What is a Therapeutic Use Exemption (TUE)?

Table Tennis Players, like all people, may have illnesses or conditions which require them to take particular medications. In line with the World Anti-Doping Code (the Code) and its International Standard for Therapeutic Use Exemptions (ISTUE), the ITTF Anti-Doping Rules (ADR), permit players with or without a disability and their physicians to apply for a Therapeutic Use Exemption (TUE) i.e. permission to use, for therapeutic purposes, substances or methods contained in the List of Prohibited Substances and Methods.

In accordance with the ADR, a panel of experts (the TUE Committee – TUEC) has been appointed by the International Testing Agency (ITA). After the TUEC has reviewed the application, you may be given the authorization to take the medicine required.

What are the criteria for granting a TUE?
The criteria are:
• The athlete would experience significant health problems without taking the prohibited substance or method;
• The therapeutic use of the substance would not produce significant enhancement of performance;
• There is no reasonable therapeutic alternative to the use of the otherwise prohibited substance or method;
• 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.

Who should apply to ITTF for a TUE?

The Code and the ADR differentiate between the players’ level, as defined in the ADR:

  • If you are an International-Level Athlete, ie:

(a) For each year, the first 250 Men and 200 Women in the January General List of ITTF World Ranking, available at ranking.ittf.com.

(b) For each year, the first 8 Men and 8 Women in each Class in the January Para Table Tennis rating, available on ipttc.org/rating.

(c) All Athletes included in the ITTF Registered Testing Pool and any Testing Pool established by the ITTF.

(d) Any other Athletes who, at any moment of the year, reach the top 100 in the General World Ranking, or the top 4 in the Para Table Tennis Ranking. The aforesaid rankings are published on ITTF’s website.

you must apply directly to ITTF for a TUE (see below how to apply to ITTF for a TUE).

If you have already a TUE granted to you by your National Anti-Doping Organisation (NADO), ITTF recognizes that TUE for international-level competitions, provided that such TUE has been reported in accordance the [email protected]

  • Your NADO, the list is available here.

    When to apply to ITTF for a TUE?

    • You should apply for a TUE as soon as possible when the need arises.
    • For substances prohibited In-Competition only, the Player should apply for a TUE at least 30 days before his/her next Competition, unless it is an emergency or exceptional situation.


    How to apply to ITTF for a TUE ?

    You must complete an ITTF TUE Application Form and attach a complete medical file.

    • Whenever possible, the forms must be submitted through ADAMS. If you do not have an ADAMS account, please contact [email protected], to have an account set up.
    • Otherwise, you can download the ITTF TUE Application Form, and once duly completed and signed, send it together with the required medical information by e-mail to [email protected].


    Submission tips and requirements:

    • The TUE Application Form (you can find it at the bottom of this page) has to be filled in English, in capital letters or typing
    • Ensure that you include all the required documentation including all the medical information, tests, laboratory results, imaging studies, clinical information to enable the TUEC to reach a decision.
    • To assist your doctor in providing the correct medical documentation we suggest that he/she consults the WADA’s documents entitled “Medical Information to Support the Decisions of TUECs” to access the medical information required to support TUE application for treatments of several common medical conditions.
    • It is not necessary to translate all the medical documents into English. However, an English summary that explains the diagnosis and key elements of the medical exams, medical tests and treatment plan is required.
      • Any TUE application that is not complete or legible will not be dealt with and will be returned to the player, who will need to submit it again.

    Will the information on the athlete’s TUE Application remain confidential?
    All the information contained in a TUE Application will be kept strictly confidential, the same as any medical information normally kept by your doctor. All members of the TUEC are required to sign confidentiality agreements and if they require advice from other scientific experts on a particular case, your name is not used when circulating the application outside the TUEC.

    How to find more about TUEs – Useful links and contact information:

    WADA International Standard For Therapeutic Use Exemptions (ISTUE)

    WADA Guidelines for Therapeutic Use Exemptions

    WADA Q&A on Therapeutic Use Exemptions

    ITA (ITTF) TUE Application Form

    ITTF Anti-Doping contact about TUEs: [email protected]