housing and Urban Development (HUD) and Federal Aviation Administration (FAA) are starting to cramp down on the bogus ESA documentation.

About That Bogus ESA Documentation

It doesn’t take much to make a fake ESA letter — all you need are flexible ethics and a printer.

So, for those clients who bought a “cheapie ESA letter online,” there’s a growing chance your reasonable accommodation request will be denied, as landlords and airlines are now carefully scrutinizing emotional support animal letters of recommendation. The pushback is across the board; even our perfectly executed emotional support animal letters are no longer the Wonka Golden Ticket.

Let alone those $35 ESA letters in 24 hours or less. Good luck with those.

Navigating The Chummy Waters

Three phrases, once considered as insider baseball, are now commonplace around the office:

  • Therapeutic relationship
  • Under the “treatment and care
  • In a position to know

The Therapeutic Relationship

When a client and therapist engage in ongoing clinical sessions, we like to refer to that as a “budding therapeutic relationship.” In that relationship, the client is under the “treatment and care” of a clinician who is in a “position to know.”

Most ESA letters purchased online are based upon a cheesy mental health exam (likely not HIPAA compliant) that’s usually a version of a DSM-5 Level 1 Cross-Cutting Symptom Measure. Self-reported answers are then reviewed offline by a licensed therapist sometimes, but not always, located within the same state as the client. Rejection letters are rare.

We also note it’s very likely there will be zero actual contact between client and therapist.

Akin to service dog fraud, we staunchly believe these false “letters” do a horrible disservice to the genuinely disabled — it’s a black eye to individuals with a legitimate need for service and emotional support animals.

With such ethical flexibility hard at work, it’s not hard to fault HUD’s keen interest in understanding the therapeutic relationship.

Local Clinicians

Taking the time to interview, vet, and hire a nationwide network of licensed therapists is a lot of work. And we know as we’ve built a therapeutic network that spans two countries and all fifty states.

Not surprisingly, this feat of ours is something all other websites have studiously avoided, as they’re just geared to perform assessments only.

What Makes a Relationship

By itself, an emotional support animal assessment does not constitute a therapeutic relationship. And, as previously mentioned, assessment-only-based letters are running into headwinds. What’s missing are ongoing therapeutic sessions, enabling the therapist to delve into understanding the client’s “disability and disability-related need for an assistance animal.”

We advise potential clients shopping online to ask these questions before making a purchase:

  • How close is my therapist?
  • How many times will we interact?
  • Will we speak via phone/video call?
  • Do they offer therapeutic sessions?

From HUD’s view, when considering ESA letters, client interaction, locality (“geographically desirable”), the total number of sessions, and calendar of events form the basis of a therapeutic relationship.

We’ve learned that HUD also applies a “reasonableness standard.” Does the therapeutic relationship make sense? Is it logical? For example, why would a Miami, FL therapist be writing an ESA letter of recommendation for a Tallahassee client? Or a Hawaii radiologist writing letters for Chicago clients (no really, that’s a thing).

And we also find these intensive reviews at the state level.

To wit, the Virginia Fair Housing Board notes, “housing providers are absolutely within their rights to focus first on establishing the legitimacy of the requesting party’s disability status,” and allows housing providers to inquire about the following: The general location and duration of care; Whether the verifier is accountable for acts of misconduct; Whether the verifier has specialty training; Whether the verifier is recognized by consumers, peers, or the public as a credible provider of therapeutic care.”

One Final Parting Thought

For me, what’s most troubling is the rampant disregard for HIPAA, in particular, the security and safety of a client’s protected health information.

With fly-by-night ESA websites appearing almost daily, I counsel visitors to be aware of the risk, and before providing any personal health information, read the site’s HIPAA disclosure policy. That is, if they even have one (and most do not).

I also advise potential clients to make sure to feel comfortable about who you trust with your most intimate secrets. How are they guarding your information against hacking? What happens if that information appears for sale on the Dark Web?