According to the tester, all options work fine.
You can also Contact the Tester: Devildog91 Link if you have any issues or questions, maybe he can help.
Odd, because it simply won't work for me. Did your guys' tester play the game in Hardcore mode? If he's playing it in easy to test it, and not trying the hardest difficulty, it would make sense that the damage spike may not work with the option. I tried all 3 levels with it on, before starting the map and during. Still die. Everything else works great.