Here's a good example of how the TUE process can be dodgy (and there's not even clear intent in this case).http://tennishasasteroidproblem.blogspot.com.au/2015/06/cas-2014a3751-x-vs-wada.htmlCAS case 2014/3751.
Read the whole decision here (12MB PDF):
http://www.doping.nl/media/kb/3098/CAS%202014_A_3751%20X%20vs%20WADA.pdfThe Dr. Serrano does not exude professionalism. As noted in the THASP first comment:
In 2.13ff of the decision, you find out that only when the ITF got involved was an endocrinologist consulted. Said Dr. Mishra (Arizona) gave a short opinion saying DHEA was OK, and then it was back to Serrano (2.16) with changes to the regime.
Finally WADA intervened (2.17) and said the "documentation" was bogus, and DHEA was unneeded.
Unphased, the Athlete met up with Dr. Larrimer (Ohio), who along with the dubious Serrano submitted the TUE paperwork anew (Mishra no longer in the loop). ITF strangely accepted the DHEA, but not the hydrocortisone (HC) at first, but the permission for HC came within a week (2.22ff).
Three days later, WADA reversed the bogus ITF TUE for DHEA, and reduced the one for HC.
Both sides had problems finding a CAS arbitrator willing to serve, and in fact it ended up with a sole arbitrator appointed by the Athlete(!).
In 6.3, the crux of the matter is met: that the Athlete has something beyond adrenal difficulties, but they disagree on what this is. WADA claims it is likely a misdiagnosis (6.18 claims that the Athlete is still lacking a proper diagnosis), though the CAS arbitrator guesses the Athlete didn't seek out dodgy doctors intentionally.
Truly in the best of hands!