Im part of the lazy ones that dont wear one. I use my climber, and dont really see where I could safely use one and get to my desired height in the same day. Once I get to my height I tie my platform on and have a bar around me that keeps me on the platform. When Im on my ladder stands I sit comfortably knowing that 3 different components would need to fail to fall.

By the way...I have my spine fused at two parts with titanium rods and screws.