Microsoft Enterprise Management Gateway Approval Tool Hangs

I ran into a problem on my production server SCOM RMS server where when I ran the
Microsoft.EnterpriseManagement.GatewayApproval.exe tool all it did was hang. No error message onscreen or in the event logs.

After troubleshooting for many hours and using process explorer I found out the problem was the account I was using didn’t have permissions to the SQL database. It didn’t say anywhere in documentation that it need SQL access but it does. After granting SQL DBO access to the account I was using it ran fine.