Mr cue

Ok here is the rules on loss of use.
And a statement from hill&poton law firm on loss of use.
This is the statement they will use to try a denied.  An not address any evidence.
Hill &poton 
To make the VA definition easier to understand, let’s take a look at an example: picture a coin on the center of your kitchen table. Are you able to pick the coin right up with your fingers, or do you need to slide the coin to the edge of the table and push it until you can allow it to fall into your hand? If you’re unable to grasp the coin immediately, that is an indicator that your hands may not have a substantial remaining function.
 
When considering whether you may qualify for Loss of Use of Hands, some other questions to ask yourself are:
 
Do I have problems lifting pots and pans in the kitchen?
Do I frequently drop my eating utensils?
Is it difficult to wash myself in the shower due to lack of control of my hands?
If someone places something in my hand, can I feel it?
Am I able to type on a computer?
Can I pick up a pen and write a grocery list?
When I am driving, do I have full control over the steering wheel?
Am I able to button my own shirt?
Can I tie my shoes? 
Here are the cfr for loss of use smc benefits.
 
Responsibility for Determining LOU The responsibility for determining whether there is loss of use (LOU) of an extremity
 
• rests with the rating activity, and
 
• cannot be delegated to the examining physician.
 
c. Information to Request From an Examiner to Determine LOU When requesting an examination to determine LOU of an extremity, ask the examiner to furnish a
 
• detailed objective description of remaining function
 
• quantitative assessment of strength for each extremity involved, and
 
• description of any pain that affects use.
 
Do not request that the examiner
 
• determine LOU, or
 
• express an opinion as to whether there is, or is not, LOU of an extremity or extremities.
 
Note: If LOU cannot be determined upon review of an examination report, request an appropriate specialized examination.
 
References: For more information on
 
• considering functional loss due to pain in claims for SMC, see Tucker v. West, 11 Vet.App 369, 374 (1998), and
 
• requesting a specialist examination, see M21-1, Part III, Subpart iv, 3.A.6.
 
d. Determining the Extent of Examinations in Claims Involving SMC Under 38 U.S.C. 1114(l) Through (n)
 
Example: A prior examination clearly established LOU of both lower extremities at a level preventing natural knee action. Do not request a complete medical examination if the only issue in question is the extent of involvement of one or both of the upper extremities. Instead, request an examination with a notation that the examination be restricted to the degree of functional impairment of the upper extremities.
 
 
 
 
 

I have seen veterans award two smc l awards.
Long as it two different body parts.
Doing a search of bva decision.
I believe asknod have won one  and it might be posted on hadit

I would appeal the new decision.
And request that they look at the smc  n and o for having two different condition at smc l.
And the smc r.
It sound like you have a good chance.
I think you would get auto grant to for loss of use. Take a look at rules.