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Introduction Work is a central occupation for adults. The presence of a chronic disease (CD) modifies the course of the workers who suffer from it and can, thus, affect their job retention (JR). Objective The aim of the study is to better understand the strategies, targeting the JR, deployed by workers living with a chronic disease (WLCD). Methods Grounded theory approach has made it possible to document in depth the JR process of WLCD working in an organization responsible for the dispensation of health care and social services in Quebec (Canada). Results In order to stay in employment, WLCD negotiate strategies in different contexts influenced by personal characteristics, the characteristics of the disease as well as the functional impacts generated by the health problem. Discussion From a perspective of health promotion and primary prevention, collective negotiation of organizational attributes in addition to individual negotiation opens up a new avenue for understanding this phenomenon. Conclusion Globally, organizations are transforming with the COVID-19 pandemic. It would be essential that during such a transformation be considered the differences between workers so that organizations are more inclusive.