After a long battle, veterans celebrate PACT Act’s passage. But the war goes on for many

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• Judy Woodruff:

  And for veterans getting to this point where they can receive VA benefits after becoming sick from toxic exposure in war zones, this has been a very long and frustrating road.

  Nick Schifrin is back now with this story. It was produced by our Dan Sagalyn. It takes a deeper look at what's in this law and the heavy price that veterans and their families have paid.

• Nick Schifrin:

  In decades of war, American Marines and soldiers faced an enemy willing to kill.

• Person:

  That is what we live next to.

• Nick Schifrin:

  But the fog of war including actual smoke and toxic fumes that could be just as deadly.

• Person:

  And there she burns every day, twice a day.

• Nick Schifrin:

  Many of the 3.5 million Americans who served in uniform since 9/11 breathed in the fumes from the garbage that the military burned, everything from plastic water bottles to styrofoam, batteries, paint cans, tires, even ammunition.

• Person:

  We have a burn pit down here. Wanted to get a good shot of it.

• Nick Schifrin:

  The toxic smoke filled the sky and bases where service members lived. It is believed to be one reason why veterans contracted higher rates of lung disease, cancer, and other serious illnesses, including Jennifer Howard's husband, 44-year-old Jason.

  Jennifer Howard, Widow of Military Veteran: When they came back, they talked a bit about how everything was on fire. They burned everything.

• Nick Schifrin:

  Howard was the son of a soldier who became a Marine and deployed to Iraq in 2003 and 2004. He was always fit and healthy and loved to run marathons. But he took these photos of burn pits in Iraq.

  Jennifer blames that toxic smoke for his 2018 diagnosis of glioblastoma, an aggressive brain cancer that usually occurs in much older adults.

• Jennifer Howard:

  I have other types of pizza too.

• Nick Schifrin:

  She says the VA resisted providing benefits because there was no proof that he got sick because of his service.

• Jennifer Howard:

  I have filled out more forms and resubmitted the same form more times than I — than I have time for. By the time I finally got it all back together and submitted again, his body was giving out from treatments.

• Nick Schifrin:

  We filmed this interview in April 2021. Three weeks later, he died. They had been married for 19 years.

  Jennifer, thank you so much for doing this.

  We spoke again about the new legislation.

• Jennifer Howard:

  I would hope now people can get the support and the services right away, so that they can get the care that they need, get the support that they need, and enjoy the time that they have, instead of spending it fighting.

• Nick Schifrin:

  The Promise to Address Comprehensive Toxics Act, or PACT Act, declares that veterans' asthma, cancers, and emphysema and other specified diseases shall be considered to have been incurred in or aggravated during active military service, notwithstanding that there is no record of evidence of such disease during the period of such service.

• Person:

  And here we have our own version of hell.

• Nick Schifrin:

  The legislation reverses decades of VA policy that forced veterans to prove toxic exposure directly caused their sickness, something families found nearly impossible to verify.

  Before Jason died, how much did you have to fight?

• Jennifer Howard:

  A lot for a long time, time that I wish I could have spent just being with him and not fighting.

  Sorry. OK. Sorry.

• Nick Schifrin:

  What are you thinking?

• Jennifer Howard:

  I just miss him. Sorry. I'm sorry. Just…

• Dr. Robert Miller, Vanderbilt University Medical Center:

  The primary victory in getting this bill passed, it takes the burden off the veteran of proving that they have a deployment-related disorder.

• Nick Schifrin:

  Dr. Robert Miller is a professor of medicine at Vanderbilt University Medical Center. In 2004, he started seeing soldiers with serious breathing difficulties. After lung biopsies, Miller discovered they had constrictive bronchiolitis, a rare lung disease where small airways are destroyed and is difficult to detect.

• Dr. Robert Miller:

  Having the biopsy is a matter of peace of mind, that now I know why I'm sure to breath.

• Nick Schifrin:

  He attended events on Capitol Hill and met with congressional staffers, veteran activist and comedian Jon Stewart to lobby Congress to change the law, so veterans could receive the benefit of the doubt.

• Dr. Robert Miller:

  The DOD and VA actually actively worked against employers in many cases. And, as a result of this bill, there are 23 new conditions that are now considered presumptively related to deployment.

• Nick Schifrin:

  The new law also covers veterans exposed to oil well fires in Iraq during Operation Desert Storm in the early 1990s, Agent Orange in Vietnam, and crash sites of nuclear-armed B-52 bombers in Greenland, Spain and the Marshall Islands in the '60s and '70s.

  And the new legislation expands the time that veterans can take to enroll in VA health care from five to 10 years after they have discharged.

  Sgt. Cynthia Aman (Ret.), U.S. Army: They're looking for recognition of what's going on.

• Nick Schifrin:

  Cynthia Aman is one of the veterans who worked to convince Congress. The "NewsHour" first met her in 2015. Her Missouri National Guard police company deployed to Kuwait and Iraq in 2003. She and others lived through massive sandstorms and toxic pollution.

  When she got back, she struggled to breathe. But she says, at first, the VA told her the problem was in her mind.

• Sgt. Cynthia Aman:

  When I first started going to the VA and explaining my symptoms, automatically they were telling me it was anxiety, I was just hyperventilating. They tried to put we on antipsychotic medications, like different mood stabilizers and things of that nature.

  And I was telling them no, my shortness of breath, it's something physical. I know it is.

  I can't explain how excited I am and happy I am that we finally got to this point.

• Nick Schifrin:

  We talked to her again as the legislation was making its way through Congress.

• Sgt. Cynthia Aman:

  What this means for other veterans who present with these symptoms, it basically is, if you were there in those areas, and you're presenting with these symptoms, we automatically have to grant you compensation.

  There's no going to a million doctors, having a million tests, having a lung biopsy. It just is what it is, for a change.

• Nick Schifrin:

  How are you doing today?

• Sgt. Cynthia Aman:

  Not super well.

  Sorry.

  I just had some tests, and I have had — I have had some decline. It's hard for me to breathe. It's hard for me to do things, but I just do them anyway. I'm just going to keep fighting.

  I have beautiful children to fight for. I have a wonderful fiance. I have a wonderful life. Life has given me so many amazing things, so just keep fighting.

• Nick Schifrin:

  Other veterans' fights also continue, despite the bill.

  Chief Warrant Ofc. James Raines (Ret.), U.S. Army: Everything I have read so far is going to have no impact for me at all.

• Nick Schifrin:

  James Raines had a 25-year career in the Army and army Reserves. He was diagnosed with constrictive bronchiolitis. And the VA acknowledged that his service caused his illness.

  But he took a pulmonary function tests like this, even though it couldn't detect his injury. And when he scored well, the VA denied him disability compensation. The PACT Act does not fix that.

• Chief Warrant Ofc. James Raines:

  The issue comes in is whenever you start exercising yourself or when you get under physical stress or aerobic stress. That's when the constrictive bronchiolitis kicks in.

  And that's when you have the limitations. Right now, as far as I know, the VA has no method for actually determining the level of injury.

• Nick Schifrin:

  Veterans Affairs Secretary Denis McDonough acknowledged the problem.

  Denis McDonough, U.S. Secretary of Veterans Affairs: I know this is a great frustration for veterans going back generations. My guess is, we don't always get that precisely correct.

• Nick Schifrin:

  After decades of fighting, the new law helps veterans win a battle. But, for many, the war goes on, and many have been lost along the way.

  For the "PBS NewsHour," I'm Nick Schifrin.