There are a number of factors that determine an athlete’s Medical Exemption requirements and which process they should follow. The standard Therapeutic Use Exemption (TUE) process is intended for athletes who can apply before they start their treatment, but when that’s not possible, the Canadian Anti-Doping Program (CADP) identifies circumstances where an athlete can apply AFTER starting their treatment. This is known as a retroactive TUE. The retroactive TUE process is available in two instances: 

  1. for athletes who don’t need a TUE in advance, and 

  2. in certain circumstances for athletes who do need one in advance but did not, or could not, get one.

Eligibility Criteria

The retroactive TUE process is available for athletes who meet one or more of the criteria below, listed in article 4.1 of the International Standard for Therapeutic Use Exemptions (ISTUE):

  • Emergency or urgent treatment of a medical condition was necessary.
  • There was insufficient time, opportunity, or other exceptional circumstances that prevented the athlete from submitting, or the TUE Committee from considering, an application for the TUE prior to sample collection.
  • The CCES did not permit or require the athlete to apply for a prospective TUE, because, for example, they are not an international- or national-level athlete.
  • The athlete used a therapeutic substance that is only prohibited in competition during an out-of-competition period.

To confirm whether the retroactive TUE process applies to you, complete the Medical Exemption Wizard.

If you are eligible for a retroactive TUE, your application must meet all the conditions of a standard TUE. These requirements are outlined in article 4.2 of the ISTUE. For more information, refer to “What’s included in a successful TUE application?”

Exceptional Circumstances

Following a positive test, an athlete might not meet the exact conditions listed above or may not have met other criteria for their TUE application. The CCES can consider retroactive TUE applications in cases where it would be “manifestly unfair” to not grant one, considering the athlete’s exceptional circumstances. 

If an athlete applies for a retroactive TUE, they will be required to submit a written explanation of their exceptional circumstances. More information on exceptional circumstances can be found in ISTUE article 4.3. 

Retroactive TUE FAQs

I have to apply for a TUE but was diagnosed years ago and have been using the medication ever since. Do I apply for a retroactive TUE?

In this situation, you should not fill out the retroactive portion of the application form unless you meet at least one of the criteria listed above. If you have been taking a medication for months or years before you were required to apply for a TUE, you should check your medical exemption requirements using the Medical Exemption Wizard to determine when to apply. 

I have never been through sample collection and the Medical Exemption Wizard says I should use the retroactive process instead of applying in advance. When should I submit an application?

If you completed the Medical Exemption Wizard and the outcome was the retroactive TUE process, then you do not have to submit a TUE application prior to doping control.

To be prepared, consult the TUE webpage to know what should be included in a TUE application in case your prescription medication is detected in your sample in the future. Then, and only then, you will be required to submit a retroactive TUE application to the CCES. 

I’m a student-athlete. Do I use the retroactive TUE process or apply for a TUE in advance?

As a student-athlete, you are eligible for the medical review process. The TUE process only applies to national- or international-level athletes. Consult the medical review page to learn more about the medical exemption that applies to you. 

Can I get a retroactive TUE for my supplement?

TUEs (retroactive or prospective) will not be issued for any type of supplement. TUEs are only granted for medications that have a Drug Identification Number (DIN), which are controlled by the Food and Drugs Act in Canada. 

Please consult the supplements page for more information about supplement use in sport. 

Why do some athletes only apply for a retroactive TUE and others apply for a TUE in advance?

Your requirements depend on your level of competition. Athletes who compete in international competitions and/or are included in the National Athlete Pool (NAP) and/or a Registered Testing Pool (RTP) require a TUE in advance of being tested. This represents a small number of athletes overall. For the majority of athletes in Canada, using a process like the retroactive TUE or the medical review is much more efficient, and only requires an application following a positive test.