Therapeutic Use Exemption (TUE)

Athletes with medical conditions competing in FIAU and continental competitions must obtain a TUE from the FIAU. The application for a TUE must be made as soon as possible (in case of an Athlete in the Registered Testing Pool, this would be when he/she is first notified of his/her inclusion in the pool) and no later than 30 days before the Athlete’s participation in the event. To obtain a TUE, fill out the Form in print or type and send it to the FIAU enclosing all relevant medical files.

WHAT IS A THERAPEUTIC USE EXEMPTION (TUE)?

Athletes may have illnesses or conditions that require them to take medications or undergo procedures. If the medication or method an athlete is required to use to treat an illness or condition is prohibited as per the World Anti-Doping Agency’s (WADA) Prohibited List a TUE may give that athlete the authorization to use that substance or method while competing without invoking an anti-doping rule violation (ADRV) and applicable sanction. Applications for TUEs are evaluated by a panel of physicians, the TUE Committee (TUEC).

WHAT ARE THE CRITERIA FOR GRANTING A TUE?

All of the four following criteria must be met (for more details, please refer to the WADA International Standard for Therapeutic Use Exemptions (ISTUE) Article 4.2):

•          The athlete has a clear diagnosed medical condition which requires treatment using a prohibited substance or method;

•          The therapeutic use of the substance will not, on the balance of probabilities produce significant enhancement of performance beyond the athlete’s normal state of health;

•          The prohibited substance or method is an indicated treatment for the medical condition, and there is no reasonable permitted therapeutic alternative;

•          The necessity to use that substance or method is not a consequence of the prior use (without a TUE), of a substance or method which was prohibited at the time of use.

WHO SHOULD APPLY FOR A TUE TO FIAU, WHERE AND WHEN?

First, check if the medication or method you intend to take or use appears on the Prohibited List.

You have the responsibility to inform your doctors that you are an athlete subject to doping control, and your doctors should check the Prohibited List whenever they prescribe a medication / method to you. If the substance / method is prohibited, check with your doctors if there are any alternative treatments that are not prohibited. If not, you have to apply for a TUE.

Second, check your competition level to determine to which organisation, and when to apply for a TUE.

==> If you are an International-Level Athlete  you must apply to FIAU in advance, as soon as the need arises, unless there are emergency or exceptional circumstances.

For substances prohibited In-Competition only, you should apply for a TUE at least 30 days before your next competition.

If you already have a TUE granted by your National Anti-Doping Organisation (NADO):

Your NADO’s TUE is only valid at the national level, and you must submit a request for recognition by FIAU of your TUE.

==> If you are NOT an International-Level Athlete, FIAU recognises a valid TUE granted by your NADO. If you are also not a National-Level Athlete as defined by your NADO, you must apply for a retroactive TUE after being tested by FIAU.

CAN A TUE BE RETROACTIVELY APPROVED?

You may only be granted retroactive approval if:

–        Emergency treatment or treatment of an acute medical condition was necessary; or

–        Due to other exceptional circumstances, there was insufficient time or opportunity to submit, or for the TUEC to consider, an application for the TUE prior to Sample collection; or

–        You are a lower level athlete who is not under the jurisdiction of FIAU or NADO and were tested.

–        You tested positive after using a substance Out-of-Competition that is only prohibited In-Competition (for example glucocorticoids).

In rare and exceptional circumstances and notwithstanding any other provision in the ISTUE, you may apply for and be granted retroactive approval for a therapeutic use of a prohibited substance or method, if considering the purpose of the Code, it would be manifestly unfair not to grant a retroactive TUE.

This unique retroactive TUE will only be granted with the prior approval of WADA.

Important note:

Using a prohibited substance or method without a TUE could result in an Anti-Doping Rule Violation.

In case an application for a retroactive TUE is necessary following sample collection, you are strongly advised to have a medical file prepared and ready to submit for evaluation.

HOW TO APPLY TO FIAU FOR A TUE?

Download the FIAU TUE Application Form, and once duly completed and signed, send it together with the required medical file to the FIAU.

Your TUE application must be submitted in legible English using capital letters or typing.

The medical file includes:

         A comprehensive medical history, including documentation from the original diagnosing physician(s) (where possible),

         The results of all examinations, laboratory investigations and imaging studies relevant to the application.

         If the medical file is not in English, a summary explaining, in English, the key elements of the diagnosis, clinical examinations, medical tests and treatment plan must be provided.

Any TUE application that is not complete or legible will not be dealt with and will be returned for completion and re-submission.

To assist you and your doctor in providing the correct medical documentation, we suggest consulting the WADA’s Checklists for TUE applications for guidance and support during the TUE application process, and Medical Information to Support the Decisions of TUECs for guidance on specific common medical conditions, treatments, substances, etc.

Keep a complete copy of the TUE application form and all medical information submitted in support of your application, and proof that it has been sent.

HOW TO SUBMIT A REQUEST FOR RECOGNITION OF YOUR NADO’S TUE TO FIAU?

Your request for recognition must be submitted using the copy of your NADO’s TUE certificate, application form (in English) and supporting medical file. Please send it to the FIAU.

Keep a complete copy of the proof that your request for recognition has been sent to TUE application form and all medical information submitted in support of your application, and proof that it has been sent to FIAU.

WHEN WILL I RECEIVE A DECISION ON MY TUE APPLICATION (OR REQUEST FOR RECOGNITION)?

FIAU’s TUEC’s decision will be communicated in writing to you within 21 days from the date of receipt of the complete TUE application (or request for recognition), including the required medical information, by FIAU.

HOW ABOUT THE RENEWAL OF MY TUE?

Each TUE has a specific duration, at the end of which it expires automatically. Should you need to continue to use the prohibited substance or method, it is your responsibility to submit a new application for a TUE with updated medical information ahead the expiry date, so that there is sufficient time for a decision to be made prior to the expiry of the current TUE.

WHAT IF MY FIAU’S TUE APPLICATION IS DENIED?

A decision to deny a TUE application will include a written explanation of the reason(s) for the denial. If it is not clear to you, please contact theFIAU to understand exactly why the TUE was denied. Sometimes, there may be a critical piece of information, diagnostic test, laboratory results missing, etc.

You or your NADO may refer the matter to WADA for review no later than 21 days after the decision was rendered by the TUEC by sending the same information that you submitted to your TUEC and on which they based their decision to deny the TUE via a secure on-line method or by registered mail at:

WADA Medical Department
World Anti-Doping Agency
Stock Exchange Tower
800 Place Victoria (Suite 1700)
P.O. Box 120
Montreal (Quebec) H4Z 1B7
Canada

The email address to enquire and/or send the request for review is: [email protected]

It should be noted that WADA is not obliged to proceed with a request for a review. In that case, you or your NADO may appeal to the Court of Arbitration for Sport (CAS).

WHAT IF MY NADO’S TUE IS NOT RECOGNIZED BY FIAU?

You and/or your NADO have 21 days from the date of decision to refer the matter to WADA for review. The email address to enquire and/or send the request for review is: [email protected] Alternatively, you may send to:

WADA Medical Department

World Anti-Doping Agency

Stock Exchange Tower

800 Place Victoria (Suite 1700)

P.O. Box 120

Montreal (Quebec) H4Z 1B7

Canada

The same information that was provided to your NADO should be submitted to WADA. Please use a secure on-line method unless sending by registered mail.

Pending WADA’s decision, your NADO TUE remains valid for national-level competition and out-of-competition testing only.

If the matter is not referred to WADA for review, your NADO must determine whether the original TUE that was granted should remain valid for national-level Competition and Out-of-Competition Testing.

WILL MY MEDICAL INFORMATION BE TREATED IN A CONFIDENTIAL MANNER?

All the information contained in a TUE application, including the supporting medical information and any other information related to the evaluation of your TUE request is kept strictly confidential and treated in accordance with the Athlete’s Declaration contained  in the TUE Application Form . All members of the TUEC and any other authorized recipients of your TUE request and related information (as described in the Athlete’s Declaration) are subject to a professional or contractual confidentiality obligation.

Please review the terms of the Athlete’s Declaration carefully. In particular, note that should you wish to revoke the right of the FIAU’s TUEC to obtain the information related to your TUE in accordance with the Athlete’s Declaration, your TUE application will be deemed withdrawn without approval (or recognition) being granted.

Your TUE request-related information will be retained by FIAU TUEC and any other authorized recipients for no longer than necessary for the purposes stated in the Athlete’s Declaration, in accordance with the International Standard for the Protection of Privacy and Personal Information.

CONTACT INFORMATION

For any further information and questions in relation to FIAU’s personal information practices and in case you have a doubt as regards to which organization you should apply for a TUE, or as to the recognition process, or any other question with regard to TUEs, please contact: [email protected]

OTHER USEFUL LINKS

WADA International Standard for Therapeutic Use Exemptions (ISTUE)

WADA Q&A on Therapeutic Use Exemptions

WADA Checklists for TUE Applications

WADA Guidelines for the 2021 International Standard for Therapeutic Use Exemptions (ISTUE)

WADA Anti-Doping Education and Learning Plattform (ADEL)