Therapeutic exemption rule
What is a Tue?
Athletes, like all people, may have illnesses or conditions that require them to take a particular medication/substance or undergo certain procedures/methods. If the substance or method appears on WADA’s List of Prohibited Substances and Methods, athletes must obtain a Therapeutic Use Exemption (TUE) in order to have the permission to take it or use it. TUEs can only be granted by Anti-Doping Organizations following a robust review process that is defined in WADA’s International Standard for Therapeutic Use Exemptions and involves evaluation by a panel of at least three physicians specialized in sports medicine and/or other relevant specialties.
Who must obtain TUE’s from ISA?
The ISA Anti-Doping Rules (ISA ADR) require that all International-level Athletes* who need to take medication/treatment which is on WADA’s Prohibited List must submit a Therapeutic Use Exemption (TUE) application to ISA as follows:
- If the Athlete does not already have a TUE granted by his/her National Anti-Doping Organisation (NADO), he/she must apply directly to ISA.
- If the Athlete already has a TUE granted for national-level competitions by his/her NADO, that TUE is automatically valid for international-level competition and it is not necessary to apply to ISA for recognition, provided that such TUE decision has been reported in accordance with Article 5.4 of the International Standard for Therapeutic Use Exemptions and therefore is available for review by WADA.
* International-level Athletes are defined in the ISA ADR as reported below.
Which athletes are considered to be “International-level athletes”?
International-level athletes are defined as (1) athletes included in the ISA Registered Testing Pool (RTP), or (2) Athletes who compete in any of the following International Events:
- World Surfing Games;
- World StandUp Paddle and Paddleboard Championship;
- World Longboard Surfing Championship;
- World Bodyboard Championship;
- World Masters Surfing Championship;
- World Adaptive (Para) Surfing Championship;
- World Kneeboard Championship;
- World Tandem Championship;
- World Junior Surfing Championship (*Athletes competing in U16 division only are not to be considered “International Athletes”).
I am an international-level athlete. How and when should I apply to ISA for a TUE?
- As soon as a new treatment is prescribed to you, you must check whether it involves prohibited substances or methods. If this is the case, a TUE Application Form must be completed, signed and sent to ISA ([email protected]) by you or through your National Federation. In accordance with the ISA ADR, TUE applications should be sent at least thirty (30) days before your next competition.
- TUE applications must be adequately documented with relevant medical records in order to be considered. According to the ISA ADR, medical evidence confirming the diagnosis and explaining the reasons for the required treatment shall be transmitted along with the TUE application. The medical evidences must include a comprehensive medical history and the results of all relevant examinations, laboratory investigation and imaging studies. Please note that applications sent without medical evidence cannot be considered. Please refer your treating physician to the medical information available on WADA’s website to support the decisions of TUE committees. In case of doubts, contact [email protected]
- Once your application is received, ISA may request additional information in order to document the clinical situation in accordance with WADA’s Standard for Therapeutic Use Exemptions. The ISA TUE Committee has twenty-one (21) days to issue a decision once the full application (including sufficient medical documentation) is received. For this reason, you should send your TUE application at least 21 days prior to your next competition.
- If it is not possible for you to apply 30 days before the decision is needed, you must imperatively attest the urgent nature of the application in the form. ISA tries to be as flexible as possible to accommodate these situations, however urgent applications should be exceptional not routine.
- TUE applications cannot be considered for retroactive approval except in the cases mentioned in article 4.3 of the International Standard for Therapeutic Use Exemptions.
- Once a TUE is granted: (1) any change in substance, dosage, route of administration and/or frequency requires the submission of a new TUE application (ISTUE Art. 6.12); and (2) in case of persistence of the medical condition, it is the athlete’s responsibility to apply in advance for renewal of the present TUE prior to its expiry date.
Athletes selected for doping control must systematically (i.e. regardless of the presence of a TUE) declare on the Doping Control Form the use of all prescribed and over-the-counter medications as well as supplements taken in the last 7 days.
What happens if my treatment involves prohibited substances/methods and I do not have a TUE?
Using a prohibited substance or method on WADA’s Prohibited List before or without TUE approval will most likely result in an Anti-Doping Rule Violation (ADRV) in the event of an anti-doping test. It is therefore important that athletes check very carefully whether any treatment they are prescribed involves prohibited substances or methods. Athlete should also not assume that all medical professionals who prescribe medication have a full understanding of anti-doping-related matters in their sport. Athletes are advised to treat the matter of TUEs seriously and in all instances seek expert advice.
For more general information about TUEs please visit WADA TUEs section.
For any request, clarification or doubt please contact: [email protected]