By Jeffrey Schaub

(KPIX 5) — Emotional support dogs have been playing an increasing role for people with mental health needs, and prompting increased scrutiny over the dogs’ access to public areas. Adding to the mix is the confusion over the differences in applicable laws dealing with these comfort animals as opposed to certified service dogs.

Mary Cortani has trained hundreds of service dogs. For the last seven years, her non-profit, Operation Freedom Paws, has matched veterans, and others suffering from post-traumatic stress disorder (PTSD) with shelter dogs.

READ MORE: San Jose Police Investigate Shooting Downtown In Hyde Park Neighborhood

Just like service dogs for the blind, Cortani’s dogs get certified to perform specific tasks. Among them, helping calm their handler during a panic attack by moving the person out of a crowd or moving behind a handler to block another person from approaching them. Training lasts for 48 weeks, with Cortani spending hundreds of hours evaluating each dog and its handler.

These dogs – while loved and cared for – are not pets, she stressed. “And that dog is no different than a wheelchair,” explained Cortani. “We teach our clients to be unobtrusive, not to be a disruption.”

Cortaini is also quick to point out that service dogs like the ones she trains should not and do not pose a safety risk to the public, but cautioned that untrained, emotional support animals can.

Earlier this year, after Cortani spoke with KPIX 5, an emotional support dog brought on board a Delta Airlines attacked a passenger. The victim suffered severe injuries to his face. The dog and its owner were later booked on another flight, and Delta said the dog was kenneled and flown in the plane’s cargo area.

Los Angeles-based attorney Ken Phillips has represented people attacked by emotional support dogs, as detailed on his website. Phillips told KPIX 5 he receives at least one phone call or email a day from someone bitten by an emotional support dog.

“It’s a really big problem,” explained Phillips. “Since 2011, nine people have been injured, six people died and of the nine, three were mutilated.”

But as dogs are flying more and more on commercial flights, other passengers are questioning what the rules are surrounding dogs on planes. Some passengers have posted and blogged about seeing dogs strolling the aisles, grabbing window seats, and even taking naps on the floor of the bulkhead with their human flying companions.

Since the incident on the Delta flight, Phillips says a closer look at the legalities involved is a must.

“It makes the public mad. It makes airlines confused. It makes landlords and restaurant owners confused,” said Phillips. “It’s a big problem.”

But knowing the laws may not even be a help. Phillips said that’s because the laws surrounding emotional support animals are confusing and difficult to enforce.

READ MORE: Calls For Justice As Suspects In Asian American Attacks Appear In San Francisco Court - 'We Are Watching'

Certified service dogs can legally go anywhere with their handlers, including restaurants, the grocery store and unrestrained on airplanes.

Emotional support dogs provide comfort to anyone with a letter from a doctor or therapist. They can’t go everywhere, but they are allowed to fly for free on airplanes.

But here is where it gets a bit tricky. Due to medical privacy laws and concerns, a restaurant owner, or grocery store manager – for instance – cannot ask what type of disability a person has. They can ask what specific tasks the dog performs to help with specific disabililtes. Airlines have rules that allow anyone with a doctor’s note to board a flight with their emotional support dog.

That is where the law becomes difficult to understand, according to Phillips.

“It’s wrong on a number of levels,” said Phillips. “If you are sitting on a plane … It’s insulting to everybody else because we know that we are paying for that seat.”

Professional therapy organizations like the California Association of Marriage and Family Therapists (CANFT) have recently issued guidelines to member practitioners who may also have questions about how and when they can and should issue a letter certifying their client as needing an emotional support dog or animal.

The guidelines advised, in part, that any emotional support animal certification letter “must identify that the client has a mental health disability” and the therapist “is not legally required to provide” certification letters to their patients.

“The distinction is clear in the law. “What I don’t think is clear is for the public understanding of the difference between a service animal and an emotional support animal,” said former CANFT President Patricia Ravitz. “An emotional support animal is not just anyone’s pet … this is really part of treatment and what we look at is the diagnosis.”

But regardless of any specific diagnosis, one thing is unlikely to change: as long as the current laws remain in place, emotional support dogs will continue to fly, perhaps unnerving fellow travelers.

So if you find yourself sitting next to a dog on a plane, you can ask to move, but that is about all you can do.

MORE NEWS: COVID Vaccine: Santa Clara County Ramps Up Effort With Dose Surplus