This is a document that outlines a company's policy on employee adoption leave. The
employee is entitled to take two (2) days unpaid leave to attend any required pre-
adoption interviews or examination as well as up to fifty-two (52) weeks of unpaid leave
for children adopted under the age of five (5). The policy also outlines which benefits
will be maintained by the employee as well as reinstatement following leave. This
document is ideal for small businesses to include in the employee handbook to notify
employees about the company's adoption leave policy.
Company Adoption Leave Policy
In instances where a request for leave is foreseeable, employees must provide 30 calendar
days advance notice of the leave request. Where circumstances make a 30-day notice
impossible, employees must provide as much advance notice as is reasonably possible.
An employee trying to adopt a child is entitled to take two (2) days unpaid leave to attend
any required pre-adoption interviews or examinations.
If the employee is planning to adopt a child under the age of five (5), the employee is
entitled to take up to fifty two (52) weeks of unpaid adoption leave. This provision
applies to both married couples and single employees who adopt. {Optional: If an
employee is planning to adopt a disabled child who is older than 5 and younger than
_____ ( ) [PROVIDE AGE], (including children with a previously diagnosed
physical, mental, and/or emotional disability), the employee will be entitled to take the
same amount of unpaid leave as for a child under 5 years of age. Company may ask
for documentation of any such claimed disability, and employee will be required to
provide this, if employee is asking for any additional leave based on a claim of
disability.}
{Instruction: If a company does NOT wish to provide additional leave for an employee
adopting a disabled/special-needs child, the above Optional paragraph should be
deleted.}
If the couple is married, only one parent will be able to take leave. The other will be
entitled to two (2) weeks of maternity/paternity leave.
[OPTIONAL PARAGRAPH]
This leave only applies where the adopted child has not previously lived with the parents
for longer than ____ ( ) [PROVIDE NUMBER] consecutive months immediately
preceding the adoption.
This leave only applies where the child is not a step-child of one of the parents, and is not
the natural child of either of the parents (or of the parent, if the employee is unmarried).
Other types of leave may be taken in conjunction with the adoption leave, as long as the
combined leave does not exceed fifty two (52) weeks.
Eligibility
To be eligible, employees must have been employed by this company for at least
____ ( ) [PROVIDE NUMBER] months and have worked at least _______ ( )
[PROVIDE NUMBER] hours during the ____ ( ) [PROVIDE NUMBER]-month
period immediately preceding the commencement of the leave.
© Copyright 2011 Docstoc Inc. registered document proprietary, copy not 2
{Instruction: The above paragraph is optional. A company can delete it, if the
company chooses to provide this benefit to all employees regardless of the length of
employments, etc.}
Benefits During Leave
The company will maintain group health insurance coverage during a covered adoption
leave on the same terms as if the employee had continued to work. Employees will be
advised by the Human Resources Office or by their supervisor about the amount and
method of payment of their portion of the health insurance premium.
Reinstatement Following Leave
Employees who return from covered FMLA leaves will be reinstated to their same or
equivalent job with equivalent pay, benefits, and other employment terms and conditions.
This company reserves the right to change the above policies from time-to-time. It is
employee's responsibility to check with their supervisor and with Human Resources, if
employee anticipates using a type of leave covered by these policies.
In the event that an employee is on a leave covered by these policies, and the company
then changes any or all of the terms of the policies, that employee's rights will NOT be
reduced during the term of the leave then in effect. Such policy changes would, however,
cover any subsequent leave taken by that employee.
© Copyright 2011 Docstoc Inc. registered document proprietary, copy not 3
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