Therapeutic Use Exemptions (TUEs)
What is a TUE?
A TUE approval is a certificate that allows you to use a prohibited substance or treatment method for a legitimate medical reason, for a specified duration. If you’re prescribed anything on the Prohibited List, you must check its TUE status before you use it, otherwise you risk committing an ADRV.
What are the criteria for granting a TUE?
A TUE will only be granted if your doctor can show that:
- The prohibited substance or method is needed to treat a diagnosed medical condition supported by medical evidence.
- Use of the prohibited substance is unlikely to enhance your performance beyond what might be expected by a return to normal health after treating a legitimate medical condition.
- There is no reasonable permitted alternative treatment.
- Your medical need is not due to prior use of a prohibited substance.
Which players should submit TUEs to World Rugby?
You should submit your TUE as a soon as possible to World Rugby if you are included in or participating in:
- Any World Rugby Testing Pool
- Rugby World Cup Tournaments or Qualification Matches (15’s and 7s, Men’s and Women’s)
- World Rugby U20 tournaments
- World Rugby Sevens World Series (Men’s and Women’s)
- All other World Rugby tournaments.
Download the form HERE and complete it with your doctor. Submit by email to World Rugby at email@example.com. All other players should consult their NADO. If your country doesn’t have a NADO, applications can be submitted to World Rugby.
When should I apply for or renew a TUE?
Applications, and requests for recognition of TUEs granted by a NADO should be submitted as soon as possible, and at least 30 days in advance (for substances prohibited In Competition only) of any match or tournament you may be involved in.
If you are renewing a TUE for an ongoing treatment (e.g. for a chronic or longstanding condition, such diabetes or ADHD) you need to reapply before your current TUE expires, or if your treatment requires a materially different dosage, frequency, route or duration of administration.
Can I get retroactive TUEs?
You may only apply retroactively for a TUE 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 World Rugby or a NADO and were tested.
- You tested positive after using a substance Out-of-Competition that is only prohibited In-Competition (for example glucocorticoids).
Note in rare and exceptional circumstances and notwithstanding any other provision in the ISTUE (International Standard for TUEs), 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.
If 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.
Who is responsible for obtaining TUE approval?
Only you and your treating doctor (together) can complete and submit your TUE. You are ultimately responsible for having a valid TUE when you play rugby.
World Rugby will recognise existing TUEs granted by NADOs if they meet the WADA criteria for granting a TUE for players who are competing at International level. If you have a valid NADO TUE and need to apply to World Rugby for recognition, please submit a request for recognition to firstname.lastname@example.org. World Rugby reserves the right to review all applications, and in some cases may request some additional medical details from you or your doctor before making a decision.
How do I know if my application has been approved?
World Rugby will notify you of a decision usually within 21 days from the date of receipt of the complete TUE application or request for recognition. If approved you will be sent a Certificate of Approval specifying the medication, administration route, dose and expiry date. You must comply with all treatment conditions for your TUE to remain valid.
What supporting information is needed?
Your application must include a statement from your doctor, showing why you need to use the banned substance, and giving a comprehensive medical history. This must include documentation from the doctor who originally gave your diagnosis, and the results of all relevant examinations, laboratory investigations and imaging studies (e.g. blood tests, X-rays and MRI). Your doctor should consult WADA resources for TUE applications, which outline the supporting information required for the most common conditions.
What if my TUE is denied?
If the criteria are not met, or the medical information to support your application is incomplete, your TUE may be denied. If this happens, you and your doctor may be asked to provide more information.
Decisions made by the World Rugby Therapeutic Use Exemption Committee (TUEC) including those not to recognise a TUE, can be referred to WADA for review within 21 days of the decision. If WADA upholds or reverses a World Rugby TUEC decision, this can be appealed to the Court of Arbitration for Sport (CAS).
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 World Rugby’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.
Should you wish to revoke the right of the World Rugby 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 World Rugby 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.