Figured it out. Was in a staff account with Primary usergroup Registered user and Secondary user groups of Administrative and Moderating. The Moderating permissions had the "Upload Attachments to Posts" set to "No", but Admin had it set to yes so my thought would be it should have been available. Just turned it on for Mods, because it should be anyway but the hierarchy of permissions may have a bug.
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After further testing everything seems to be ok. This is the first time I've messed with permissions since doing a site import, might of needed to just re-save each usergroup in case of some import issue. All seems to be working now.