If your voice program deals with indirect inputs (such as mimicking a keyboard and mouse) instead of trying to send direct inputs to the game, then you should be fine. Injecting code (through virtual access and the like) can lead to a ban, so not good to try and send direct inputs and force the game to accept the input. So you may want to speak with whoever set up your hands-off system to find out exactly how it interacts with other software. As far as macros in general go, one-to-one action macros (pretty much macros that re-purpose one input for another singular input) are safe. So using a voice command to jump would probably be okay, but using a single voice command that would make you aim up slightly and fire 10 times with a scout rifle would be bad. Bungie knows some people don't have full access to all buttons and the like for various reasons, and as long as the macro setup isn't granting extra benefits (such as a one to many [automation and the like] action), they've commented that it's generally okay. I'd actually suggest reaching out to Cozmo on Twitter concerning your unique situation, as dialog might be able to be opened concerning such specific circumstances. https://twitter.com/cozmo23 Another thing I'd recommend looking into is the Microsoft Adaptive Controller (it works on PC as well as Xbox out of the box): https://www.microsoft.com/en-us/p/xbox-adaptive-controller/8nsdbhz1n3d8 If you have assistive services or advocates, you can reach out to them concerning the above controller as well, as it may improve your quality of life as far as entertainment and the like even outside of Destiny 2. Being able to play games with less frustration can definitely reduce stress, anxiety, and depression. Best of luck to you.