Therapeutic Use Exemption-TUE

WADA Code: Art. 2.1.1 It is each Athlete’s (International or National Level) personal duty to ensure that no Prohibited Substance enters his or her body. Athletes are responsible for any Prohibited Substance or its Metabolites or Markers found to be present in their Samples.

The International Committee of Sports for the Deaf would like to insist on reminding how to obtain the TUE Certificate and when it should be done.

Deaf Athletes, like all people, may have illnesses or conditions that require them to take a particular medication/substance or undergo certain procedures/methods. For Athletes, the substance or method may appear on WADA’s List of Prohibited Substances and Methods (List). In such instance, they may be granted a TUE, which gives them permission to take a substance or use a method.

Please keep in mind: the athlete should obtain the permission as well as the TUE Certificate before starting to use the prohibited method or substance.

All athletes that compete in sport at the International Level (as defined by the International Committee of Sports for the Deaf) or the National Level (as defined by each National Anti-Doping Organization) can apply for a TUE.

Please keep in mind: A TUE granted by an Athlete’s National Anti-Doping Organization that meets ISTUE (International Standard for Therapeutic Use Exemptions) criteria must be recognized by the International Committee of Sports for the Deaf. This option accelerates the process of obtaining a new TUE.

The criteria for granting a TUE are as follows:
1. The athlete would experience significant health problems without taking the prohibited substance or method;
2. The therapeutic use of the substance would not produce significant enhancement of performance;
3. There is no reasonable therapeutic alternative to the use of the otherwise prohibited substance or method;
4. The requirement to use that substance or method is not due to the prior use of the substance or method without a TUE, which was prohibited at the time of use.

For the TUE to be granted, all four criteria must be met.

The  following  supporting documents  must  be  attached  to  the  completed  TUE application form:
A statement by an appropriately qualified physician, attesting to the Athlete’s diagnosis and need to Use the Prohibited Substance or Prohibited Method in question for Therapeutic reasons;
A comprehensive medical history, including documentation from the original diagnosing physician(s) (where possible) and the results of all examinations, Laboratory investigations and imaging studies relevant to the application.

Please keep in mind: A summary that explains the diagnosis and key elements of the clinical exams, medical tests and treatment plan as well as all forms are required to be submitted in English or French.

TUE is granted for a specific method or a substance with a defined dosage and route of administration. They are also granted for a specific period and do expire. The athlete must comply with all the treatment conditions outlined in the TUE application. Material changes to the treatment require a new application and TUEC review.

Please keep in mind: Once a TUE has been granted by an Anti-Doping Organization, it will inform WADA, which then has the opportunity to review the decision. If the decision does not conform to the ISTUE, WADA may reverse it and deny the TUE.

TUE Application Form

Therapeutic Use Exemptions Frequently Asked Questions

At-a-Glance - Therapeutic Use Exemptions


Series of Therapeutic Use Exemption (TUE) Checklists, which provide guidance and support to athletes, their physicians, and National Deaf Sports Federations during the TUE application process. 

These Checklists are based on the Medical Information to Support the Decisions of TUECs documents, which were developed by WADA and external medical specialists primarily for TUECs. The Checklists – which cover the most commonly seen conditions – list the requirements for completing the TUE Application Form, including the medical evidence that must be submitted along with it.

International Committee of Sports for the Deaf strongly urges all NDSF to use these Checklists in their interactions with athletes and applying physicians.

TUE Checklist - ADHD

TUE Checklist - Adrenal Insufficiency

TUE Checklist - Anaplylaxis

TUE Checklist - Asthma

TUE Checklist - Cardiovascular Conditions

TUE Checklist - Diabetes

TUE Checklist - IBD

TUE Checklist - IV Infusion

TUE Checklist - Male Hypogonadism

TUE Checklist - Musculoskeletal Conditions

TUE Checklist - Neuropathic Pain

TUE Checklist - Renal Transplantation

TUE Checklist - Sinusitis_Rhinosinusitis

TUE Checklist - Sleep Disorders

TUE Checklist - Transgender Athletes