Robert Saucedo sits in a straight-back chair holding a 1964 photo of himself in fatigues with a handgun holstered on his hip. Also on his lap is a form showing his proof of service and a certificate stating he fought in the battle in Vietnam that was immortalized in the book and movie, We Were Soldiers Once … and Young.

The wiry 81-year-old veteran, wearing an olive drab shirt, drove 120 miles from the central Texas town of Giddings to join about 210 people at the Audie L. Murphy Memorial Veterans’ Hospital on Dec. 14 enrolling for health care, filing claims or receiving toxic-exposure screenings.

Saucedo is one of an estimated 3.5 million veterans across the U.S. now eligible for health care or new benefits after Congress passed the Honoring our Promise to Address Comprehensive Toxics (PACT) Act in August 2022.

Robert Saudedo, 81 years old, displays a photo of him in 1964, his proof of service (DD Form 214) and certificate for his service in Vietnam.
Robert Saucedo, 81, displays a photo of him in 1964, his proof of service (Form DD-214) and a certificate for his service in Vietnam. Credit: Courtesy / Todd Vician

The legislation is one of the most comprehensive expansions of care benefits for veterans in almost 30 years. Veterans have filed more than 213,000 PACT Act-related claims since President Joe Biden signed the law on Aug. 10.

The Veterans Benefits Administration began processing claims from terminally ill veterans in December and started reviewing all PACT Act-related claims on Jan. 1.

Area hospitals and clinics are preparing for the influx now: U.S. Department of Veterans Affairs (VA) officials said it’s too early to tell how many people in the San Antonio area will submit claims but estimate there are thousands of veterans and survivors locally who are eligible for new health care and benefits.

The PACT Act expands access to health and financial benefits for veterans from the Vietnam era to post-9/11. Most significantly, the law adds more than 20 new conditions, such as cancers, chronic breathing problems and high blood pressure, that the VA will presume were caused by exposure to Agent Orange, burn pits and toxic substances such as air pollutants and chemicals. Essentially, the responsibility for linking health problems resulting from exposure to toxins while in the military has shifted from the veteran to the government. 

Mari, who requested her last name be withheld, first deployed to Iraq in 2005 and also attended the PACT Act open house, one of 90 happening nationwide, to check on the claim she filed as the COVID-19 pandemic began. While serving, she said she lived and worked adjacent to a burn pit the size of a football field that spewed smoke day and night. The six-year Army veteran said she didn’t experience breathing problems while overseas, but decided to submit a claim after noting breathing problems beginning five years ago. 

“I think my lungs are affected by the toxins that I was exposed to,” said the 38-year old San Antonio native, who served on two year-long tours in Iraq. “Now, it’s hard to breathe. I always feel tightness in my chest with anything like smoke, aerosol or fragrance. I feel like I’m always choking.”

Tim Jensen, chief strategy officer for San Antonio-based clothing company Grunt Style, lobbied Congress alongside veteran service organizations such as the VFW for passage of the PACT Act. 

“The things that we are exposed to over there was not part of the deal. Never did I think that I would have to be sitting on the steps of my own government to advocate and protest to get some basic dignity in the health care that we deserve,” the Marine Corps veteran said. “Especially after going off and fighting for our rights and the things that we believe in this country to be true.”

Growing number of patients

San Antonio-New Braunfels is one of the fastest-growing large metropolitan areas in the nation, and the veterans health care system isn’t immune to the pains associated with rapid growth.

Veterans wait to speak to Veterans Benefits Administration counselors about their claim related to the PACT Act. on Dec. 14 at the Audie Murphy Hospital Center.
Veterans wait to speak to Veterans Benefits Administration counselors about their claims related to the PACT Act on Dec. 14 at the Audie L. Murphy Memorial Veterans’ Hospital. Credit: Courtesy / Todd Vician

More than 110,000 veterans are enrolled in the South Texas VA Health Care System, which is quickly becoming one of the largest in the nation. Patients tallied more than 1.8 million visits to the Audie L. Murphy hospital, Kerrville and Northwest centers, and 14 outpatient clinics in and near San Antonio in 2019.

To learn more about the PACT Act and how to file a claim, see the VA’s explainer here.

For more information on the South Texas Veterans Health Care System, see local resources here.

“We’ve got a higher percentage of dental eligible veterans served by San Antonio,” said Jason Cave, acting medical center director for the South Texas Veterans Health Care System. “Dental eligibility is a higher standard in the regulations, so it is likely we will have a higher percentage of people eligible under the PACT Act here compared to national averages.”

After Saucedo returned from Vietnam and left the Army, he tried to get a disability rating and VA health benefits, but didn’t succeed until 2004. He hopes it will be easier now to file a claim for Agent Orange exposure. At the Audie L. Murphy hospital in December, a former soldier and airman who already have 100% disability ratings were filing claims for additional health conditions that may be connected to their service. 

If the VA determines the veterans’ claimed health conditions are connected to their service, it is more likely their surviving spouse or child will be eligible for monthly tax-free dependency and indemnity compensation payments.

Ahead of the Jan. 1 PACT Act claims changes, the Veterans Benefits Administration is already working at record-high levels. Veterans filed 19% more claims in 2022 than in the previous year, and the VA is processing up to 7,900 claims a day, according to VA Secretary Denis McDonough. Locally, 2,740 new veterans enrolled in the South Texas system in the three months before the PACT Act was passed. 

Hiring to keep pace

The Veterans Health Administration hired a record 48,500 clinical and administrative staff in fiscal year 2022. VA leaders have said they need to hire 52,000 employees each year for five years — including 45,000 nurses in the next three years — to keep pace with the largest expansion of veteran health benefits in the agency’s history. The VA launched a national hiring campaign in mid-November and has already hired or made offers to more than 12,800 new employees, nearly double the VA’s goal. 

In San Antonio, the VA health care system added 528 providers and support staff in fiscal year 2022, and between 800 and 1,000 people are in the recruitment process at any given time, according to Cave. 

“We’re still hiring like mad,” Cave said. “We are in a growth, growth, growth mode because of organically how we’re growing but also because of the eligibility here. If we don’t bring on a new PACT team or a new entire care team every 90 days, access numbers will start to suffer as a result.”

Since Nov. 8, all veterans who enroll in VA health care have been screened for toxic exposure. Veterans whose previously filed claims were denied need to file a supplemental claim to be considered again, according to the VA’s PACT Act FAQ site.

“It is critical that veterans, their families, and survivors apply today for the benefits they have earned,” said Bobbi Gruner, deputy director of VA’s Dallas regional public affairs office.

The VA says it is prioritizing PACT Act claims filed by terminally ill veterans and those with toxic-exposure related cancers, those experiencing homelessness, those older than 85 or experiencing financial hardship, and Medal of Honor and Purple Heart recipients.

Todd Vician

A retired Air Force colonel, Todd Vician is a freelance writer who was previously the director of public affairs for the Air Education and Training Command at Joint Base San Antonio-Randolph.