When the client is capable of appropriately responding to and answering questions while no visual information is available, and the test results you are shown seem to indicate a profound hearing loss,...

When the client is capable of appropriately responding to and answering questions while no visual information is available, and the test results you are shown seem to indicate a profound hearing loss, suspicion (a red flag) should immediately arise. The question one might explore in such a situation is whether the outcome of testing has a monetary or other tangible motivation.