I give full credits to the concept art artists, any day. I'm always baffled by the quality of some concept arts, hell, even for mediocre games.
But the thing is, Fallout 3 doesn't do them a good justice. Hell, even Unreal Tournament had more visual fidelity to its concept arts, the maps are big, beautiful, unique and they really look like what you had in mind, watching the work of the artists. Same for Dishonored, which is admirable in terms of level design, and fidelity with its concept arts. You can really see that there was a synergy in the dev team, between the concept artists and the actual level designers.
As much as Fallout 3 tried, I see it far behind these titles, unfortunately. Blame the game's engine for that, because Unreal Tournament came out in 2004 and even by today's standards, has pretty good looking sets. Fallout 3 came out, what, four, five years later ?
Or blame the lack of coordination and synergy within Bethesda's team. Maybe the concept arts never actually met the level designers, which would be a shame. It's like if a movie's writer never gets to be on set, talking to the director. That can only result in poor concept fidelity, for obvious reasons.