TUE

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).

NADO TUEs are only valid for national-level Competition and Out-of-Competition Testing.

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 the 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? WHERE AND WHEN TO APPLY?

Athletes who are subject to anti-doping rules would need a TUE to take a prohibited substance or use a prohibited method. You should verify with the National Anti-doping Agency of the Republic of Belarus (further – BNADA) to know to whom you need to apply and if you can apply retroactively.

First, check if the required medication or method you intend to take or use is prohibited as per the WADA Prohibited List through DopingCheck.

You have a responsibility to inform your physician(s) that you are an Athlete bound to anti-doping rules. You and your physician(s) should check the Prohibited List for whatever substance/method you are prescribed. If the substance/method is prohibited, discuss non-prohibited alternatives, if there are none, apply for a TUE. Remember athletes have the ultimate responsibility. Contact BNADA if you are having difficulties.

Then, contact BNADA to determine your competition level and TUE application requirements.

If it is determined that you are a National-Level Athlete (athlete who competes at championship(s), cup(s) and any other national sport competitions organized and held by National sport federations, state bodies or organizations unless mentioned athletes belong to international-level athletes according to criteria set by his or her international sport federation) 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. Please refer to the section “How to apply to BNADA for a TUE?” below.

If your level is lower than the “National-Level” as defined above, you are entitled to apply for a retroactive TUE after being tested by BNADA or any other Anti-Doping Organization (ADO).

Important note:

A TUE granted by BNADA is only valid at the national level. If you are, or become an International-Level Athlete, or compete at Major Games, that TUE will not be valid unless it is recognized by the relevant International Federation (IF) or Major Event Organization (MEO). It is your responsibility to check if your BNADA’s TUE is automatically recognized by such IF or MEO.

BNADA can assist you in the determination of your level and TUE application requirements, and, should the need occur, assist you in presenting your BNADA’s TUE to an IF or MEO for recognition. Please contact via phones: 8(017) 227-28-90, 8(025) 604-40-19 or e-mail: tue@nada.by.

CAN I GET A RETROACTIVE TUE?

You may only apply retroactively for a TUE to BNADA if:

-You required emergency or urgent treatment of a medical condition.

-There was insufficient time, opportunity or other exceptional circumstances that prevented you from submitting the TUE application, or having it evaluated, before getting tested.

-You are a lower level athlete who is not under the jurisdiction of an International Federation or National Anti-Doping Organization and were tested.

-You tested positive after using a substance Out-of-Competition that was 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 (and WADA may in its absolute discretion agree with or reject the BNADA’s decision).

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 BNADA FOR A TUE?

BNADA encourages to submit TUE applications via ADAMS, together with the required medical file. If you do not have an ADAMS account yet, please contact via phones: 8(017) 227-28-90, 8(025) 604-40-19 or e-mail: tue@nada.by to have it set up.

Otherwise, please download the BNADA’s TUE Application Form, and once duly completed and signed, send it together with the required medical file to email tue@nada.by, post or in person (220020, Republic of Belarus, Minsk, Pobediteley Ave.109 Б, office 305).

Your TUE application must be submitted in a legible form using capital letters or typing. The application must be signed by the athlete and treating physician and accompanied by 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.

Important note:

Medical files must include an English summary that includes explanation of the diagnosis, key elements of the clinical exams, medical tests performed and treatment plan, when not in this language.

A TUE application will only be considered by the Therapeutic Use Exemption Commission (TUEC) under BNADA following the receipt of a properly completed application form, accompanied by all relevant documents. Any TUE application that is not complete or legible will not be dealt with and will be returned for completion and re-submission.

The TUEC may request from the Athlete or their physician any additional information, examinations or imaging studies, or other information that it is necessary in order to consider the Athlete’s application; and/or it may seek the assistance of such other medical or scientific experts as it is appropriate.

Any costs incurred by the Athlete in making the TUE application and in supplementing it as required by the TUEC are the responsibility of the Athlete.

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.

WHAT HAPPENS AT MAJOR EVENTS?

A Major Event Organization (MEO) requires athletes to apply for the recognition of their TUE if they wish to use a prohibited substance or method in connection with the Event.

If you have a TUE granted by BNADA and you will be competing at a Major Event e.g., the Olympic Games, you should contact the MEO for information on their recognition process.

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

BNADA’s TUEC’s must render a decision as soon as possible, and usually within 21 days from the date of receipt of the complete TUE application, including the required medical information.

WHAT IF I NEED TO RENEW 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 of the expiry date, so that there is sufficient time for a decision to be made prior to the expiry of the current TUE.

Important note:

The presence (following sample collection), use, possession or administration of the prohibited substance or method shall be consistent with the terms of your TUE. Therefore, if you require a materially different dosage, frequency, route or duration of administration, you should contact BNADA, as you may be required to apply for a new TUE. Some substances and dosages, e.g. insulin, are often modified during treatment and these possible fluctuations should be mentioned by the treating physician in the TUE application and would usually be accepted by the ADO TUEC. If the presence, Use, Possession or Administration of the Prohibited Substance or Prohibited Method is not consistent with the terms of the TUE granted, the fact that the Athlete has the TUE will not prevent the finding of an anti-doping rule violation.

WHAT IF MY BNADA’S TUE APPLICATION IS DENIED?

A decision to deny a TUE application includes a written explanation of the reason(s) for the denial. If it is not clear to you, please contact BNADA to understand exactly why the TUE was denied. Sometimes, there may be a critical piece of information, diagnostic test, laboratory results missing, etc. In which case, you should re-apply to us.

Otherwise, you may appeal the denial decision exclusively to the Arbitral Tribunal for Sport under the public organization “Belarusian republican union of lawyers” in accordance with the procedure established by the regulations of this tribunal.

WHAT IF MY BNADA’S TUE IS NOT RECOGNIZED BY MY INTERNATIONAL FEDERATION?

You or BNADA have 21 days to refer the matter to WADA for review after notification of the non-recognition. You should send the same information that you submitted to BNADA, and on which their TUEC based their decision, 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: medical@wada-ama.org.

Pending WADA’s decision, BNADA’s TUE remains valid for national-level competition and out-of-competition testing only. If the matter is not referred to WADA for review, BNADA 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 ADAMS TUE process (For Option 2 in “How to apply” only:), add: and in the BNADA’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 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 BNADA’s TUEC to obtain the information related to your TUE request in accordance with the Athlete’s Declaration, your TUE application will be deemed withdrawn without approval being granted.

Your TUE request-related information will be retained by BNADA 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 BNADA’s personal information practices, please contact via e-mail: law@nada.by.

OTHER USEFUL LINKS:

Download a TUE Policy

Sample of a properly completed TUE application form

Glucocorticoids and TUE