Have they come out with a mod that makes the game extremely realistic. Like if you shoot a guy in the head once or get shot once you automatically die and game over.
Or if you get shot once in the leg or arm you're limping or can't use your arm.
Maybe if this is the case you should get less loot and less XP for killing people as well or else it could be too easy
And then maybe some of the monsters or guys with head gear might be able to take a couple more shots than the average raider.