The tablet is picked up.
bash-4.3$ xsetwacom --list
Wacom Intuos3 12x12 Pen stylus id: 11 type: STYLUS
Wacom Intuos3 12x12 Pad pad id: 12 type: PAD
Wacom Intuos3 12x12 Pen eraser id: 14 type: ERASER
Wacom Intuos3 12x12 Pen cursor id: 15 type: CURSOR

The cursor is controlled by the pen but it doesn't draw on a surface (except for the scratch surface on MyPaint (you can create custom color gamuts with it) but does nothing anywhere else in the program.

I have the Wacom Tablet app but didn't see anything regarding this. Its mapped to my first display correctly. Any ideas how to get it to work correctly?

I figured it out. The pen nib is considered to be button 1. I used the KDE wacom tablet settings app and went to stylus and set button 1 to left mouse click. I feel stupid!