PACT Act Problems: The VA is unprepared for a flood of claims from veterans disabled by toxic exposure.

• Author: Gordon, Suzanne
• Position: Promise to Address Comprehensive Toxics Act

When President Joe Biden braved Republican jeers and boos to deliver his State of the Union address in February, one of the few lines that received bipartisan applause recalled Congressional action last year on what he hailed then as the "most significant law our nation has ever passed to help millions of veterans."

Called the Promise to Address Comprehensive Toxics (PACT) Act, this legislation allocates $280 billion over the next decade for health care and disability pay for former service members harmed by toxic substances. An estimated 3.5 million service members were exposed to noxious fumes from open burn pits and other hazards during three decades of U.S. military intervention in the Middle East. Many others developed long-term health problems during the Vietnam War, Cold War weapons' testing, and even from serving in the United States, where some drank poisoned water at North Carolina's Camp Lejeune.

Veterans' organizations fought long and hard for federal recognition of a devastating array of service-related ailments. The PACT Act directs the Department of Veterans Affairs (VA) to consider twenty-three conditions ranging from bronchial asthma to a series of rare cancers as presumptively related to burn-pit exposure and other environmental hazards. By January of this year, according to VA Secretary Denis McDonough, his agency had received about 278,000 PACT Act claims, processing nearly 40,000 of them with a much-improved 85 percent approval rate.

The VA-run Veterans Benefits Administration (VBA) decides what compensation veterans should receive if they suffer from toxic exposures and whether they are eligible for care from the nation's largest public health care system, the Veterans Health Administration (VHA).

A recent national survey of VA staff, interviews with their local union leaders and frontline staff, and reports by the government itself reveal that VA functioning has, over the last nine years, been greatly impaired by understaffing, costly and wasteful outsourcing, and other organizational problems inherited from the administrations of Barack Obama and Donald Trump. Despite pleas from frontline staff and even some of their managers, McDonough has, so far, failed to address these challenges.

As a result, too many veterans will continue experiencing what one VA benefits expert, Gulf War veteran Paul Sullivan, calls "an adversarial, complex, and burdensome claims nightmare," which breeds anger and frustration over delayed disability payments and health care access. And when hundreds of thousands of new PACT Act patients finally join the nine million veterans already being treated by the VHA, many will discover that its direct care capacity has been undermined...