At your service

A woman and a kangaroo walk into a bar… Well, it wasn’t really a bar; it was actually a McDonalds. According to Wisconsin’s Daily Citizen , as reported in the Huffington Post (posted on February 5, 2015), it seems that the woman brought the 8-month-old animal with her because “Jimmy,” as the roo is called, is her therapy pet and helps her cope with her emotional distress. Yes, that’s right, she claimed that the roo is her service animal. It seems that she takes Jimmy everywhere: to church, the movies, and of course, Mickey D’s. As the story unfolds, we discover that during this outing, another customer complained. The woman showed the responding police officer a note from her doctor as to the animal’s status, but the officer apparently wasn’t moved by the marsupial’s role, all of which resulted in the woman and Jimmy being summarily escorted out, leaving their Big Macs behind. McDonalds issued a statement saying that “it strives to serve all customers, including those with disabilities and special needs, in compliance with all laws and regulations.” The question is, what will you do when Mrs Igotsome Issues presents herself to your office accompanied by a kangaroo… or worse? The Americans with Disability Act (ADA) limits service animals to dogs and miniature horses, but in Wisconsin, there is an exception for “other animals” as long as they are individually trained to help those with disabilities. Because Jimmy’s pedigree did not include such training, he did not fit the defined exemption.

Our offices are places of “public accommodation” and thus require us as business owners serving the public to comply with the ADA. We must allow our business invitees—our patients—to be accompanied by any dog or miniature horse that is “individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual or other mental disability.” You may not ask to see the supporting paperwork of such training, nor can you inquire into the nature of the patron’s disability.

Don’t make the mistake of assuming that the ADA applies equally to your employees if any of them have disabilities; they don’t. As a small business owner, you are required to make reasonable accommodations that far exceed the requirements elaborated in the ADA. If you have more than 15 employees, federal law will apply, and you must make reasonable accommodations for an employee with a disability unless it creates an undue hardship. This is an interactive process, and as a general rule, a requested accommodation is considered reasonable if it is plausible and feasible. These terms are left intentionally broad and vague so that they are flexible to meet a variety of circumstances and disabilities. An undue hardship is something that requires significant expense or difficulty with the focus on resources relating to the particulars of the employee’s disability and the type of accommodation requested. However, the requested accommodation cannot pose a threat to the health or safety of any other employee or the public at large. If an employer has fewer than 15 employees, the state’s law will usually apply.

On September 15, 2011, under Titles II and III of the ADA as noted in the Federal Register , only dogs were defined as service animals; service animals are further defined as dogs that are individually trained to do work or perform tasks for people with disabilities. The characterized work includes assisting those who are blind or deaf, pulling a wheelchair, alerting and protecting persons who are having seizures, reminding the mentally ill to take medication, and calming someone with posttraumatic stress disorder during an anxiety attack. The bottom line is that the work or service performed must relate to the person’s disability. As an aside, dogs whose sole function is to provide emotional support do not qualify as service animals under the ADA but do qualify under a broader definition promulgated by the Fair Housing Act and the Air Carrier Access Act. Often, state and local laws are broader than their federal counterparts. There is a separate provision for miniature horses.

Miniature horses serving as service animals generally measure 24 to 34 inches high at the shoulders and weigh between 70 and 100 pounds. Affected entities must make reasonable accommodations to accept these service animals where practical. The factors determining practicality are whether (1) the horse is housebroken, (2) the horse is totally under control, (3) the facility in question can accommodate an animal of the horse’s size and weight, and (4) the horse’s presence will not compromise the safe operation of the facility in question.

Service animals must be permitted access to all facilities that serve the public unless health and safety are compromised. In addition, they must be appropriately harnessed, leashed, or tethered unless such restraint interferes with their ability to provide the service in question. If such is the case, the service animal must be controlled through voice or other controlling signals. If a person is allergic to the dander of a particular service animal, that is not a sufficient reason to prevent the animal from entering the office. In that case, reasonable accommodations should be made, such as relocating the allergic patient outside the range of the allergen to a different part of the office. Service animals can be denied access only if they are not under control or are not housebroken.

As far as treatment is concerned, service animals and those whom they serve cannot be isolated or ostracized from other patrons or customers in a facility, treated less favorably than others, charged fees not charged to those who are not accompanied by service animals, and so on. In short, the disabled person and the service animal must be treated like everyone else. You are not required to feed someone’s service animal.

Psychiatric and emotional support animals are different from service animals. Support animals are individually trained to assist people who have significant mental impairments that interfere with their ability to perform at least one major life task such as feeding, bathing, dressing, grooming, work, homemaking, and various leisure activities of daily living. In addition, these tasks can be interpreted to include doing housework, preparing meals, taking prescribed medications in a timely manner, managing money, shopping for groceries or clothing, using various forms of communication, and using transportation in the community. To qualify as a service animal of this type, the need must be prescribed by a licensed mental health therapist. Emotional support animals should be able to walk beside the impaired person without straining the leash, sit and lie down on command, come when called, and show no aggression toward humans or other animals if unprovoked while working.

One should also not become confused between a service or support animal and a therapy animal. Therapy animals may be one of any number of species but are usually dogs that have been obedience trained and screened for their ability to interact favorably with humans and other animals they encounter in providing their particular forms of service. These animals provide affection and comfort to people in hospitals, nursing homes, retirement facilities, schools, hospices, and disaster areas, and to those with significant learning disabilities. The requirements for these animals are that they have a good temperament, are well socialized, and do not shed excessively.

Therapy animals may conduct therapeutic visitations. Essentially, they visit those who are displaced from their homes for various reasons and thus cannot bond with their own pets. Visiting people in these facilities can lift the recipients’ spirits or motivate them regarding their therapy or treatment. A second type of visit encompasses assisting with one’s rehabilitative therapy so that it enhances a patient’s gross or fine motor skills. Another task is facility therapy, usually performed in nursing homes or Alzheimer’s support units, whereby the animal, usually a dog, is specifically trained to assist those who are mentally compromised from harming themselves.

Having looked at service animals, now we should ask whether a person is disabled to the extent that he or she requires one. Essentially, one is disabled for the purposes of the ADA if he or she cannot perform one major life activity as previously described. There is no need for a formal diagnosis or a substantiating physician’s letter; merely possessing the disability qualifies a person. In addition, one need not be afflicted 24/7. If someone has an inner ear disturbance that can make him or her unbalanced without notice or has a systemic condition that can cause dizziness or fainting, again without warning, the disability attaches. The only requisite is that there is a documented record of the impairment that interferes with a major life activity. Temporary nonchronic impairments of short duration without residual effects are not considered disabilities.

The impairment can be physical, physiological, or cosmetic as long as it affects one of the following body systems: neurological, musculoskeletal, special sensory organs, respiratory, cardiovascular, reproductive, digestive, genitourinary, hemic and lymphatic, skin, and endocrine. Mental disorders include such impairments as mental retardation, organic brain syndrome, mental illness, and specific learning disabilities. Deviant behavior and interpersonal or societal conflicts are not considered impairments under the act unless such behavior leads to one of the recognized dysfunctions as stated above.

Finally, facilities that are not places of public accommodation need not adhere to the requirements of the ADA and do not have to accept or admit service animals. Examples of such places are any number or type of private clubs that are not open to the general public. Another example is offices of religious organizations and certain places of worship.

Commentary

When they approached the bar, the bartender asked, “What do you mean by bringing that animal in here?” I’m sure you’ve heard the rest of the joke. Regardless, dealing with the ADA and all of its edicts is no laughing matter as we go about our daily ministrations. There are obviously far more considerations than just dealing with service animals. We need to provide wheelchair-accessible services, we need to accommodate the blind, we need to provide interpreters—the list goes on. These are neither bad nor good things; they are the right things. Remember, we serve society at large. We provide a somewhat required and often requested service for which we are handsomely compensated. We cannot, and should not, discriminate against those with access issues or other disabilities. To turn the table slightly, from a purely greedy perspective, we should embrace the opportunity to serve more of the general public when they seek our services.

What will you do if a little boy who has had some horrific dental experiences and is subsequently referred to you for orthodontic treatment wants to be accompanied by his therapy dog? What if you say, “sure, no problem,” but one of your other patients in your open-bay setup is highly allergic to dogs, and her mom objects to the animal’s presence. What if it’s a miniature horse? What if it’s a kangaroo? When is the last time you discussed this at one of your morning huddles?

Like it or not, this is real-life stuff, at least for some of us. Each of us must put on our Boy Scout uniform even if we were not a Scout. We need to be prepared. You don’t want to react impulsively. A small error could land you in big trouble. Dealing with a discrimination suit and having to face the Equal Opportunity Commission is no walk in the park. Discuss this matter with your staff. Figure it out in advance. Acting seamlessly and being prepared for contingencies are parts of being a professional.

Oh, yeah, make sure that your hitching post is in good shape for that miniature horse. As for the roo, well…

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Apr 6, 2017 | Posted by in Orthodontics | Comments Off on At your service
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