Therapeutic exepmtions

What is a Therapeutic Use Exemption (TUE)?

Athletes, like all people, may have illnesses or conditions that require them to take particular medications or undergo procedures. If the medication or method an athlete is required to take to treat an illness or condition happens to fall on the World Anti-Doping Agency’s (WADA) Prohibited List, a Therapeutic Use Exemption (TUE) may give that athlete the authorization to take a substance or use a method that is prohibited.

Applications for TUEs are reviewed by a panel of experts, the TUE Committee (TUEC) [If found appropriate, describe briefly the composition of the TUEC e.g. number, areas of expertise, etc.], who may give such permission. 

What are the criteria for granting a TUE?

All four following criteria must be met:

  • The athlete has a clear diagnosed medical condition which requires treatment using a prohibited substance or method;
  • The therapeutic use of the substance would not produce significant enhancement of performance;
  • There is no reasonable therapeutic alternative to the use of the prohibited substance or method;
  • 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 FIAS, where and when?

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

Download the 2020 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 organization, and when to apply for a TUE:

A. If you are an International-Level Athlete member of FIAS 2020 RTP/TP or holder of FIAS International License you must apply to FIAS 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 already a TUE granted by your National Anti-Doping Organization (NADO):

  • FIAS automatically recognizes that TUE. You do not need to take any further action.

B. If you are NOT an International-Level Athlete, FIAS recognizes 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 FIAS.

Important note:

Unless your competition level requires or permits that you apply for a TUE retroactively, taking a prohibited substance before being granted a TUE could result in an Adverse Analytical Finding and potential anti-doping rule violation. However, as stated above, a retroactive TUE may be granted where a medical emergency or an acute medical condition occurs, where failure to immediately administer a prohibited substance or method could significantly put an athlete’s health at risk.

How to apply to FIAS for a TUE?

FIAS encourages TUE applications using the form available in ADAMS, and submitting the required medical file through ADAMS. If you do not have an ADAMS account yet, please contact anti-doping@sambo-fias.com to have your account set up.

Otherwise, please download the FIAS’s TUE Application Form and once duly completed and signed, send it together with the required medical file to anti-doping@sambo-fias.com .

Your TUE application must be submitted in legible English (or French) 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 or French, a summary explaining, in English or French, 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.

When will I receive a decision on my TUE application FIAS?

FIAS’s TUEC’s decision will be communicated in writing to you within 21 days from the date of receipt of the complete TUE application, including the required medical information, by FIAS.

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.

How about confidentiality?

All the information contained in a TUE application and file 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 ADAMS TUE process and in the FIAS’s 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 required to sign confidentiality agreements and/or are subject to professional confidentiality obligations.

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