This is to clarify other posts that focus on Publication 502 as the sole guidance for service animal expenses for medical deductions. Although Publication 502 retains the adjective “physical” (“You can include in medical expenses the costs of buying, training, and maintaining a guide dog or other service animal to assist a visually-impaired or hearing-impaired person, or a person with other physical disabilities.”) (emphasis added). Emotional Support Animals expenses can qualify... The costs of buying, training, and maintaining a service animal to assist an individual with mental disabilities may qualify as medical care if the taxpayer can establish that the taxpayer is using the service animal primarily for medical care to alleviate a mental defect or illness and that the taxpayer would not have paid the expenses but for the disease or illness. Reference: http://www.irs.gov/pub/irs-wd/10-0129.pdf and http://doglawreporter.blogspot.com/2010/07/irs-affirms-deductibility-of.html