Some smiled over an honor they felt was overdue, but also clenched their teeth over needs in their scarred and injured lives they say the Army has denied.
"I try not to be bitter. But it's kind of hard not to be bitter," said Jackson, a former staff sergeant. "You wonder, where's the respect? Where's the recognition? Where's the support for what you've gone through and what you're continuously going through?"
Thirteen people were killed and 31 were injured in the 2009 attack carried out by an Army psychiatrist who is now on military death row. Following years of tension, the Army gave the Purple Hearts to survivors and relatives of the dead in a somber ceremony on the Texas military post, just two miles from where Nidal Hasan had opened fire in a room of unarmed soldiers.
Top military commanders recalled tables that became makeshift stretchers to transport the wounded and dying. Ten of the survivors remain on active duty.
"It is our sincere hope that in some small way this will help heal the wounds you have suffered," Army Lt. Gen. Sean MacFarland said.
But words of gratitude from military leaders and elected officials, including Republican Texas senators John Cornyn and Ted Cruz, gave way to medal recipients pressing and chastising the Pentagon over combat benefits. The Purple Heart, given to military personnel wounded in battle, offers increased retirement pay.
Cornyn said he expects Fort Hood victims to finally get approved for entitlements within weeks, noting that he spoke to Army Secretary John McHugh before the ceremony.
Many survivors are also seeking separate financial damages in a lawsuit, claiming the U.S. government should have known of Hasan's extremist views.
During his 2013 trial, Hasan told jurors he had "switched sides" in what he called America's war with Islam. He admitted beginning the rampage by pulling out a pistol and shouting "Allahu akbar" (God is great) and said he wanted to stop American soldiers from being deployed to kill fellow Muslims.
Kimberly Munley, a Fort Hood police officer at the time, helped end the attack in a gunfight with Hasan. She was awarded the Defense of Freedom medal but after the ceremony expressed frustration over uncertainty about the level of benefits Fort Hood victims would receive.
"These soldiers are going to get what they rightfully deserve," Munley said.
Military officials had long denied the Purple Heart awards because they called the attack an act of workplace violence, not terrorism. Cornyn and others have long condemned that classification, but he said changing the distinction could have jeopardized the case against Hasan, who was not charged with terrorism.
Last year, Congress approved new eligibility requirements for Purple Hearts that forced the Defense Department to reconsider.
The daughter of Michael Cahill, a physician's assistant who was the only civilian killed in the attack, accepted the Defense of Freedom medal for her father and used the occasion to draw attention to veteran suicides. Cahill was shot while as he rushed toward Hasan with a chair lifted over his head.
"The first month after dad died, everyone asked us, 'What can I do?' And it was great," Kerry Cahill said. "Nobody asks me that any more. We're not done." null