Fallout 4 has the similar problem Skyrim had at release: some keys are unbindable, making it very annoying or next to unplayable for anyone with non-WASD setups. It is perplexing how such basic problem can still happen in such a high budget game in 2015.
As a left handed player I use cursor keys for movement and the keys around it for other things. One very important area being the numpad. So I have multiple problems.
First that loot keys are unbindable. It is infuriating having to move my hand from the mouse every single time there is a loot to be picked up from containers. Very annoying and tiresome.
Second, the cancel action is fixed to be TAB. Same issue.
Third, gear hotkeys are fixed on number keys. I guess the original intention was them to be fixed on normal number keys (not sure for what reason), but unfortunately it also treats numpad keys as number keys, making half of my usual bound keys unusable. After using num0 as jump and num1 as reload in every game in the last 15 years makes it very very hard to change. I used up all my stimpack by instinctive hits on those keys before I got out of the vault.
There are other problems like this (like the perk rank stepping being fixed on left ctrl and left alt) but I could live with that, not being action keys.
Solution is obvious but just in case I'll say it: make those keys bindable. In the current state I get way too annoyed after 20 mins of playing. If I didn't have faith that it will be fixed I'd have opted for refund.