This study extended research on Psychology of Working Theory (PWT) by examining the connection of decent work to work fulfillment and general well-being in 346 predominantly U.S. adult workers diagnosed with Chiari malformation (CM), a chronic health condition involving a structural malformation affecting the posterior region and base of the skull, and commonly presenting with chronic head and neck pain and related physical (e.g., fatigue) and psychological (e.g., anxiety, depression) complications. Participants completed an online survey containing measures of PWT’s outcomes of decent work constructs as well as the domain-specific marginalization constructs of condition severity and workplace limitations. Results of structural equation modeling analyses supported 12 of 19 hypotheses. Decent work directly and positively predicted survival, social contribution, and self-determination needs; social contribution and self-determination needs directly and positively predicted work fulfillment; survival and self-determination needs directly and positively predicted general well-being; decent work indirectly (via social contribution and self-determination needs) and positively predicted work fulfillment and indirectly (via survival and self-determination needs) and positively predicted general well-being; and condition severity directly and negatively predicted general well-being. Consistent with PWT, attaining decent work contributes to meeting needs for survival, social contribution, and self-determination, which in turn contributes to greater work fulfillment and general well-being in workers with CM.