A Therapeutic Use Exemption takes effect on the date on which it is notified. However, an authorisation may take effect on an earlier date, which it mentions:
1° In an emergency or in the case of urgent and necessary treatment of a medical condition;
2° In the event that, due to lack of time or the impossibility of proceeding or other exceptional circumstances, prior to the collection of the sample :
a) The athlete was in a situation that prevented him/her from submitting an application for a therapeutic use exemption ;
b) Or the expert committee referred to in article L. 232-2 found itself in a situation that prevented it from examining such an application for authorisation;
3° Where such authorisation is sought by an athlete who is neither national nor international level, as defined in article L. 230-3, after he has been notified of the information provided for in article L. 232-21-1 because of the alleged commission of one of the violations mentioned in article L. 232-9 or in 2° of article L. 232-10;
4° If the athlete has used, out-of-competition, for therapeutic reasons, a substance that is prohibited only in-competition;
5° In exceptional circumstances and notwithstanding any other provision applicable to Therapeutic Use Exemptions, where it would be manifestly unfair not to grant such an exemption to an athlete who so requests. The Therapeutic Use Exemption may then only be granted to an international-level or national-level athlete subject to the assent of the World Anti-Doping Agency.
For athletes who are not international-level athletes or national-level athletes, the Agency may grant such an authorisation to the athlete in accordance with this 5° without first consulting the World Anti-Doping Agency. However, the World Anti-Doping Agency may review an Anti-Doping Organisation’s decision to grant such authorisation at any time. The French Anti-Doping Agency withdraws its decision to grant an authorisation and substitutes the decision of the World Anti-Doping Agency where the latter, following its review of the decision in question, has reached a different decision.